Isathuthwane

Isathuthwane kukuphazamiseka kwengqondo apho umntu ephindaphinde ukuxhuzula ngokuhamba kwexesha. Ukuxhuzula iziqendu zokungalawulwa okungalawulwayo kunye nokudubula okungaqhelekanga kweeseli zengqondo ezinokubangela utshintsho kuqwalaselo okanye ekuziphatheni.

Ukuxhuzula kwenzeka xa utshintsho kwingqondo lubangela ukuba lube krakra kakhulu okanye lube nomsindo. Ngenxa yoko, ingqondo ithumela imiqondiso engaqhelekanga. Oku kukhokelela ekubanjweni okuphindaphindiweyo, okungalindelekanga. (Ukubanjwa okungaphindi kwenzeke ayisosathuthwane.)

Isathuthwane sinokubangelwa yimeko yonyango okanye ukwenzakala okuchaphazela ingqondo. Okanye, unobangela unokungaziwa (idiopathic).

Izizathu eziqhelekileyo zokuxhuzula zibandakanya:

• Stroke okanye uhlaselo lwexeshana lwe-ischemic (TIA)
• Isifo sengqondo esixhalabisayo, esifana nesifo se-Alzheimer
• Ukonzakala kwengqondo ebuhlungu
• Usulelo, kubandakanya ithumba lobuchopho, i-meningitis, i-encephalitis, kunye ne-HIV / AIDS
• Iingxaki zobuchopho ezikhoyo ekuzalweni (ukuzalwa sinesiphene engqondweni)
• Ukulimala kwengqondo okwenzeka ngexesha lokuzalwa okanye kufutshane
• Iziphazamiso zeMetabolism ezikhoyo ngexesha lokuzalwa (njengephenylketonuria)
• Ithumba lobuchopho
• Imithambo yegazi engaqhelekanga kwingqondo
• Esinye isigulo esonakalisa okanye esonakalisa izicwili zobuchopho
• Ukuphazamiseka ekubanjweni ziintsapho (ilifa lokuwa)

Ukuxhuzula ngokwesiqhelo kuhlala kuqala phakathi kweminyaka emi-5 ukuya kwengama-20. Kukwakho namathuba aphezulu okuxhuzula kubantu abadala abangaphezu kweminyaka engama-60. Kunokubakho imbali yosapho yokuxhuzula okanye isifo sokuwa.

Iimpawu ziyahluka kuye ngomntu. Abanye abantu banokuba nokujonga okulula. Abanye banogonyamelo olushushu kunye nokulahleka. Uhlobo lokuhlutha luxhomekeke kwinxalenye yengqondo echaphazelekayo.

Uninzi lwexesha, ukuxhuzula kuyafana naphambi kwayo. Abanye abantu abanesathuthwane banoluvo olungaqhelekanga phambi kokuba baxhuzule. Imvakalelo inokuba kukurhawuzelela, kunuke ivumba elingekho ngokwenene, okanye utshintsho lweemvakalelo. Oku kubizwa ngokuba yi-aura.

Ugqirha wakho unokukuxelela ngakumbi malunga nohlobo oluthile lokubanjwa onokuba nalo:

• Ukungabikho (petit mal) ukubanjwa (ukukhangela)
• Ukubanjwa ngokubanzi kwe-tonic-clonic (enkulu ye-mal) (kubandakanya umzimba uphela, kubandakanya i-aura, izihlunu eziqinileyo, kunye nokulahleka kokuphapha
• Inxalenye (egxile) ekuthinjweni (inokubandakanya naziphi na iimpawu ezichazwe apha ngasentla, kuxhomekeke ekubeni ingqondo ithathe ntoni ekubanjweni)

Ugqirha uya kwenza uvavanyo lomzimba. Oku kuyakubandakanya ukujonga okunzulu kubuchwephesha nakwinkqubo yemithambo-luvo.

Kuya kwenziwa i-EEG (electroencephalogram) ukukhangela umbane kwingqondo. Abantu abanesathuthwane bahlala benombane ngendlela engaqhelekanga ebonwa kolu vavanyo. Kwezinye iimeko, uvavanyo lubonisa indawo kwingqondo apho ukuxhuzula kuqala khona. Ingqondo inokubonakala iqhelekile emva kokubanjwa okanye phakathi kokubanjwa.

Ukufumanisa isifo sokuxhuzula okanye ukucwangcisa utyando lokuxhuzula, kuya kufuneka:

• Nxiba irekhoda ye-EEG kangangeentsuku okanye iiveki njengoko uqhubeka nobomi bakho bemihla ngemihla.
• Hlala kwisibhedlele esikhethekileyo apho imisebenzi yobuchopho inokurekhodwa khona ngelixa iikhamera zevidiyo zithatha into eyenzekayo kuwe ngexesha lokubanjwa. Oku kubizwa ngokuba yi-EEG yevidiyo.

Uvavanyo olunokwenziwa lunokubandakanya:

• Ikhemesti yegazi
• Iswekile yegazi
• Gcwalisa ubalo lwegazi (CBC)
• Uvavanyo lwezintso
• Uvavanyo lomsebenzi wesibindi
• Ukugqobhoza iLumbar (impompo yomqolo)
• Uvavanyo lwezifo ezosulelayo

Intloko ye-CT okanye i-MRI scan ihlala isenziwa ukufumana unobangela kunye nendawo yengxaki kwingqondo.

Unyango lwesifo sokuwa kubandakanya ukuthatha amayeza, utshintsho kwindlela ophila ngayo, kwaye ngamanye amaxesha utyando.

Ukuba ukuxhuzula kungenxa yethumba, imithambo yegazi engaqhelekanga, okanye ukopha ebuchotsheni, utyando lokunyanga ezi ngxaki zinokubangela ukubamba kume.

Amayeza okuthintela ukuxhuzula, okubizwa ngokuba zii-anticonvulsants (okanye amachiza e-antiepileptic), anokunciphisa inani lokuxhuzula kwixesha elizayo:

• La machiza athathwa ngomlomo. Luhlobo luni olumiselweyo luxhomekeke kuhlobo lokuthimba onalo.
• Umthamo wakho unokufuna ukutshintsha amaxesha ngamaxesha. Unokufuna uvavanyo lwegazi rhoqo ukukhangela iziphumo ebezingalindelekanga.
• Soloko uthatha amayeza akho ngexesha kwaye njengoko uyalelwe. Ukuphosa idosi kunokubangela ukuba ubambe. SUKUYEKE ukuthatha okanye ukutshintsha amayeza ngokwakho. Thetha nogqirha wakho kuqala.
• Amayeza amaninzi okuxhuzula abangela iziphene zokuzalwa. Abasetyhini abaceba ukukhulelwa kufuneka baxelele ugqirha wabo kwangaphambili ukuze bahlengahlengise amayeza.

Amachiza amaninzi okuxhuzula anokuchaphazela impilo yamathambo akho. Thetha nogqirha wakho malunga nokuba ufuna iivithamini kunye nezinye izongezo.

Isathuthwane esingangcoliyo emva kokuvavanywa kweziyobisi zokuthintela ukuxhuzula ezi-2 okanye ezi-3 kuthiwa "sisifo sokuxhuzula esinganyangekiyo kwezonyango." Kule meko, ugqirha unokucebisa utyando ku:

• Susa iiseli zengqondo ezingaqhelekanga ezibangela ukuxhuzula.
• Beka isikhuseli se-vagal nerve (VNS). Esi sixhobo sifana nentliziyo pacemaker. Inokukunceda ukunciphisa inani lokubanjwa.

Abanye abantwana babekwa kukutya okukhethekileyo ukunceda ukuthintela ukuxhuzula. Eyona idumileyo kukutya kwe ketogenic. Ukutya okunee-carbohydrate ezincinci, njengokutya kwe-Atkins, kunokuba luncedo nakwabanye abantu abadala. Qiniseka ukuba uxoxa ngezi ndlela ngaphambi kokuba uzame.

Indlela yokuphila okanye utshintsho kwezonyango lunokunyusa umngcipheko wokubanjwa kwabantu abadala kunye nabantwana abanesathuthwane. Thetha nogqirha wakho malunga:

• Amachiza amatsha amiselweyo, iivithamini, okanye izongezo
• Uxinzelelo lweemvakalelo
• Ukugula, ngakumbi usulelo
• Ukungabikho kobuthongo
• Ukukhulelwa
• Ukutsiba iidosi zamayeza okuxhuzula
• Ukusetyenziswa kotywala okanye ezinye iziyobisi zokuzonwabisa
• Ukubonakaliswa kwezibane ezikhanyayo okanye i-stimuli
• Hyperventilation

Ezinye izinto eziqwalaselwayo:

• Abantu abanesathuthwane kufuneka banxibe ubucwebe bezonyango ukuze bafumane unyango olukhawulezileyo.
• Abantu abanesifo sokuxhuzula abalawulwa ngendlela efanelekileyo akufuneki baqhube. Jonga umthetho welizwe lakho malunga nabantu abanembali yokuthimba abavunyelwe ukuqhuba.
• MUSA ukusebenzisa oomatshini okanye wenze izinto ezinokubangela ukulahleka kolwazi, ezinje ngokukhwela kwiindawo eziphakamileyo, ukukhwela ibhayisikile, nokuqubha wedwa.

Uxinzelelo lokuba nesifo sokuxhuzula okanye ukunyamekela umntu onesathuthwane kunokuncedwa ngokujoyina iqela lenkxaso. Kula maqela, amalungu abelana ngamava aqhelekileyo kunye neengxaki.

Abanye abantu abanesathuthwane banokuthi banciphise okanye bayeke amayeza abo okulwa ukuxhuzula emva kokungaxhuzuli iminyaka eliqela. Iindidi ezithile zokuxhuzula kwabantwana ziyahamba okanye ziphucuke ngokuhamba kweminyaka, zihlala zikwishumi elivisayo okanye kwi-20s.

Kubantu abaninzi, umntu unesathuthwane ubomi bakhe bonke. Kule meko, iziyobisi ezichasene nokuhlutha kufuneka ziqhubeke. Kukho umngcipheko ophantsi kakhulu wokufa ngesiquphe unesifo sokuwa.

Iingxaki zinokubandakanya:

• Kunzima ukufunda
• Ukuphefumla ukutya okanye amathe emiphungeni ngexa lokubanjwa, kunokubangela ukuba inyumoniya ibe nomnqweno
• Ukwenzakala ngenxa yokuwa, ukuqhuma, ukuzibetha, ukuqhuba okanye ukusebenzisa oomatshini ngexesha lokuthimba
• Ukulimala kwengqondo okungapheliyo (ukubetha okanye omnye umonakalo)
• Iziphumo ebezingalindelekanga zamayeza

Fowunela inombolo yongxamiseko yendawo yakho (enje nge-911) ukuba:

• Eli lixesha lokuqala umntu exhuzula
• Ukuhluthwa kwenzeka emntwini onganxibanga isongo se-ID yonyango (enemiyalelo echaza ukuba wenzeni)

Kwimeko yomntu okhe waxhuzula ngaphambili, tsalela umnxeba u-911 ngazo naziphi na kwezi meko zikaxakeka:

• Oku kuthabatha ixesha elide kunokuba umntu enesiqhelo, okanye inani elingaqhelekanga lokuhlutha umntu
• Ukuxhuzula okuphindiweyo ngaphezulu kwemizuzu embalwa
• Ukubanjwa okuphindaphindiweyo apho ukungazi okanye isimilo esiqhelekileyo kungafunyanwa kwakhona phakathi kwabo (imeko yesathuthwane)

Biza ugqirha wakho ukuba kukho naziphi na iimpawu ezintsha ezenzekayo:

• Ukulahleka kweenwele
• Isihlunu okanye ukugabha
• Irhashalala
• Iziphumo ebezingalindelekanga zamayeza, ezinje ngokozela, ukungazinzi, ukudideka, ukudumba
• Iinyikima okanye iintshukumo ezingaqhelekanga, okanye iingxaki ngokulungelelaniswa

Ayikho indlela eyaziwayo yokuthintela isifo sokuwa. Ukutya okufanelekileyo kunye nokulala, kwaye ukuhlala kude notywala kunye neziyobisi ezingekho mthethweni kunokunciphisa amathuba okubangela ukuxhuzula kubantu abanesathuthwane.

Nciphisa umngcipheko wokonzakala entlokweni ngokunxiba isigcina-ntloko ngexesha lezinto ezinobungozi. Oku kunokunciphisa amathuba okonzakala kwengqondo okukhokelela ekubanjweni kunye nokuxhuzula.

Ukuphazamiseka kwengqondo; Isathuthwane - isifo sokuwa

• Utyando lobuchopho-ukukhutshwa
• Ukuxhuzula kubantu abadala - yintoni ekufuneka uyibuze kugqirha wakho
• Ukuxhuzula ebantwaneni - ukubhobhoza
• Ukuxhuzula ebantwaneni-yintoni ekufuneka uyibuze kugqirha wakho
• Ukuxhuzula okanye ukuxhuzula - ukubhobhoza
• Ukuxhuzula ngoFebruwari-yintoni ekufuneka uyibuze kugqirha wakho
• I-radiosurgery yestereotactic-ukukhutshwa

• Ulwakhiwo lobuchopho
• Inkqubo yeLimbic
• Indima ye-vagus nerve kwisifo sokuwa
• Inkqubo ye-nervous central kunye ne-peripheral system
• Ukuxhuzula-uncedo lokuqala-uthotho

UAbou-Khalil BW, uGallagher MJ, uMacdonald RL. Ukuxhuzula. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahl. 101.

UGonzález HFJ, uYengo-Kahn A, uDJ Englot. Ukukhuthaza imithambo-luvo yonyango lwesifo sokuwa. Iklinikhi yeNeurosurg N Am. 2019; 30 (2): 219-230. IINKCUKACHA: 30898273 www.ncbi.nlm.nih.gov/pubmed/30898273.

I-Thijs RD, i-Surges R, i-O'Brien TJ kunye ne-Sander JW. Ukuxhuzula kubantu abadala. ILancet. Ngo-2019; 393 (10172): 689-701. IINKCUKACHA: 30686584 pubmed.ncbi.nlm.nih.gov/30686584/.

I-Wiebe S. Ukuxhuzula. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 375.