Umvakalelo yokitazo

I-Cerebral palsy liqela leengxaki ezinokuthi zibandakanye ingqondo, echaphazela ukusebenza kwenkqubo ye-neva, njengokuhamba, ukufunda, ukuva, ukubona nokucinga.

Kukho iintlobo ezahlukeneyo zokukhubazeka kwengqondo, kubandakanya ispastic, idyskinetic, ataxic, hypotonic, kunye nokudityaniswa.

I-Cerebral palsy ibangelwa kukonzakala okanye ukuphazamiseka kwengqondo. Uninzi lwezi ngxaki lwenzeka njengokuba umntwana ekhula esibelekweni. Kodwa zinokwenzeka nangaliphi na ixesha kwiminyaka emi-2 yokuqala yobomi, ngelixa ingqondo yomntwana isakhula.

Kwabanye abantu abane-cerebral palsy, iinxalenye zobuchopho zenzakala ngenxa yenqanaba eliphantsi leoksijini (hypoxia) kwezo ndawo. Ayaziwa ukuba kutheni le nto isenzeka.

Iintsana ezingaphambi kwexesha zinomngcipheko ophakamileyo wokufumana ukukhubazeka kwengqondo. I-cerebral palsy inokuthi yenzeke kwasebusaneni ngenxa yemeko ezininzi, kubandakanya:

• Ukopha kwingqondo
• Usulelo lobuchopho (i-encephalitis, i-meningitis, usulelo lwe-herpes simplex)
• Ukwenzakala entloko
• Usulelo kumama ngexesha lokukhulelwa (rubella)
• I-jaundice enganyangekiyo
• Ukonzakala kwengqondo ngexesha lenkqubo yokubeleka

Kwezinye iimeko, isizathu sokukhubazeka kwengqondo asikaze simiselwe.

Iimpawu zokukhubazeka kwengqondo kwi-cerebral palsy zinokwahluka kakhulu phakathi kwabantu abaneli qela lokuphazamiseka. Iimpawu zinokuthi:

• Yiba nobulali okanye ubukhali kakhulu
• Bandakanya kuphela icala elinye lomzimba okanye omabini amacala
• Yiba ngakumbi kwiingalo okanye imilenze, okanye ubandakanye zombini iingalo kunye nemilenze

Iimpawu zihlala zibonwa ngaphambi kokuba umntwana abe neminyaka emi-2 ubudala. Ngamanye amaxesha iimpawu ziqala kwinyanga ezintathu. Abazali banokuthi baqaphele ukuba umntwana wabo uyalibaziseka ukufikelela kwinqanaba lokukhula njengokuhlala, ukuziqengqa, ukukhasa okanye ukuhamba.

Kukho iintlobo ezahlukeneyo zokukhubazeka kwengqondo. Abanye abantu banomxube weempawu.

I-Spastic cerebral palsy lolona hlobo luqhelekileyo. Iimpawu zibandakanya:

• Izihlunu ezixineneyo kwaye azoluli. Banokuqina ngakumbi ngokuhamba kwexesha.
• Ukuhamba okungaqhelekanga (gait) - iingalo zixinene emacaleni, amadolo awele okanye achukumise, imilenze yenza "isikere" iintshukumo, hamba kwiinzwane.
• Amalungu aqinile kwaye awavuleki kuyo yonke indlela (ebizwa ngokudibana).
• Ubuthathaka bemisipha okanye ukulahleka kwentshukumo kwiqela lezihlunu (ukukhubazeka).
• Iimpawu zinokuchaphazela ingalo enye okanye umlenze, icala elinye lomzimba, imilenze yomibini, okanye zombini iingalo kunye nemilenze.

Ezi mpawu zilandelayo zinokwenzeka kwezinye iintlobo zedumbe yobuchopho:

• Ukuhamba okungaqhelekanga (ukujija, ukuxhuzula, okanye ukusonta) kwezandla, iinyawo, iingalo, okanye imilenze xa uvukile, okuba mandundu ngamaxesha oxinzelelo
• Iinyikima
• Ukuhamba okungazinzanga
• Ukuphulukana nolungelelwaniso
• Izihlunu zeFloppy, ngakumbi ekuphumleni, kunye namalungu ahamba kakhulu

Ezinye iimpawu zengqondo kunye neenkqubo zovalo zinokubandakanya:

• Ukukhubazeka kokufunda kuqhelekile, kodwa ubukrelekrele buqhelekile
• Iingxaki zentetho (idysarthria)
• Iingxaki zokuva okanye umbono
• Ukuxhuzula
• Iintlungu, ngakumbi kubantu abadala, ekunokuba nzima ukuzilawula

Ukutya kunye neempawu zokugaya:

• Ubunzima bokuncancisa okanye ukondla kwiintsana, okanye ukuhlafuna nokuginya kubantwana abadala nakubantu abadala
• Ukugabha okanye ukuqhina

Ezinye iimpawu:

• Ukonyuka kokutsala amathe
• Cotha ukukhula okuqhelekileyo
• Ukuphefumla ngokungaqhelekanga
• Ukungahambi kakuhle komchamo

Umboneleli wezempilo uya kwenza uvavanyo olupheleleyo lwe-neurologic. Kubantu abadala, ukuvavanya ukusebenza kwengqondo kubalulekile.

Olunye uvavanyo lunokwenziwa njengoko kufuneka, amaxesha amaninzi ukulawula ezinye iingxaki:

• Uvavanyo lwegazi
• Ukuvavanywa kwentloko kwe-CT
• I-Electroencephalogram (i-EEG)
• Isikrini sokuva
• I-MRI yentloko
• Ukuvavanywa kombono

Akukho lunyango lokukhubazeka kwengqondo. Injongo yonyango kukunceda umntu azimele kangangoko.

Unyango lufuna indlela yeqela, kubandakanya:

• Ugqirha wokhathalelo lokuqala
• Ugqirha wamazinyo (ukuhlolwa kwamazinyo kuyacetyiswa malunga neenyanga ezi-6)
• Unontlalontle
• Abongikazi
• Iingcali zasemsebenzini, zomzimba nezentetho
• Ezinye iingcali, kubandakanya ugqirha wemithambo-luvo, ugqirha wokuvuselela, ugqirha wamaphaphu, kunye nesifo sezifo zesisu

Unyango lusekwe kwiimpawu zomntu kunye nesidingo sokuthintela iingxaki.

Ukuzinyamekela kunye nokunakekelwa ekhaya kubandakanya:

• Ukufumana ukutya okwaneleyo kunye nesondlo
• Ukugcina ikhaya likhuselekile
• Ukwenza umthambo ocetyiswa ngababoneleli
• Ukuziqhelanisa nokunakekelwa kwamathumbu okufanelekileyo (isitulo sokuthambisa, ulwelo, ifayibha, laxatives, imikhwa rhoqo yamathumbu)
• Ukukhusela amalungu ukuba angonzakali

Ukufakwa komntwana kwizikolo eziqhelekileyo kuyacetyiswa ngaphandle kokuba ukukhubazeka emzimbeni okanye ukukhula kwengqondo kwenza oku kungenzeki. Imfundo ekhethekileyo okanye imfundo inokunceda.

Oku kulandelayo kunokunceda kunxibelelwano nokufunda:

• Iiglasi
• Izinto zokuncedisa ukuva
• Izihlunu kunye nemithambo
• Izixhobo zokuhamba
• Izitulo ezinamavili

Unyango lomzimba, unyango lomsebenzi, uncedo lwamathambo, okanye olunye unyango lunokufuneka ukunceda kwimisebenzi yemihla ngemihla kunye nokhathalelo.

Amayeza anokubandakanya:

• Ii-anticonvulsants ukunqanda okanye ukunciphisa ukubanda kokubanjwa
• Ityhefu yeBotulinum yokunceda ukuqaqamba kunye nokuwisa amathe
• Ukuphumla kwezihlunu ukunciphisa ukungcangcazela kunye nokuqina

Utyando lunokufuneka kwezinye iimeko uku:

• Lawula i-reflux yegastroesophageal
• Sika imithambo-luvo ethile kumqolo womqolo ukunceda ngeentlungu kunye nokuxinana
• Beka iityhubhu zokondla
• Ukukhupha iikhontrakthi ezidibeneyo

Uxinzelelo kunye nokudinwa phakathi kwabazali kunye nabanye abanonopheli babantu abane-cerebral palsy kuyinto eqhelekileyo. Funa inkxaso kunye nolwazi oluthe kratya kwimibutho egxile kukukhubazeka kwengqondo.

I-Cerebral palsy sisifo esihlala ixesha elide. Ukunyamekela kwexesha elide kunokufuneka. Esi sifo asichaphazeli ubude bexesha lokuphila. Inani lokukhubazeka liyahluka.

Uninzi lwabantu abadala luyakwazi ukuhlala ekuhlaleni, nokuba ngokuzimeleyo okanye ngamanqanaba ohlukeneyo oncedo.

Ukukhubazeka kwengqondo kungakhokelela kwezi ngxaki zilandelayo zempilo:

• Ukucoca amathambo (i-osteoporosis)
• Ukuthintelwa kwamathumbu
• Ukuqhekeka kwe-Hip kunye ne-arthritis kwilungu le-hip
• Ukonzakala xa usiwa
• Izilonda zoxinzelelo
• Iikhontrakthi ezidibeneyo
• Inyumoniya ebangelwa kukukrwitshwa
• Ukungondleki
• Ukunciphisa izakhono zonxibelelwano (ngamanye amaxesha)
• Ukwehla kwengqondo (ngamanye amaxesha)
• Scoliosis
• Ukuxhuzula (malunga nesiqingatha sabantu abachaphazelekayo yi-cerebral palsy)
• Ibala ekuhlaleni

Biza umnikezeli wakho ukuba iimpawu zesifo sokukhubazeka kwengqondo zikhula, ngakumbi ukuba uyazi ukuba ukwenzakala kwenzeke ngexesha lokuzalwa okanye kwasebusaneni.

Ukufumana ukhathalelo olufanelekileyo ngaphambi kokubeleka kunokunciphisa umngcipheko wezinye izizathu ezinqabileyo zokukhubazeka kwengqondo. Kwiimeko ezininzi nangona kunjalo, ukwenzakala okubangela ukuphazamiseka akunakuthintelwa.

Oomama abakhulelweyo abaneemeko ezithile zonyango banokufuna ukuba balandelwe kwiklinikhi yaphambi kokubeleka.

Ukukhubazeka okuguqukayo; Ukukhubazeka - i-spastic; Ukuqaqanjelwa kwemiphunga; I-diplegia ebabayo; I-quadriplegia ethe kratya

• Isondlo sangaphakathi-iingxaki zokulawula umntwana
• Ityhubhu yokondla isisu - i-bolus
• Ityhubhu yokondla iJejunostomy

• Inkqubo ye-nervous central kunye ne-peripheral system

IGreenberg JM, uHaberman B, uNarendran V, uNatan AT, uSchibler K.Izifo ezibangelwa kukuzalwa komntwana ngaphambi kokuzalwa kunye nemvelaphi yangaphambi kokubeleka. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Isilivere RM, ii-eds. I-Creasy kunye neResnik's Maternal-Fetal Medicine: Imigaqo kunye nokuziqhelanisa. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 73.

UJohnston MV. I-Encephalopathies. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 616.

UNass R, uSidhu R, uRoss G. Autism kunye nokunye ukukhubazeka kophuhliso. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 90.

U-Oskoui M, uShevell MI, uSwaiman KF. Umvakalelo yokitazo. Ku: Swaiman KF, Ashwal S, Ferriero DM, et al, ii-eds. I-Swaiman's Pediatric Neurology: Imigaqo kunye nokuziqhelanisa. Umhla wesi-6. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 97.

IVerschuren O, iPeterson MD, iBalemans AC, iHurvitz EA. Ukuzivocavoca kunye nokucebisa ngomsebenzi wabantu abanesifo sokukhubazeka kwengqondo. I-Dev Med yomntwana iNeurol. Ngo-2016; 58 (8): 798-808. IINKCUKACHA: 26853808 www.ncbi.nlm.nih.gov/pubmed/26853808.