Isifo sengqondo esixhalabisayo

Isifo sengqondo esixhalabisayo (Frontotemporal dementia) (FTD) luhlobo olunqabileyo lwesifo sengqondo esixhalabisayo esifana nesifo se-Alzheimer, ngaphandle kokuba sithambekele ekuchaphazeleni iindawo ezithile zobuchopho.

Abantu abane-FTD banezinto ezingaqhelekanga (ezibizwa ngokuba ziingqungquthela, imizimba yePiki, kunye neeseli zePick, kunye neeproteni zetau) ngaphakathi kwiiseli zemithambo-luvo kwiindawo ezonakeleyo zobuchopho.

Oyena nobangela wezinto ezingaqhelekanga awaziwa. Zininzi iintlobo zofuzo ezingaqhelekanga eziye zafunyanwa ezinokubangela i-FTD. Amanye amatyala e-FTD adluliselwa kwiintsapho.

I-FTD inqabile. Inokwenzeka kubantu abancinci kangangeminyaka engama-20. Kodwa ihlala iqala phakathi kweminyaka engama-40 nama-60.

Esi sifo siba mandundu ngokuthe ngcembe. Izicubu ezikwiinxalenye zobuchopho ziyancipha ngokuhamba kwexesha. Iimpawu ezinje ngokutshintsha kokuziphatha, ubunzima bokuthetha, kunye neengxaki zokucinga zivela kancinci kwaye ziya zisonakala.

Utshintsho lobuntu bokuqala lunokunceda oogqirha baxelele i-FTD ngaphandle kwesifo se-Alzheimer. (Ukuphulukana nenkumbulo kuhlala kuyinto ephambili, kwaye kwangoko, luphawu lwesifo se-Alzheimer.)

Abantu abane-FTD bavame ukuziphatha ngendlela engafanelekanga kwiindawo ezahlukeneyo zentlalo. Utshintsho kwindlela yokuziphatha luyaqhubeka nokuba mandundu kwaye zihlala zizezona mpawu ziphazamisayo zesi sifo. Abanye abantu banobunzima ngakumbi ekwenzeni izigqibo, imisebenzi enzima, okanye ulwimi (ukufumana ingxaki okanye ukuqonda amagama okanye ukubhala).

Iimpawu ngokubanzi zibandakanya:

UTSHINTSHO LOKUZIPHATHA:

• Andikwazi ukugcina umsebenzi
• Ukuziphatha okunyanzelekileyo
• Ukuziphatha okungxamisekileyo okanye okungafanelekanga
• Ukungakwazi ukusebenza okanye ukunxibelelana kwiimeko zentlalo okanye zobuqu
• Iingxaki ngococeko lomntu
• Ukuziphatha okuphindaphindiweyo
• Ukurhoxa kunxibelelwano lwasentlalweni

UTSHINTSHO KWIMVO

• Utshintsho olwenzeka ngesiquphe
• Ukwehla komdla kwimisebenzi yokuphila yemihla ngemihla
• Ukusilela ukuqonda utshintsho kwindlela yokuziphatha
• Ukusilela ukubonisa ubushushu beemvakalelo, inkxalabo, uvelwano, uvelwano
• Isimo esingafanelekanga
• Ukungakhathali ngeziganeko okanye imeko-bume

UTSHINTSHO KULWIMI

• Awunakuthetha (mutism)
• Ukwehla kokukwazi ukufunda okanye ukubhala
• Kunzima ukufumana igama
• Kunzima ukuthetha okanye ukuqonda intetho (aphasia)
• Ukuphinda nantoni na eyithethiweyo kubo (i-echolalia)
• Ukuncipha kwesigama
• Izandi zentetho ebuthathaka, engalungelelaniswanga

IINGXAKI ZENKQUBO ETHILE

• Ukunyuka kwethoni yemisipha (ukuqina)
• Ukuphulukana nenkumbulo okuya kusiba mandundu
• Ukuhamba / ubunzima bokuququzelela (apraxia)
• Ubuthathaka

EZINYE IINGXAKI

• Ukungahambi kakuhle komchamo

Umboneleli wezempilo uya kubuza malunga nembali yonyango kunye neempawu.

Uvavanyo lunokuyalelwa ukuba luncede ukulawula ezinye izizathu zesifo sengqondo esixhalabisayo, kubandakanya isifo sengqondo esixhalabisayo ngenxa yoonobangela bemetabolism. I-FTD ifunyaniswa isekwe kwiimpawu kunye neziphumo zovavanyo, kubandakanya:

• Uvavanyo lwengqondo nokuziphatha (uvavanyo lwe-neuropsychological)
• I-Brain MRI
• I-Electroencephalogram (i-EEG)
• Uvavanyo lwengqondo kunye nenkqubo yeemvakalelo (uviwo lwe-neurological)
• Ukuvavanywa kolwelo olujikeleze inkqubo ye-nervous system (i-cerebrospinal fluid) emva kokugqobhoza i-lumbar
• Ukuskena iNtloko ye-CT
• Uvavanyo lweemvakalelo, ukucinga kunye nokuqiqa (umsebenzi wokuqonda), kunye nokusebenza kwemoto
• Iindlela ezintsha zokuvavanya imetabolism yengqondo okanye iidipozithi zeprotheyini zinokuvumela ngcono ukuxilongwa ngokuchanekileyo kwixa elizayo
• I-Positron emission tomography (PET) yokuskena kwengqondo

I-biopsy yengqondo kuphela kovavanyo olunokuqinisekisa ukuxilongwa.

Akukho lonyango oluthile lwe-FTD. Amayeza anokunceda ukulawula utshintsho lwemood.

Ngamanye amaxesha, abantu abane-FTD bathatha amayeza afanayo asetyenziselwa ukunyanga ezinye iintlobo zesifo sengqondo esixhalabisayo.

Ngamanye amaxesha, ukuyeka okanye ukutshintsha amayeza enza mandundu ukudideka okanye angafunekiyo kunokuphucula ukucinga neminye imisebenzi yengqondo. Amayeza afaka:

• Uhlalutyo
• I-Anticholinergics
• Ukudakumba kwenkqubo ye-nervous system
• Cimetidine
• Lidocaine

Kubalulekile ukunyanga naziphi na iingxaki ezinokubangela ukudideka. Oku kubandakanya:

• Ukunqongophala kwegazi
• Ukunciphisa ioksijini (hypoxia) inqanaba
• Ukumelwa yintliziyo
• Inqanaba eliphezulu le-carbon dioxide
• Usulelo
• Ukungaphumeleli kwezintso
• Ukungaphumeleli kwesibindi
• Ukuphazamiseka kwesondlo
• Iingxaki ze-thyroid
• Ukuphazamiseka kwemood, njengokudakumba

Amayeza anokufuneka ukulawula ubundlongondlongo, ubungozi, okanye isimilo esikhathazayo.

Ukulungiswa kokuziphatha kunokunceda abanye abantu balawule indlela yokuziphatha engamkelekanga okanye eyingozi. Oku kubandakanya umvuzo okanye isimilo esifanelekileyo kunye nokungahoyi isimilo esingafanelekanga (xa kukhuselekile ukwenza njalo).

Unyango lokuthetha (unyango lwengqondo) alusoloko lusebenza. Kungenxa yokuba kunokubangela ukudideka ngakumbi okanye ukuphazamiseka.

Ukuqhelaniswa kwenyani, okuqinisa okusingqongileyo kunye nezinye iindlela, kunokunceda ukunciphisa ukudideka.

Kuxhomekeke kwiimpawu nokuba qatha kwesi sifo, ukujonga kunye noncedo ngezempilo kunye nokuzikhathalela kunokufuneka. Ekugqibeleni, kunokubakho isidingo sokukhathalelwa kweeyure ezingama-24 kunye nokubeka iliso ekhaya okanye kwindawo ekhethekileyo. Iingcebiso kusapho zingamnceda umntu akwazi ukumelana notshintsho olufunekayo lokhathalelo lwasekhaya.

Inkathalo inokubandakanya:

• Iinkonzo zokukhusela abantu abadala
• Izixhobo zoluntu
• Abenzi bamakhaya
• Abongikazi abatyelelayo okanye abancedisi
• Iinkonzo zokuzithandela

Abantu abane-FTD kunye neentsapho zabo banokufuna ukufumana iingcebiso zomthetho kwangethuba kwesi sifo. Isikhokelo sokhathalelo kwangaphambili, amandla egqwetha, kunye nezinye izinto ezisemthethweni zinokwenza kube lula ukwenza izigqibo ngokubhekisele kukhathalelo lomntu one-FTD.

Unokwenza lula uxinzelelo lwe-FTD ngokujoyina iqela lenkxaso. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo. Olunye ulwazi kunye nenkxaso kubantu abane-FTD kunye neentsapho zabo zifumaneka kwi:

Umbutho woPhuculo lweFototemporal - www.theaftd.org/get-involve/in-your-region/

Ukuphazamiseka ngokukhawuleza kwaye ngokuthe ngcembe kuya kusiba mandundu. Umntu ukhubazeka ngokupheleleyo kwasekuqaleni kwesi sifo.

I-FTD ihlala ibangela ukufa kwisithuba seminyaka esi-8 ukuya kweli-10, ngesiqhelo ukusuleleka, okanye ngamanye amaxesha ngenxa yokuba iinkqubo zomzimba zisilela.

Fowunela umboneleli wakho okanye uye kwigumbi likaxakeka ukuba ukusebenza kwengqondo kuya kusiba mandundu.

Akukho sithintelo saziwayo.

Ukuwohloka kwengqondo; Isifo sengqondo esiyingozi - semantic; Isifo sengqondo esixhalabisayo; FTD; Isifo seArnold Pick; Chonga isifo; I-3R tauopathy

• Inkqubo ye-nervous central kunye ne-peripheral system
• Ingqondo
• Ingqondo kunye nenkqubo yovalo

U-Bang J, uSpina S, uMiller BL. Isifo sengqondo esixhalabisayo. ILancet. Ngo-2015; 386 (10004): 1672-1682. IINKCUKACHA: 26595641 pubmed.ncbi.nlm.nih.gov/26595641/.

UPeterson R, uGraff-Radford J. Isifo i-Alzheimer kunye nezinye isifo sengqondo esixhalabisayo. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 95.