Isifo se-Osmotic demyelination syndrome

I-Osmotic demyelination syndrome (ODS) kukungasebenzi kakuhle kweseli kwengqondo. Kubangelwa kukutshatyalaliswa kocingo (i-myelin sheath) egubungele iiseli zemithambo-luvo embindini wesixokelelwano sobuchopho (iipon).

Xa i-myelin sheath egubungela iiseli zemithambo-luvo yatshatyalaliswa, imiqondiso esuka kwimbilini ethile iye kwenye ayidluliswanga ngokufanelekileyo. Nangona i-brainstem ichaphazeleka ikakhulu, ezinye iindawo zobuchopho nazo zinokubandakanyeka.

Isizathu esiqhelekileyo se-ODS kukutshintsha ngokukhawuleza kumanqanaba esodium emzimbeni. Oku kuhlala kwenzeka rhoqo xa umntu ephathwa nge-sodium esezantsi yegazi (i-hyponatremia) kwaye isodiyam ithathelwa indawo ngokukhawuleza okukhulu. Ngamanye amaxesha, kwenzeka xa inqanaba eliphezulu lesodium emzimbeni (hypernatremia) lilungiswa ngokukhawuleza okukhulu.

I-ODS ayiqhelekanga iyodwa. Rhoqo, yingxaki yonyango lwezinye iingxaki, okanye ezivela kwezinye iingxaki ngokwazo.

Iingozi zibandakanya:

• Ukusetyenziswa kotywala
• Isifo sesibindi
• Ukungondleki kwizifo ezinzulu
• Unyango ngemitha yengqondo
• Isicaphucaphu esiqatha nokugabha ngexesha lokukhulelwa

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Ukudideka, ukuphambana, nemibono
• Iingxaki zokulinganisela, ukuthuthumela
• Ingxaki yokuginya
• Ukuphaphama kokuphaphama, ukozela okanye ukozela, ukonqena, iimpendulo ezingalunganga
• Intetho egudileyo
• Ubuthathaka ebusweni, iingalo, okanye imilenze, zihlala zichaphazela amacala omzimba

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu.

Iskena se-MRI esentloko sinokuveza ingxaki kwi-brainstem (pons) okanye kwezinye iindawo zobuchopho. Olu lolona vavanyo luphambili lokuqonda isifo.

Olunye uvavanyo lunokubandakanya:

• Inqanaba lesodiyam yegazi kunye nolunye uvavanyo lwegazi
• Impendulo ye-Brainstem ekhutshwe yimpendulo (BAER)

I-ODS sisifo esingxamisekileyo esidinga ukunyangwa esibhedlele nangona uninzi lwabantu olunale meko sele lisesibhedlele yenye ingxaki.

Akukho lunyango laziwayo lwe-pontine myelinolysis. Unyango lujolise ekunciphiseni iimpawu.

Unyango lomzimba lunokunceda ukugcina amandla emisipha, ukuhamba, kunye nokusebenza kweengalo kunye nemilenze ebuthathaka.

Umonakalo wemithambo-luvo obangelwa yi-pontine myelinolysis ihlala ihlala ihlala ixesha elide. Esi sifo sinokubangela ukukhubazeka okude (okungapheliyo).

Iingxaki zinokubandakanya:

• Ukwehla kokunxibelelana nabanye
• Ukwehla kokusebenza okanye ukuzikhathalela
• Ukungakwazi ukuhamba, ngaphandle kokuqhwanyaza amehlo ("itshixiwe" kwisifo)
• Umonakalo wesistim osisigxina

Akukho sikhokelo sokwenyani sokuba ufune nini unyango, kuba i-ODS inqabile kuluntu ngokubanzi.

Esibhedlele, ukunyanga okucothayo, okulawulwayo kwinqanaba elisezantsi lesodium kunokunciphisa umngcipheko wokonakaliswa kwemithambo-luvo kwiipon.Ukwazi indlela amanye amayeza anokutshintsha ngayo amanqanaba esodium kunokuthintela inqanaba ekubeni litshintshe ngokukhawuleza.

I-ODS; Ukudilizwa kwisikhundla esiphambili sepontine

• Inkqubo ye-nervous central kunye ne-peripheral system

U-Weissenborn K, uLockwood AH. I-encephalopathies enetyhefu kunye ne-metabolic. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahl. 84.

I-Yaqoob MM, iMcCafferty K. Ibhalansi yamanzi, ulwelo kunye neelectrolyte. Ku: Intsiba A, uRandall D, indlu yamanzi M, ii-eds. Kumar kunye noClarke's Clinical Medicine. Ngomhla we-10. IPhiladelphia, PA: Elsevier; 2021: isahluko 9.