Into ekufuneka uyazi ngeCatonia

Umxholo

• Zeziphi iintlobo ezahlukeneyo zecatatonia?
• Yintoni ebangela icatatonia?
• Amayeza
• Oonobangela bezinto eziphilayo
• Yeyiphi imiba yomngcipheko wekatatonia?
• Ziintoni iimpawu zecatatonia?
• I-catatonia enomdla
• I-catatonia enobungozi
• Ukufana kwezinye iimeko
• I-catatonia ifunyaniswa njani?
• Inyangwa njani icatatonia?
• Amayeza
• Unyango lwe-Electroconvulsive (ECT)
• Iyintoni imbonakalo yekatatonia?
• Ngaba icatatonia inokuthintelwa?

Yintoni icatatonia?

ICatatonia sisifo se-psychomotor disorder, esithetha ukuba sibandakanya unxibelelwano phakathi kokusebenza kwengqondo kunye nentshukumo. ICatatonia ichaphazela ukubanakho komntu ukuhamba ngendlela eqhelekileyo.

Abantu abane-catatonia banokufumana iimpawu ezahlukeneyo. Olona phawu luqhelekileyo bubuthongo, oko kuthetha ukuba umntu akakwazi ukuhamba, ukuthetha, okanye ukuphendula kwisikhuthazi. Nangona kunjalo, abanye abantu abane-catatonia banokubonisa intshukumo egqithileyo kunye nokuziphatha okungafunekiyo.

ICatatonia inokuhlala naphi na ukusuka kwiiyure ezimbalwa ukuya kwiiveki, kwiinyanga, okanye kwiminyaka. Inokuphinda yenzeke kwakhona kangangeeveki ukuya kwiminyaka emva kwesiqendu sokuqala.

Ukuba icatatonia luphawu lwesizathu esichongiweyo, ibizwa ngokuba yi-extrinsic. Ukuba akukho sizathu sinokumiselwa, sithathwa njengesiqhelo.

Zeziphi iintlobo ezahlukeneyo zecatatonia?

Ushicilelo lwamva nje lweDiagnostic and Statistical Manual of Mental Disorders (DSM-5) ayisayihluli icatatonia kwiindidi. Nangona kunjalo, uninzi lweengcali zempilo yezengqondo zisenokuluhlula katatonia kwiindidi ezintathu: ukudodobala, ukonwaba, kunye nokubi.

I-catatonia ebuyiselweyo lolona hlobo luqhelekileyo lwe-catatonia. Ibangela ukuhamba kancinci. Umntu one-catatonia edodobeleyo unokujonga esithubeni kwaye uhlala engathethi. Oku kwaziwa ngokuba yi-akinetic catatonia.

Abantu abane-catatonia abanemincili babonakala "bekhawulezile," bengonwabanga, kwaye bephazamisekile. Ngamanye amaxesha babandakanyeka ekuziphatheni okubi. Le fomu yaziwa ngokuba yi-hyperkinetic catatonia.

Abantu abane-catatonia enobungozi banokufumana i-delirium. Bahlala benomkhuhlane. Banokuba nentliziyo ebetha ngokukhawuleza kunye noxinzelelo lwegazi oluphezulu.

Yintoni ebangela icatatonia?

Ngokwe-DSM-5, iimeko ezininzi zinokubangela ikatatonia. Ziquka:

• ukuphazamiseka kwengqondo kwi-neurodevelopmental (ukuphazamiseka okuchaphazela ukukhula kwenkqubo yemithambo-luvo)
• ukuphazamiseka kwengqondo
• ukuphazamiseka kwengqondo okuguquguqukayo
• ukuphazamiseka koxinzelelo
• ezinye iimeko zonyango, ezinje ngokusilela kwe-cerebral folate, iingxaki ezinqabileyo zomzimba, kunye nokuphazamiseka okungaqhelekanga kwe-paraneoplastic (ezinxulumene nezomhlaza)

Amayeza

ICatatonia sisiphumo esinqabileyo secandelo lamayeza asetyenziselwa ukunyanga izifo zengqondo. Ukuba ukrokrela ukuba iyeza libangela ikatatonia, funa unyango kwangoko. Oku kuthathwa njengongxamiseko kwezonyango.

Ukurhoxa kwamanye amayeza, afana ne-clozapine (Clozaril), kunokubangela i-catatonia.

Oonobangela bezinto eziphilayo

Izifundo zokulinganisa ziphakamise ukuba abanye abantu abane-catatonia engapheliyo banokuba nokuchaphazeleka kwengqondo.

Ezinye iingcali zikholelwa ukuba ukubangaphezu okanye ukungabikho kweeurotransmitters kubangela ikatatonia. I-Neurotransmitters ziikhemikhali zobuchopho ezihambisa imiyalezo ukusuka kwi-neuron ukuya kwenye.

Enye inkcazo kukuba ukunciphisa ngokukhawuleza kwi-dopamine, i-neurotransmitter, kubangela i-catatonia. Enye ithiyori kukuba ukuncitshiswa kwe-gamma-aminobutyric acid (GABA), enye i-neurotransmitter, kukhokelela kwimeko.

Yeyiphi imiba yomngcipheko wekatatonia?

Abasetyhini banomngcipheko ophezulu wokufumana i-catatonia. Umngcipheko unyuka ngokudala.

Nangona i-catatonia ibisoloko inxulunyaniswa ne-schizophrenia, oogqirha bengqondo ngoku bahlela icatatonia njengengxaki yayo, eyenzeka kwimeko yezinye iingxaki.

Uqikelelo lweepesenti ezili-10 zabaguli abagula ngengqondo abagula ngamava e-catatonia. Iipesenti ezingamashumi amabini zezifo ze-catatonic zine-schizophrenia diagnostic, ngelixa iipesenti ezingama-45 zinesifo sokuphazamiseka kwemood.

Abasetyhini abanesifo sokudakumba emva kokubeleka (PPD) banokufumana ikatatonia.

Eminye imingcipheko kukusetyenziswa kwecocaine, ityuwa esezantsi egazini, kunye nokusetyenziswa kwamayeza afana ne-ciprofloxacin (Cipro).

Ziintoni iimpawu zecatatonia?

ICatatonia ineempawu ezininzi, ezona zixhaphakileyo zibandakanya:

• ububhanxa, apho umntu engakwaziyo ukushukuma, engakwazi ukuthetha, kwaye kubonakala ngathi ujonge esithubeni
• ukuma okanye "ukuguquguquka kwe-wax," apho umntu ahlala kwindawo enye ixesha elide
• ukungondleki kunye nokuphelelwa ngumzimba ngenxa yokungatyi okanye ukusela
• i-echolalia, apho umntu ephendula kwincoko ngokuphinda kuphela oko akuvileyo

Ezi mpawu ziqhelekileyo zinokubonakala kubantu abane-catatonia edodobeleyo.

Ezinye iimpawu zecatatonia zibandakanya:

• catalepsy, eluhlobo lokuqina kwemisipha
• negativism, Kukungabikho kwempendulo okanye inkcaso kukhuthazo lwangaphandle
• I-echopraxia, elinganisa iintshukumo zomnye umntu
• Ukuthula
• grimacing

I-catatonia enomdla

Iimpawu ezithile kwi-catatonia enemincili zibandakanya ukunyakaza okungaqhelekanga, okungaqhelekanga. Oku kubandakanya:

• ukuphazamiseka
• ukungazinzi
• iintshukumo ezingenanjongo

I-catatonia enobungozi

I-catatonia enobungozi ibangela ezona mpawu zinzima. Ziquka:

• Ukuphambuka
• ifiva
• ukuqina
• ukubila

Iimpawu ezibalulekileyo ezifana noxinzelelo lwegazi, inqanaba lokuphefumla, kunye nokubetha kwentliziyo kunokutshintsha. Ezi mpawu zifuna unyango kwangoko.

Ukufana kwezinye iimeko

Iimpawu zeCatatonia zibonisa ezo zezinye iimeko, kubandakanya:

• isifo sengqondo esibuhlungu
• i-encephalitis, okanye ukudumba kwizihlunu zobuchopho
• isifo se-neuroleptic malignant syndrome (NMS), impendulo enqabileyo nenobuzaza kumayeza antipsychotic
• imeko yokungaxhuzuleli epilepticus, uhlobo lokuthimba kakhulu

Oogqirha kufuneka bayikhuphe le miqathango ngaphambi kokuba bafumane i-catatonia. Umntu kufuneka abonakalise ubuncinci iimpawu eziphambili ze-catatonia kwiiyure ezingama-24 ngaphambi kokuba ugqirha abhaqe i-catatonia.

I-catatonia ifunyaniswa njani?

Akukho luvavanyo luqinisekileyo lwe Katatonia ekhoyo. Ukufumanisa i-catatonia, uvavanyo lomzimba kunye nokuvavanywa kufuneka kuqala kulawule ezinye iimeko.

Isikali seBush-Francis Catatonia Scale Scale (BFCRS) luvavanyo oluhlala lusetyenziselwa ukuxilonga icatatonia. Eli nqanaba linamanqaku angama-23 afumene amanqaku ukusuka kwi-0 ukuya kwi-3. Inqanaba elithi "0" lithetha ukuba uphawu alukho. Inqanaba elithi "3" lithetha ukuba uphawu lukhona.

Uvavanyo lwegazi lunokunceda ukulawula ukungalingani kwe-electrolyte. Oku kunokubangela utshintsho ekusebenzeni kwengqondo. I-pulmonary embolism, okanye i-clot yegazi kwimiphunga, inokukhokelela kwiimpawu zecatatonia.

Uvavanyo lwegazi lwe-fibrin D-dimer lunokuba luncedo. Izifundo zamva nje zibonisa ukuba icatatonia inxulunyaniswa namanqanaba aphezulu e-D-dimer. Nangona kunjalo, iimeko ezininzi (ezinjenge-pulmonary embolism) zinokuchaphazela amanqanaba e-D-dimer.

Ukuskena i-CT okanye iMRI kuvumela oogqirha ukuba babone ubuchopho. Oku kunceda ukukhupha ithumba lobuchopho okanye ukudumba.

Inyangwa njani icatatonia?

Amayeza okanye i-electroconvulsive therapy (ECT) inokusetyenziselwa ukunyanga ikatatonia.

Amayeza

Amayeza ahlala eyindlela yokuqala yokunyanga ikatatonia. Iindidi zamachiza anokumiselwa zibandakanya i-benzodiazepines, izihlunu eziphumlayo, kwaye kwezinye iimeko, i-tricyclic antidepressants. I-Benzodiazepines ihlala iyeza lokuqala elichaziweyo.

I-Benzodiazepines ibandakanya i-clonazepam (iKlonopin), i-lorazepam (Ativan), kunye ne-diazepam (Valium). La mayeza andisa i-GABA kwingqondo, exhasa ithiyori yokunciphisa i-GABA ikhokelela kwikatatonia. Abantu abanezinga eliphezulu kwi-BFCRS bahlala bephendula kakuhle kunyango lwe-benzodiazepine.

Amanye amayeza athile anokumiselwa, ngokusekwe kwimeko yomntu, kubandakanya:

• i-amobarbital, ibarbiturate
• bromocriptine (ICycloset, iParlodel)
• icarbamazepine (iCarbatrol, i-Epitol, iTegretol)
• lithium carbonate
• idlala lengqula
• zolpidem (Ambien)

Emva kweentsuku ezi-5, ukuba akukho mpendulo kunyango okanye ukuba iimpawu ziya zisiba mbi, ugqirha unokucebisa ngezinye iindlela zonyango.

Unyango lwe-Electroconvulsive (ECT)

Unyango lwe-Electroconvulsive (ECT) lunyango olusebenzayo lwe-catatonia. Olu nyango lwenziwa esibhedlele phantsi kweliso lonyango. Yinkqubo engenabuhlungu.

Nje ukuba umntu ahlaliswe phantsi, umatshini okhethekileyo uhambisa umothuko wombane kwingqondo. Oku kukhuthaza ukubanjwa kwengqondo kangangexesha elijikeleze umzuzu.

Kukholelwa ukuba ukubanjwa kubangela utshintsho kumanani ee-neurotransmitters kwingqondo. Oku kunokuphucula iimpawu zecatatonia.

Ngokwe-2018 yokuphononongwa koncwadi, i-ECT kunye ne-benzodiazepines kuphela konyango oluye lwangqinwa ukuba lunyanga ikatatonia.

Iyintoni imbonakalo yekatatonia?

Abantu baphendula ngokukhawuleza kunyango lwekatonia. Ukuba umntu akaphenduli kumayeza amiselweyo, ugqirha unokuyalela amanye amayeza kude kuphele iimpawu.

Abantu abangena kwi-ECT banamazinga aphezulu okubuyela kwakhona kwi-catatonia. Iimpawu zihlala zivela kwakhona kwisithuba sonyaka.

Ngaba icatatonia inokuthintelwa?

Kuba oyena nobangela wekatatonia uhlala engaziwa, ukuthintela akunakwenzeka. Nangona kunjalo, abantu abane-catatonia kufuneka bakuphephe ukuthatha amayeza e-neuroleptic, njenge-chlorpromazine. Ukusetyenziswa gwenxa kwamayeza kunokwenza mandundu iimpawu zecatatonia.