I-PANDAS: Isikhokelo sabazali

Umxholo

• Ziintoni iimpawu?
• Ibangelwa yintoni?
• Ngubani osemngciphekweni?
• Kufunyaniswa njani?
• Yintoni unyango?
• Ukunyanga usulelo lwe-strep
• Ukunyanga iimpawu zengqondo
• Ngaba zikhona iingxaki ezinokubakho?
• Ndingalufumana phi uncedo?
• Yintoni imbonakalo?

Yintoni iPANDAS?

I-PANDAS imele ukuphazamiseka kwengqondo okuzenzekelayo kwe-neuropsychiatric ehambelana ne-streptococcus. Isifo sengqondo siquka ngokukhawuleza kwaye kaninzi utshintsho olukhulu kubuntu, indlela yokuziphatha, kunye nokuhamba kubantwana emva kosulelo olubandakanya IStreptococcus pyogenes (iStreptococcal-Ukosuleleka).

Izifo ezosulelayo zinokuba buthathaka, zingabangeli nto ngaphandle kosulelo oluncinci lolusu okanye umqala obuhlungu. Kwelinye icala, zinokubangela umqala obuhlungu, umqala obomvu, kunye nezinye izifo. I-Strep ifunyanwa ngaphakathi emqaleni nakumphezulu wolusu. Uyasifumana xa umntu osulelekileyo ekhohlela okanye ethimla kwaye uphefumlela amathontsi okanye uchukumise iindawo ezingcolileyo, emva koko uchukumise ubuso bakho.

Uninzi lwabantu abanesifo se-strep usulelo lubuyisela ngokupheleleyo. Nangona kunjalo, abanye abantwana baba neempawu ezenzeka ngesiquphe emzimbeni nasengqondweni kwiiveki ezimbalwa emva kosulelo. Nje ukuba baqale, ezi mpawu zihlala zisiba mandundu.

Qhubeka ufunda ukuze ufunde okungakumbi malunga neempawu zePANDAS, indlela ephathwa ngayo, kunye nalapho unokulufumana khona uncedo.

Ziintoni iimpawu?

Iimpawu zePANDAS ziqala ngequbuliso, malunga neeveki ezine ukuya kwezintandathu emva kosulelo lwe-strep. Babandakanya isimilo esifana nokuphazamiseka okungafunekiyo (OCD) kunye neTourette syndrome. Ezi mpawu zinokuphazamisa ukufunda kwaye zikhawuleze zibe buthathaka. Iimpawu ziba mandundu kwaye zifikelele kwincopho yazo kwiintsuku ezimbini ukuya kwezintathu, ngokungafaniyo nezinye izifo zengqondo ebuntwaneni ezikhula ngokuthe chu.

Iimpawu zengqondo zinokubandakanya:

• ukujonga izinto ngokungakhathali, okunyanzelekileyo, kunye nokuphindaphindayo
• Ukwahlula ixhala, uloyiko kunye nohlaselo
• ukukhala okungapheliyo, ukucaphuka, kunye nokutshintsha kwemood rhoqo
• Ukuhlehla ngokweemvakalelo kunye nokukhula
• ukubonwa okanye ukuva izinto ezingekhoyo
• uxinzelelo kunye neengcinga zokuzibulala

Iimpawu ezibonakalayo zinokubandakanya:

• tics kunye neentshukumo ezingaqhelekanga
• iimvakalelo zokukhanya, isandi kunye nokuchukumisa
• ukonakala kwezakhono ezincinci zemoto okanye ukubhala ngesandla okungafanelekanga
• Uxinzelelo okanye ukungakwazi ukugxila
• iingxaki zememori
• ingxaki yokulala
• ukwala ukutya, nto leyo enokubangela ukunciphisa umzimba
• intlungu edibeneyo
• ukuchama rhoqo kunye nokuchopha ebhedini
• kufutshane nekati

Abantwana abanePANDAS abasoloko benazo zonke ezi mpawu, kodwa ngokubanzi banomxube weempawu ezininzi zomzimba nezengqondo.

Ibangelwa yintoni?

Isizathu esona sizathu sePANDAS sisifundo sophando oluqhubekayo.

Enye inkcazo iphakamisa ukuba kungenxa yempendulo engalunganga yomzimba kwi-strep usulelo. Iibhakteria ze-Strep zilunge ngakumbi ekufihleni amajoni omzimba. Bazifihla ngeemolekyuli ezibonakala zifana neemolekyuli eziqhelekileyo ezifumaneka emzimbeni.

Amajoni omzimba ekugqibeleni abambelela kwi-strep bacteria kwaye iqala ukuvelisa ii-antibodies. Nangona kunjalo, ukuzifihla kuyaqhubeka nokudida ii-antibodies. Ngenxa yoko, izilwa-buhlungu zihlasela izicwili zomzimba. Ii-antibodies ezijolise kwindawo ethile yobuchopho, i-basal ganglia, inokubangela iimpawu ze-neuropsychiatric zePANDAS.

Iseti efanayo yeempawu inokuziswa zizifo ezingabandakanyi i-strep bacteria. Xa kunjalo, ibizwa ngokuba yi-pediatric acute-onset neuropsychiatric syndrome (PANS).

Ngubani osemngciphekweni?

I-PANDAS inokwenzeka ukuba ikhule ebantwaneni abaphakathi kweminyaka emi-3 ukuya kweli-12 ubudala abanesifo esosulelayo kwiiveki ezine ukuya kwezintandathu ezidlulileyo.

Eminye yemingcipheko enokubakho ibandakanya imeko yemfuza kunye nosulelo oluphindaphindiweyo.

Umntwana wakho kunokwenzeka ukuba afumane usulelo lwe-strep ngasekupheleni kokwindla nasekuqaleni kwentwasahlobo, ngakumbi xa bekwiindawo zokuhlala ezikufutshane namaqela amakhulu abantu. Ukunceda ukuthintela usulelo lwe-strep, fundisa umntwana wakho ukuba angabelani ngeempahla zokutya okanye ukusela iiglasi, kwaye ahlambe izandla rhoqo. Kuya kufuneka bakuphephe ukuthinta amehlo kunye nobuso babo nanini na kunokwenzeka.

Kufunyaniswa njani?

Ukuba umntwana wakho ubonakalisa iimpawu ezingaqhelekanga emva kosulelo lwalo naluphi na uhlobo, yenza idinga nogqirha wabantwana ngoko nangoko. Kunokuba luncedo ukugcina ijenali ebonisa ezi mpawu, kubandakanya ukuba ziqale nini kwaye zibuchaphazela njani ubomi bomntwana wakho. Zisa olu lwazi, kunye noluhlu lwawo nawuphi na amayeza okanye amayeza awathathayo okanye asandula ukuwathatha, xa undwendwela ugqirha. Qiniseka ukuba uxela naluphi na usulelo okanye izigulo ebezijikeleza esikolweni okanye ekhaya.

Ukufumanisa usulelo lwe-strep, ugqirha wabantwana wakho unokuthatha inkcubeko yomqala okanye aqhube uvavanyo lwegazi. Nangona kunjalo, akukho zilabhoratri okanye iimvavanyo ze-neurological zokufumanisa i-PANDAS. Endaweni yoko, ugqirha wakho unokufuna ukwenza uvavanyo lwegazi kunye nomchamo ukulawula ezinye izifo zobuntwana.

Ukuxilongwa kwe-PANDAS kufuna imbali yonyango kunye novavanyo lomzimba. Iikhrayitheriya zokufumanisa isifo zezi:

• phakathi kweminyaka emithathu ubudala nokufikisa
• Ukuqala ngesiquphe okanye ukonakala kweempawu esele zikho, kunye neempawu ziba nzima kakhulu ngamaxesha athile
• ubukho bokuziphatha okunyanzelekileyo, okungafunekiyo, okanye zombini
• ubungqina bezinye iimpawu ze-neuropsychiatric, ezinje nge-hyperactivity, ukutshintsha kwemozulu, ukuhlengahlengisa ukukhula, okanye uxinzelelo
• usulelo lwangaphambili okanye lwangoku-Usulelo, oluqinisekiswe yinkcubeko yomqala okanye uvavanyo lwegazi

Yintoni unyango?

Ukunyanga i-PANDAS kubandakanya ukujongana neempawu zomzimba kunye nezengqondo. Ukuqala, ugqirha wabantwana uza kugxila ekuqinisekiseni ukuba usulelo lwe-strep luphelile. Kuya kufuneka uphinde usebenze noochwephesha onelayisensi yezempilo oqhelene ne-OCD kunye nePANDAS.

Ukunyanga usulelo lwe-strep

Izifo ezosulelayo ziyanyangwa ngamayeza okubulala iintsholongwane. Uninzi losulelo olusasazwayo lunyangwa ngempumelelo ngekhosi enye ye-antibiotics. Ezinye ze-antibiotics ezisetyenziselwa ukuphatha i-strep ziquka:

• ifumobillin
• izithromycin
• icephalosporin
• penicillin

Kuya kufuneka uthathele ingqalelo ukuba namanye amalungu osapho avavanyelwe i-strep kuba kunokwenzeka ukuba uphathe ibhaktheriya nangona ungenazimpawu. Ukukunceda ukunqanda ukuphinda usuleleke, buyisela ibrashi yamazinyo yomntwana wakho ngoko nangoko kwaye kwakhona xa begqibile ikhosi yabo epheleleyo yezibulali ntsholongwane.

Ukunyanga iimpawu zengqondo

Iimpawu zengqondo zingaqala ukuphucula ngamayeza okubulala iintsholongwane, kodwa kusenokwenzeka ukuba kusafuneka zijongiwe ngokwahlukeneyo. I-OCD kunye nezinye iimpawu zengqondo zihlala ziphathwa ngokunyanga ngokuziphatha.

I-OCD nayo ihlala iphendula kakuhle ekukhetheni i-serotonin reuptake inhibitors, uhlobo lwe-antidepressant. Ezinye eziqhelekileyo ziquka:

• fluoxetine
• fluvoxamine
• Unyango
• paroxetine

La mayeza aya kumiselwa kwiidosi ezincinci ukuqala. Banokunyuka kancinci ukuba kukho imfuneko.

Olunye unyango luyimpikiswano kwaye kufuneka kugqitywe ngalo kwimeko ngamatyala. Abanye oogqirha banokumisela i-corticosteroids, enje nge-prednisone, ukuphucula iimpawu ze-OCD. Nangona kunjalo, ii-steroids zingenza i-tics ibe mandundu. Ukongeza, xa i-steroids isebenza, inokusetyenziselwa ixesha elifutshane. Ngeli xesha, ii-steroids azikhuthazwa rhoqo kunyango lwe-PANDAS.

Ezinye iimeko ezinzima ze-PANDAS zingenakuphendula kumayeza kunye nonyango. Ukuba oku kuyenzeka, ukutshintshwa kweplasma yegazi ukususa ii-antibodies eziphosakeleyo egazini lazo kuyacetyiswa ngamanye amaxesha. Ugqirha wakho unokucebisa unyango lwe-immunoglobulin. Le nkqubo isebenzisa iimveliso zeplasma yegazi enikelayo ukunceda ukukhulisa amajoni omzimba womntwana wakho. Ngelixa abanye oogqirha bexela impumelelo kolu nyango, akukho zifundo ziqinisekisa ukuba ziyasebenza.

Ngaba zikhona iingxaki ezinokubakho?

Iimpawu zePANDAS zinokushiya umntwana wakho engakwazi ukusebenza esikolweni okanye kwiimeko zentlalo. Ukunganyangwa, iimpawu ze-PANDAS zingaqhubeka ziba zimbi kwaye zingakhokelela kumonakalo ongapheliyo wokuqonda. Abanye abantwana, i-PANDAS ingaba yimeko engapheliyo yokuzimela.

Ndingalufumana phi uncedo?

Ukuba nomntwana nge-PANDAS kunokuba noxinzelelo kakhulu kuba kuhlala kuza ngaphandle kwesilumkiso. Ngaphezulu kweentsuku ezimbalwa, unokuqaphela utshintsho olumangalisayo kwindlela yokuziphatha ngaphandle kwesizathu. Ukongeza kulo mceli mngeni kukuba akukho luvavanyo lunye lwe-PANDAS, nangona imigaqo yokuqonda isifo iphuhlisiwe. Kubalulekile ukuba uqinisekise ukuba ezi ndlela ziyafezekiswa ngaphambi kokufumanisa i-PANDAS.

Ukuba uziva ukhathazekile, jonga ezi zixhobo:

• Inethiwekhi yePANDAS ibonelela ngolwazi ngokubanzi, iindaba malunga nophando lwamva nje, kunye noluhlu loogqirha kunye namaqela enkxaso.
• Isiseko se-OCD samanye amazwe sinolwazi malunga ne-OCD ebantwaneni kunye nephepha elinokukhutshelwa xa kuthelekiswa i-OCD ne-PANDAS ne-PANS. Oku kuluncedo ngakumbi ukuba ugqirha wabantwana akaqhelananga nePANDAS.
• I-PANDAS Physicians Network inikezela nge-PANDAS Directory Directory, i-database ekhangekayo yoogqirha abaqhelene ne-PANDAS.

Umntwana wakho unokufuna uncedo olongezelelweyo esikolweni. Thetha notitshala wabo okanye abaphathi besikolo malunga nokuchongwa, ukuba kuthetha ntoni, kunye nendlela eninokusebenzisana ngayo ukuze kulungelwe umntwana wakho.

Yintoni imbonakalo?

I-PANDAS ayichongwanga kude kube ngo-1998, ngoko akukho zifundo zexesha elide labantwana abanePANDAS. Nangona kunjalo, oku akuthethi ukuba umntwana wakho akanakuba ngcono.

Abanye abantwana baphucula ngokukhawuleza emva kokuqala i-antibiotics, nangona iimpawu zingabuya xa zifumana usulelo olutsha lwe-strep. Uninzi luyachacha ngaphandle kweempawu zexesha elide. Kwabanye, inokuba yingxaki eqhubekayo efuna ukuba kusetyenziswe amaxesha amayeza okubulala iintsholongwane ukulawula ukosuleleka okunokubangela ukuqaqanjelwa.