Isifo sokuwa

Isifo sokuwa ukuphazamiseka kobuchopho lapho umuntu ephindaphindwe ukuqubuka ngokuhamba kwesikhathi. Ukuquleka yiziqephu zokudubula okungalawuleki nokungajwayelekile kwamaseli obuchopho okungadala ushintsho ekunakeni noma ekuziphatheni.

Isithuthwane senzeka lapho izinguquko ebuchosheni zibangela ukuba sithambekele kakhulu noma sicasuke. Ngenxa yalokho, ubuchopho buthumela izimpawu ezingejwayelekile. Lokhu kuholela ekuqulekeni okuphindiwe, okungalindelekile. (Ukuquleka okukodwa okungenzeki futhi akusikho isithuthwane.)

Isifo sokuwa kungenzeka ngenxa yesimo sezokwelapha noma ukulimala okuthinta ubuchopho. Noma, imbangela ingahle ingaziwa (idiopathic).

Izimbangela ezivamile zesifo sokuwa zihlanganisa:

• Ukuhlaselwa yisifo sohlangothi noma okwedlulayo kwe-ischemic (TIA)
• Ukuwohloka komqondo, njengesifo i-Alzheimer
• Ukulimala kwengqondo okubuhlungu
• Ukutheleleka, kufaka phakathi ithumba lobuchopho, i-meningitis, i-encephalitis, ne-HIV / AIDS
• Izinkinga zobuchopho ezikhona lapho kuzalwa (ukukhubazeka kobuchopho bokuzalwa)
• Ukulimala kobuchopho okwenzeka ngesikhathi sokuzalwa noma esiseduze
• Izinkinga zeMetabolism zikhona lapho kuzalwa (njenge phenylketonuria)
• Isigaxa sobuchopho
• Imithambo yegazi engajwayelekile ebuchosheni
• Okunye ukugula okulimaza noma okucekela phansi izicubu zobuchopho
• Ukuphazamiseka kokugijima okusebenza emindenini (isifo sokuwa)

Ukuquleka kwesithuthwane kuvame ukuqala phakathi kweminyaka yobudala eyi-5 nengama-20. Kukhona namathuba aphezulu okuquleka kubantu abadala abaneminyaka engaphezu kwengama-60. Kepha ukuquleka kwesithuthwane kungenzeka nganoma yisiphi isikhathi. Kungaba nomlando womndeni wesifo sokuwa noma sokuwa.

Izimpawu ziyahlukahluka kuye ngomuntu. Abanye abantu bangahle babe neziphonso ezilula zokubuka. Abanye banokuthuthumela okunodlame futhi balahlekelwe ukuqapha. Uhlobo lokuquleka kuncike engxenyeni yobuchopho ethintekile.

Isikhathi esiningi, ukuquleka kuyefana nokwangaphambi kwaso. Abanye abantu abanesithuthwane banomuzwa ongajwayelekile ngaphambi kokuquleka ngakunye. Ukuzwa kungahle kube ukushoshozela, ukuhogela iphunga elingekho empeleni, noma izinguquko ezingokomzwelo. Lokhu kubizwa ngokuthi i-aura.

Udokotela wakho angakutshela kabanzi ngohlobo oluthile lokubanjwa ongahle ube nalo:

• Ukungabikho (petit mal) ukuthunjwa (ukubuka iziphonso)
• Ukubanjwa okujwayelekile kwe-tonic-clonic (grand mal) (kufaka umzimba wonke, kufaka phakathi i-aura, imisipha eqinile, kanye nokulahlekelwa ukuqapha)
• Ukubanjwa okuncane (okugxile) (kungafaka noma yiziphi izimpawu ezichazwe ngenhla, kuya ngokuthi ubuchopho buqala kuphi ebuchosheni)

Udokotela uzokwenza ukuhlolwa komzimba. Lokhu kuzobandakanya ukubukeka okuningiliziwe ebuchosheni nasesimisweni sezinzwa.

Kuzokwenziwa i-EEG (electroencephalogram) ukuhlola ukusebenza kukagesi ebuchosheni. Abantu abanesithuthwane bavame ukuba nemisebenzi kagesi engajwayelekile ebonwe kulolu vivinyo. Kwezinye izimo, ukuhlolwa kukhombisa indawo ebuchosheni lapho kuqala khona ukuqubuka. Ubuchopho bungabonakala bujwayelekile ngemuva kokuquleka noma phakathi kokuquleka.

Ukuthola isifo sokuwa noma ukuhlela ukuhlinzeka ngesifo sokuwa, kungadingeka:

• Gqoka irekhoda ye-EEG izinsuku noma amasonto njengoba uqhubeka nempilo yakho yansuku zonke.
• Hlala esibhedlela esikhethekile lapho kungabhalwa khona imisebenzi yobuchopho ngenkathi amakhamera wevidiyo ethatha okwenzeka kuwe ngesikhathi sokubanjwa. Lokhu kubizwa nge-video EEG.

Ukuhlolwa okungenziwa kufaka phakathi:

• Amakhemikhali egazi
• Ushukela wegazi
• Qedela ukubalwa kwegazi (CBC)
• Ukuhlolwa kokusebenza kwezinso
• Ukuhlolwa kokusebenza kwesibindi
• Ukubhoboza i-Lumbar (umpompi womgogodla)
• Ukuhlolwa kwezifo ezithathelwanayo

Iskena se-Head CT noma se-MRI kuvame ukwenziwa ukuthola imbangela nendawo yendawo ebuchosheni.

Ukwelashwa kwesifo sokuwa kuhlanganisa ukuthatha imishanguzo, ukushintsha indlela ophila ngayo, futhi kwesinye isikhathi ukuhlinzwa.

Uma isithuthwane singenxa yesimila, imithambo yegazi engajwayelekile, noma ukuphuma kwegazi ebuchosheni, ukuhlinzwa ukwelapha lezi zinkinga kungenza ukuqubuka kuyeke.

Imithi yokuvikela ukuquleka, ebizwa ngokuthi ama-anticonvulsants (noma imishanguzo yokulwa nesifo sokuwa), inganciphisa inani lokuquleka esikhathini esizayo:

• Le mithi iphuzwa ngomlomo. Uhlobo olumisiwe oluncike ohlotsheni lokuquleka onakho.
• Umthamo wakho ungadinga ukuguqulwa ngezikhathi ezithile. Ungadinga ukuhlolwa kwegazi njalo ukubheka imiphumela engemihle.
• Njalo thatha umuthi wakho ngesikhathi futhi njengokuyalelwa. Ukuphuthelwa umthamo kungadala ukuthi ubambe. UNGAYEKISI ukuthatha noma ukushintsha imithi uwedwa. Khuluma nodokotela wakho kuqala.
• Imithi eminingi yesifo sokuwa idala ukukhubazeka kokuzalwa. Abesifazane abahlela ukukhulelwa kufanele batshele udokotela wabo kusengaphambili ukuze bakwazi ukulungisa imithi.

Izidakamizwa eziningi zesifo sokuwa zingathinta impilo yamathambo akho. Khuluma nodokotela wakho mayelana nokuthi uyawadinga yini amavithamini nezinye izithako.

Isifo sokuwa esingabi ngcono ngemuva kokuzanywa kwezidakamizwa ezi-2 noma ezi-3 zokulwa nokuquleka sibizwa ngokuthi "isithuthwane esiphikisayo ngokwezokwelapha." Kulokhu, udokotela angancoma ukuhlinzekwa ku:

• Susa amangqamuzana obuchopho angajwayelekile abanga ukuquleka.
• Beka i-vagal nerve stimulator (VNS). Le divayisi iyefana ne-pacemaker yenhliziyo. Kungasiza ukunciphisa inani lokuquleka.

Ezinye izingane zibekwa ekudleni okukhethekile ukusiza ukuvimbela ukuquleka. Okuthandwa kakhulu ukudla kwe-ketogenic. Ukudla okuphansi kuma-carbohydrate, njengokudla kwe-Atkins, nakho kungasiza kwabanye abantu abadala. Qiniseka ukuthi uxoxa nodokotela wakho ngalezi zinketho ngaphambi kokuzama.

Indlela yokuphila noma izinguquko kwezokwelapha zingakhuphula ubungozi bokuquleka kubantu abadala nezingane ezinesifo sokuwa. Khuluma nodokotela wakho mayelana:

• Izidakamizwa ezintsha ezinqunyiwe, amavithamini, noma izithasiselo
• Ukucindezeleka ngokomzwelo
• Ukugula, ikakhulukazi ukutheleleka
• Ukungalali
• Ukukhulelwa
• Ukweqa isilinganiso semithi yesithuthwane
• Ukusetshenziswa kotshwala noma ezinye izidakamizwa zokuzijabulisa
• Ukuvezwa kwezibane ezikhanyayo noma izikhuthazi
• I-Hyperventilation

Okunye ukucatshangelwa:

• Abantu abanesithuthwane kufanele bagqoke ubucwebe bezokwazisa bezokwelapha ukuze kutholakale ukwelashwa okusheshayo uma kwenzeka ukuquleka.
• Abantu abanesithuthwane esingalawulwa kahle akufanele bashayele. Hlola umthetho wezwe lakho wokuthi abantu abanomlando wokuquleka bavunyelwe yini ukushayela.
• UNGAYisebenzisi imishini noma wenze izinto ezingadala ukulahleka kokuqwashisa, njengokukhuphukela ezindaweni eziphakeme, ukuhamba ngebhayisikili nokubhukuda wedwa.

Ingcindezi yokuba nesifo sokuwa noma ukuba ngumnakekeli womuntu onesifo sokuwa kungasizwa ngokujoyina iqembu elisekelayo. Kula maqembu, amalungu abelana ngokuhlangenwe nakho okuvamile nezinkinga.

Abanye abantu abanesithuthwane bangakwazi ukunciphisa noma ngisho ukuyeka imishanguzo yabo yokulwa nokuquleka ngemuva kokungaququki iminyaka eminingana. Izinhlobo ezithile zesithuthwane ebuntwaneni ziyaphela noma zithuthuke ngeminyaka, imvamisa iba seminyakeni yentsha noma yama-20.

Kubantu abaningi, isithuthwane yisimo sempilo yonke. Kulezi zimo, kudingeka ukuthi kuqhutshekwe nemithi elwa nokuquleka. Kukhona ingozi ephansi kakhulu yokufa okungazelelwe ngesifo sokuwa.

Izinkinga zingafaka:

• Kunzima ukufunda
• Ukuphefumulela ukudla noma amathe emaphashini ngesikhathi sokudlikiza, okungadala i-aspiration pneumonia
• Ukulimala ngokuwa, ukuqhuma, ukuzilimaza, ukushayela noma ukusebenzisa imishini ngesikhathi sokudlikiza
• Ukulimala kobuchopho unomphela (isifo sohlangothi noma omunye umonakalo)
• Imiphumela emibi yemithi

Shayela inombolo yakho yendawo ephuthumayo (njenge-911) uma:

• Kungokokuqala umuntu eba nokuquleka
• Ukuquleka kwenzeka kumuntu ongagqokile isongo le-ID yezokwelapha (elinemiyalo echaza okufanele ukwenze)

Endabeni yomuntu oke waquleka phambilini, shayela u-911 nganoma yisiphi salezi zimo eziphuthumayo:

• Lokhu kuthatha isikhathi eside kunalokho umuntu anakho ngokuvamile, noma inombolo engajwayelekile yokuquleka komuntu
• Ukuquleka okuphindaphindiwe ngaphezu kwemizuzu embalwa
• Ukubanjwa okuphindaphindiwe lapho ukwazi noma indlela yokuziphatha ejwayelekile kungatholakali phakathi kwabo (status epilepticus)

Shayela udokotela wakho uma kukhona izimpawu ezintsha ezenzekayo:

• Ukulahleka kwezinwele
• Isicanucanu noma ukuhlanza
• I-Rash
• Imiphumela emibi yemithi, njengokuwozela, ukungahlaliseki, ukudideka, ukuthamba
• Ukudlidliza noma ukunyakaza okungajwayelekile, noma izinkinga ngokusebenzisana

Ayikho indlela eyaziwayo yokuvimbela isithuthwane. Ukudla ngendlela efanele nokulala, nokuziqhelelanisa notshwala nezidakamizwa ezingekho emthethweni kunganciphisa amathuba okubanga ukuquleka kubantu abanesithuthwane.

Nciphisa ingozi yokulimala ekhanda ngokugqoka isigqoko sokuzivikela ngesikhathi semisebenzi eyingozi. Lokhu kunganciphisa amathuba okulimala ebuchosheni okuholela ekuqulekeni nasekuhluthweni.

Ukuphazamiseka kwesifo; Isithuthwane - isithuthwane

• Ukuhlinzwa kobuchopho - ukukhishwa
• Isifo sokuwa kubantu abadala - okufanele ubuze udokotela wakho
• Isifo sokuwa ezinganeni - ukukhipha
• Isifo sokuwa ezinganeni - yini ongayibuza udokotela wakho
• Isithuthwane noma isithuthwane - ukukhipha
• Ukuquleka kwefebrile - okufanele ubuze udokotela wakho
• Ama-radiosurgery we-stereotactic - ukukhishwa

• Izakhiwo zobuchopho
• Uhlelo lwezitho zomzimba
• Iqhaza le-vagus nerve ku-isithuthwane
• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo
• Ukudlikizela - usizo lokuqala - uchungechunge

U-Abou-Khalil BW, uGallagher MJ, uMacdonald RL. Isifo sokuwa. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 101.

UGonzález HFJ, uYengo-Kahn A, uDJ Englot. Ukugqugquzela izinzwa ze-Vagus ekwelashweni kwesifo sokuwa. Umtholampilo weNeurosurg N Am. 2019; 30 (2): 219-230. I-PMID: 30898273 www.ncbi.nlm.nih.gov/pubmed/30898273.

UThiys RD, uSurges R, u-O'Brien TJ, uSander JW. Isifo sokuwa kubantu abadala. I-Lancet. 2019; 393 (10172): 689-701. I-PMID: 30686584 pubmed.ncbi.nlm.nih.gov/30686584/.

Wiebe S. Isifo sokuwa. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 375.