I-Multiple sclerosis

I-Multiple sclerosis (MS) isifo esizimele esithinta ubuchopho nomgogodla (uhlelo oluphakathi lwezinzwa).

I-MS ithinta abesifazane kakhulu kunabesilisa. Lesi sifo sitholakala kakhulu phakathi kweminyaka yobudala engama-20 kuye kwengama-40, kepha singabonakala kunoma yisiphi isikhathi.

I-MS ibangelwa ukulimala emgodleni we-myelin. Lo mgogodla yisembozo esivikelayo esizungeze amangqamuzana ezinzwa. Lapho lokhu kumbozwa kwezinzwa kulimele, amasiginali ezinzwa ahamba kancane noma ayama.

Ukulimala kwezinzwa kubangelwa ukuvuvukala. Ukuvuvukala kwenzeka lapho amaseli omzimba uqobo ehlasela isimiso sezinzwa. Lokhu kungenzeka kunoma iyiphi indawo yobuchopho, i-optic nerve, nentambo yomgogodla.

Akukaziwa ukuthi yini ngempela ebangela i-MS. Umcabango ovame kakhulu ukuthi ubangelwa igciwane, ukukhubazeka kofuzo, noma kokubili. Izici zemvelo nazo zingadlala indima.

Unamathuba amancane okuthuthukisa lesi simo uma unomlando womndeni we-MS noma uhlala engxenyeni yomhlaba lapho i-MS ijwayelekile khona.

Izimpawu ziyahlukahluka ngoba indawo nobukhulu bokuhlasela ngakunye kungahluka. Ukuhlaselwa kungahlala izinsuku, amasonto, noma izinyanga. Ukuhlaselwa kulandelwa ukuxolelwa. Lezi yizikhathi zezimpawu ezincishisiwe noma azikho izimpawu. Imfiva, ukugeza okushisayo, ukushiswa yilanga, kanye nengcindezi kungadala noma kuhlasele kakhulu ukuhlaselwa.

Kuvamile ukuthi lesi sifo sibuye (sibuyele emuva). Lesi sifo singaqhubeka nokuba sibi kakhulu ngaphandle kokuxolelwa.

Izinzwa kunoma iyiphi ingxenye yobuchopho noma umgogodla zingalimala. Ngenxa yalokhu, izimpawu ze-MS zingavela ezingxenyeni eziningi zomzimba.

Izimpawu zemisipha:

• Ukulahlekelwa ibhalansi
• Ukudumba kwemisipha
• Ukuba ndikindiki noma ukuzwa okungavamile kunoma iyiphi indawo
• Izinkinga zokuhambisa izingalo noma imilenze
• Izinkinga ukuhamba
• Izinkinga ngokuxhumanisa nokwenza ukunyakaza okuncane
• Ukuthuthumela engalweni eyodwa noma ngaphezulu noma emilenzeni
• Ubuthakathaka engalweni eyodwa noma ngaphezulu noma emilenzeni

Izimpawu zamathumbu nesinye:

• Ukuqunjelwa nokuqothuka kwendle
• Kunzima ukuqala ukuchama
• Isidingo esivela njalo sokuchama
• Isifiso esinamandla sokuchama
• Ukuvuza komchamo (ukungasebenzi)

Izimpawu zamehlo:

• Umbono ophindwe kabili
• Ukungaphatheki kahle kwamehlo
• Ukunyakaza kwamehlo okungalawuleki
• Ukulahleka kombono (kuvamise ukuthinta iso elilodwa ngasikhathi)

Ubuntununtunu, ukushoshozela, noma ubuhlungu:

• Ubuhlungu ebusweni
• Ubuhlungu bemisipha obuhlungu
• Ukuthungela, ukukhasa, noma umuzwa ovuthayo ezingalweni nasemilenzeni

Ezinye izimpawu zobuchopho nezinzwa:

• Ukwehla kwesikhathi sokunaka, ukwahlulela kabi, kanye nokulahleka kwememori
• Kunzima ukucabanga nokuxazulula izinkinga
• Ukudangala noma imizwa yokudabuka
• Isiyezi kanye nezinkinga zokulinganisela
• Ukulahlekelwa ukuzwa

Izimpawu zocansi:

• Izinkinga ngokufakwa
• Izinkinga zokugcoba kwesitho sangasese sowesifazane

Izimpawu zokukhuluma nokugwinya:

• Inkulumo eshwibeka noma enzima ukuyiqonda
• Inkinga yokuhlafuna nokugwinya

Ukukhathala kuyisifo esivamile futhi esihluphayo njengoba i-MS iqhubeka. Kuvame ukuba kubi kakhulu ntambama.

Izimpawu ze-MS zingalingisa lezo zezinye izinkinga eziningi zesistimu yezinzwa. I-MS itholakala ngokunquma ukuthi ngabe zikhona yini izimpawu zokuhlaselwa okungaphezu kokukodwa ebuchosheni noma emgogodleni nangokukhipha ezinye izimo.

Abantu abanesimo se-MS esibizwa ngokuthi yi-relapsing-remitting MS banomlando wokuhlaselwa okungenani kabili okuhlukaniswe nokuxolelwa.

Kwabanye abantu, lesi sifo singakhula kancane phakathi kokuhlaselwa okusobala. Leli fomu libizwa ngokuthi yi-MS yesibili eqhubekayo. Ifomu elinenqubekela phambili ehamba kancane, kepha akukho ukuhlaselwa okucacile okubizwa nge-MS okuqhubekayo okuyisisekelo.

Umhlinzeki wezokunakekelwa kwempilo angasola i-MS uma kukhona ukuncipha ekusebenzeni kwezingxenye ezimbili ezihlukene zesistimu yezinzwa emaphakathi (njengokucabanga okungajwayelekile) ngezikhathi ezimbili ezihlukene.

Ukuhlolwa kwesistimu yezinzwa kungabonisa ukunciphisa ukusebenza kwezinzwa endaweni eyodwa yomzimba. Noma umsebenzi wezinzwa owehlisiwe ungasakazeka ezingxenyeni eziningi zomzimba. Lokhu kungafaka:

• I-reflexes yezinzwa engajwayelekile
• Ukwehla kwekhono lokuhambisa ingxenye yomzimba
• Ukwehla noma ukuzwa okungavamile
• Okunye ukulahleka kwemisebenzi yesistimu yezinzwa, njengokubona

Ukuhlolwa kwamehlo kungakhombisa:

• Izimpendulo zomfundi ezingejwayelekile
• Izinguquko ezinkambeni ezibonakalayo noma ukunyakaza kwamehlo
• Ukwehla kokubuka okunciphile
• Izinkinga ngezingxenye zangaphakathi zeso
• Ukunyakaza kwamehlo okusheshayo kwaqala lapho iso lihamba

Ukuhlolwa kokuthola i-MS kufaka phakathi:

• Ukuhlolwa kwegazi ukukhipha ezinye izimo ezifana ne-MS.
• Ukubhoboza i-Lumbar (umpompi womgogodla) wezivivinyo ze-cerebrospinal fluid (CSF), kufaka phakathi i-CSF oligoclonal banding kungadingeka.
• Ukuskena kwe-MRI kobuchopho noma umgogodla, noma kokubili kubalulekile ukusiza ukuxilonga nokulandela i-MS.
• Ukutadisha umsebenzi wemizwa (okukhishwe ukuhlolwa okungenzeka, njengokuphendula okubukwayo okubukwayo) akuvamile ukusetshenziswa.

Alikho ikhambi elaziwayo le-MS ngalesi sikhathi, kepha kunezindlela zokwelapha ezingasinciphisa isifo. Inhloso yokwelashwa ukuyeka ukuqhubeka, izimpawu zokulawula, nokusiza ukuthi ugcine ikhwalithi ejwayelekile yokuphila.

Imithi ivame ukuphuzwa isikhathi eside. Lokhu kufaka phakathi:

• Imithi yokwehlisa lesi sifo
• Ama-steroid ukunciphisa ukwehla kobukhulu bokuhlaselwa
• Imithi yokulawula izimpawu ezinjenge-spasms yemisipha, izinkinga zomchamo, ukukhathala, noma izinkinga zemizwa

Imithi isebenza kangcono kwifomu lokubuyisela emuva kunezinye izinhlobo ze-MS.

Okulandelayo kungasiza nabantu abane-MS:

• Ukwelashwa ngokomzimba, ukwelashwa kokukhuluma, ukwelashwa emsebenzini, namaqembu okusekela
• Izinsiza ezisizayo, ezinjengezihlalo ezinamasondo, amalifti okulala, izihlalo zeshawa, izihambahamba nemigoqo yodonga
• Uhlelo lokuzivocavoca oluhleliwe ekuqaleni kwesifo
• Indlela yokuphila enempilo, enokudla okunomsoco nokuphumula okwanele nokuphumula
• Ukugwema ukukhathala, ingcindezi, ukweqisa kwezinga lokushisa, nokugula
• Izinguquko kokudlayo noma okuphuzwayo uma kunezinkinga zokugwinya
• Ukwenza izinguquko ekhaya ukuvimbela ukuwa
• Abasebenzi bezenhlalakahle noma ezinye izinsizakalo zokwelulekwa ukukusiza ukubhekana nalesi sifo futhi uthole usizo
• Uvithamini D noma ezinye izithako (khuluma nomhlinzeki wakho kuqala)
• Izindlela ezihambisanayo nezenye indlela, njenge-acupuncture noma i-cannabis, ukusiza ngezinkinga zemisipha
• Izinsimbi zomgogodla zinganciphisa ubuhlungu nokuqina kwemilenze

Ukuphila ne-MS kungaba yinselele. Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokuxhaswa le-MS. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Umphumela uyehluka, futhi kunzima ukubikezela.Yize lesi sifo sihlala isikhathi eside (esingapheli) futhi singelapheki, isikhathi sokuphila singaba sejwayelekile noma sicishe sijwayelekile. Iningi labantu abane-MS liyasebenza futhi lisebenza emsebenzini nokukhubazeka okuncane.

Labo abavame ukuba nombono omuhle kakhulu yilaba:

• Abesifazane
• Abantu ababebancane (abangaphansi kweminyaka engama-30 ubudala) ngenkathi kuqala lesi sifo
• Abantu abahlaselwa njalo
• Abantu abanephethini yokubuyisela emuva
• Abantu abanesifo esilinganiselwe ezifundweni ze-imaging

Inani lokukhubazeka nokungaphatheki kahle kuncike ku:

• Ukuhlasela kukaningi kangakanani futhi kubi kangakanani
• Ingxenye yesistimu yezinzwa emaphakathi ethintekayo ekuhlaselweni ngakunye

Iningi labantu libuyela emsebenzini ojwayelekile noma oseduze kokujwayelekile phakathi kokuhlaselwa. Ngokuhamba kwesikhathi, kukhona ukulahleka okukhulu komsebenzi ngokuthuthuka okuncane phakathi kokuhlaselwa.

I-MS ingaholela kokulandelayo:

• Ukucindezeleka
• Kunzima ukugwinya
• Kunzima ukucabanga
• Ikhono elincane nelincane lokuzinakekela
• Isidingo se-catheter yokuhlala
• I-osteoporosis noma ukuncipha kwamathambo
• Izilonda zengcindezi
• Imiphumela emibi yemithi esetshenziselwa ukwelapha lesi sifo
• Ukutheleleka ngomgudu womchamo

Shayela umhlinzeki wakho uma:

• Uba nezimpawu ze-MS
• Izimpawu zakho ziba zimbi kakhulu, ngisho nangokwelashwa
• Isimo siba sibi kakhulu lapho ukunakekelwa kwasekhaya kungasenakwenzeka

MS; Ukubulala izifo

• Ukunakekela ukuqina kwemisipha noma ama-spasms
• Ukuqunjelwa - ukuzinakekela
• Uhlelo lokunakekelwa kwamathumbu nsuku zonke
• Multiple sclerosis - ukukhipha
• Ukuvimbela izilonda zengcindezi
• Izinkinga zokugwinya

• I-Multiple sclerosis
• I-MRI yobuchopho
• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo
• I-Myelin nesakhiwo sezinzwa

ICalabresi PA, Multiple sclerosis kanye nezimo zokudonswa phansi kohlelo lwezinzwa oluphakathi. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 383.

UFabian MT, uKrieger SC, uLublin FD. I-Multiple sclerosis nezinye izifo zokuvuvukala ezidiliza uhlelo lwesistimu yezinzwa. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 80.

URae-Grant A, uSuku lwe-GS, uMarrie RA, et al. Isifinyezo sezincomo zomhlahlandlela wokuzijwayeza: izindlela zokwelapha eziguqula izifo zabantu abadala abane-multiple sclerosis: umbiko we-Guideline Development, Dissemination, kanye ne-Implementation Subcommittee ye-American Academy of Neurology. Neurology. 2018; 90 (17): 777-788. I-PMID: 29686116 pubmed.ncbi.nlm.nih.gov/29686116.