Multiple system atrophy - uhlobo lweparkinsonia

Izinhlobo eziningi ze-atrophy- parkinsonian type (MSA-P) yisimo esingajwayelekile esidala izimpawu ezifana nesifo i-Parkinson. Kodwa-ke, abantu abane-MSA-P banomonakalo osabalele engxenyeni yesistimu yezinzwa elawula imisebenzi ebalulekile njengokushaya kwenhliziyo, umfutho wegazi nokujuluka.

Enye ingxenye engezansi ye-MSA yi-MSA-cerebellar. Kakhulu kuthinta izindawo ezijulile ebuchosheni, ngenhla nje komgogodla.

Imbangela yeMSA-P ayaziwa. Izindawo ezithintekile zobuchopho ziyagqagqana nezindawo ezithintwe yisifo i-Parkinson, ezinezimpawu ezifanayo. Ngalesi sizathu, le nhlobo engezansi ye-MSA ibizwa nge-parkinsonian.

I-MSA-P ivame ukutholakala emadodeni amadala kunama-60.

I-MSA ilimaza uhlelo lwezinzwa. Lesi sifo sivame ukuthuthuka ngokushesha. Cishe uhhafu wabantu abane-MSA-P balahlekelwe iningi lamakhono abo ezimoto kungakapheli iminyaka emihlanu lesi sifo siqale.

Izimpawu zingafaka:

• Ukuthuthumela
• Ubunzima bokuhamba, njengokuhamba kancane, ukulahlekelwa ibhalansi, ukushova lapho uhamba
• Ukuwa njalo
• Ubuhlungu bemisipha nezinhlungu (myalgia), nokuqina
• Izinguquko ebusweni, njengokuvela kobuso obufana nobuso nokugqolozela
• Kunzima ukuhlafuna noma ukugwinya (ngezikhathi ezithile), ukungakwazi ukuvala umlomo
• Amaphethini wokulala aphazamisekile (imvamisa phakathi nokunyakaza kwamehlo okusheshayo [REM] ukulala ebusuku)
• Isizungu noma ukuquleka lapho umile noma ngemuva kokuma unganyakazi
• Izinkinga zokwakhiwa
• Ukulahlekelwa ukulawula amathumbu noma isinye
• Izinkinga ngomsebenzi odinga ukunyakaza okuncane (ukulahleka kwamakhono emoto amahle), njengokubhala okuncane futhi okunzima ukufundwa
• Ukulahlekelwa ukujuluka kunoma iyiphi ingxenye yomzimba
• Yehla ekusebenzeni kwengqondo
• I-nausea nezinkinga ngokugaya
• Izinkinga zokuma, njengokungazinzi, ukugoba, noma ukwehla
• Ukushintsha kombono, ukwehla noma ukufiphala kwamehlo
• Izinguquko zezwi nezenkulumo

Ezinye izimpawu ezingase zivele ngalesi sifo:

• Ukudideka
• Ukuwohloka komqondo
• Ukucindezeleka
• Ubunzima bokuphefumula obuhlobene nokulala, kufaka phakathi i-apnea yokulala noma ukuvinjelwa endimeni yomoya okuholela emsindweni onzima

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlola, futhi akuhlole amehlo, izinzwa nemisipha.

Umfutho wegazi lakho uzothathwa ngenkathi ulele phansi futhi umile.

Azikho izivivinyo ezithile zokuqinisekisa lesi sifo. Udokotela ogxile ohlelweni lwezinzwa (i-neurologist) angenza ukuxilongwa kususelwe ku:

• Umlando wezimpawu
• Imiphumela yokuhlolwa ngokomzimba
• Ukukhipha ezinye izimbangela zezimpawu

Ukuhlolwa ukusiza ukuqinisekisa ukuxilongwa kungafaka:

• I-MRI yekhanda
• Amazinga wePlasma norepinephrine
• Ukuhlolwa komchamo kwemikhiqizo yokuwohloka kwe-norepinephrine (ama-catecholamines womchamo)

Alikho ikhambi le-MSA-P. Ayikho indlela eyaziwayo yokuvimbela lesi sifo ukuthi sande kakhulu. Umgomo wokwelashwa ukulawula izimpawu.

Imithi ye-Dopaminergic, efana ne-levodopa ne-carbidopa, ingasetshenziselwa ukunciphisa ukuzamazama kokuqala noma okuncane.

Kepha, kubantu abaningi abane-MSA-P, le mithi ayisebenzi kahle.

Imithi ingasetshenziselwa ukwelapha umfutho wegazi ophansi.

I-pacemaker eyenzelwe ukushukumisa inhliziyo ukuba ishaye ngesivinini esisheshayo (esheshayo ukwedlula i-100 beats ngomzuzu) ingakhuphula umfutho wegazi kwabanye abantu.

Ukuqunjelwa kungalashwa ngokudla okune-fiber ephezulu kanye nama-laxatives. Kunemithi yokwelapha izinkinga zokwakhiwa.

Imininingwane engaphezulu nokusekelwa kwabantu abane-MSA-P nemindeni yabo kungatholakala ku:

• Inhlangano Kazwelonke Yezinkinga Ezingajwayelekile - rarediseases.org/rare-diseases/multiple-system-atrophy
• I-MSA Coalition - www.multiplesystematrophy.org/msa-resource/

Umphumela we-MSA mubi. Ukulahleka kwemisebenzi yengqondo nengokwenyama kuya ngokuya kuba kubi. Ukufa ngaphambi kwesikhathi kungenzeka. Ngokuvamile abantu baphila iminyaka engu-7 kuya kwengu-9 ngemuva kokuxilongwa.

Shayela umhlinzeki wakho uma uba nezimpawu zalesi sifo.

Shayela umhlinzeki wakho uma utholwe une-MSA futhi izimpawu zakho ziyabuya noma ziba zimbi kakhulu. Shayela futhi uma kuvela izimpawu ezintsha, kufaka phakathi imiphumela emibi yemithi, efana:

• Izinguquko ekuqapheleni / ekuziphatheni / kwemizwa
• Ukuziphatha okukhohlisayo
• Isiyezi
• Ukusangana
• Ukunyakaza okungazinikeli
• Ukulahleka kokusebenza kwengqondo
• Isicanucanu noma ukuhlanza
• Ukudideka okukhulu noma ukudideka

Uma unelungu lomndeni eline-MSA futhi isimo salo sincipha size singakwazi ukunakekela umuntu ekhaya, funa iseluleko kumhlinzeki welungu lomndeni wakho.

I-Shy-Drager syndrome; I-neurologic orthostatic hypotension; I-Shy-McGee-Drager syndrome; I-Parkinson plus syndrome; I-MSA-P; I-MSA-C

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo

UFanciulli A, Wenning GK. Multiple-system yoma. N Engl J Med. 2015; 372 (3): 249-263. I-PMID: 25587949 pubmed.ncbi.nlm.nih.gov/25587949/.

Isifo sikaJankovic J. Parkinson nezinye izinkinga zokuhamba. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 96.

URomero-Ortuno R, uWilson KJ, uHampton JL. Ukuphazamiseka kwesistimu yezinzwa ezizimele. Ku: Gcwalisa i-HM, i-Rockwood K, i-Young J, ama-eds. Incwadi kaBrocklehurst ye-Geriatric Medicine ne-Gerontology. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2017: isahluko 63.