I-Osmotic demyelination syndrome

I-Osmotic demyelination syndrome (ODS) ukungasebenzi kweseli lobuchopho. Kubangelwa ukubhujiswa kongqimba (i-myelin sheath) emboza amangqamuzana ezinzwa maphakathi ne-brainstem (pons).

Lapho umgogodla we-myelin ohlanganisa amangqamuzana ezinzwa ubhujiswa, amasiginali asuka kolunye uhlangothi aya kolunye awadluliswa kahle. Yize i-brainstem ithinteka kakhulu, ezinye izindawo zobuchopho nazo zingabandakanyeka.

Isizathu esivame kakhulu se-ODS ukushintsha okusheshayo emazingeni e-sodium yomzimba. Lokhu kwenzeka kakhulu lapho umuntu elashelwa i-sodium ephansi yegazi (i-hyponatremia) bese kuthi i-sodium ishintshwe ngokushesha okukhulu. Kwesinye isikhathi, kwenzeka lapho izinga eliphezulu le-sodium emzimbeni (hypernatremia) lilungiswa ngokushesha okukhulu.

I-ODS ayivamisile ukwenzeka yodwa. Ngokuvamile, kuyinkinga yokwelashwa kwezinye izinkinga, noma kwezinye izinkinga ngokwazo.

Izingozi zifaka:

• Ukusetshenziswa kotshwala
• Isifo sesibindi
• Ukungondleki kahle kwezifo ezimbi
• Ukwelashwa ngemisebe yobuchopho
• Isicanucanu esikhulu nokuhlanza ngesikhathi sokukhulelwa

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukudideka, i-delirium, ukusangana
• Izinkinga zebhalansi, ukuthuthumela
• Inkinga yokugwinya
• Ukuphaphama okwehlisiwe, ukozela noma ukulala, ukukhathala, izimpendulo ezingezinhle
• Inkulumo eshisiwe
• Ubuthakathaka ebusweni, izingalo, noma imilenze, imvamisa kuthinta izinhlangothi zombili zomzimba

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu.

Iskena se-MRI ekhanda singaveza inkinga ku-brainstem (pons) noma kwezinye izingxenye zobuchopho. Lokhu ukuhlolwa okuyinhloko kokuxilonga.

Ezinye izivivinyo zingafaka:

• Izinga le-sodium yegazi nokunye ukuhlolwa kwegazi
• Ukuphendula okukhishwe kwe-Brainstem audition (BAER)

I-ODS yisifo esiphuthumayo esidinga ukwelashwa esibhedlela yize abantu abaningi abanalesi simo sebesesibhedlela enye inkinga.

Alikho ikhambi elaziwayo le-pontine myelinolysis ephakathi. Ukwelashwa kugxile ekunciphiseni izimpawu.

Ukwelashwa ngokomzimba kungasiza ekugcineni amandla emisipha, ukuhamba, nokusebenza ezingalweni nasemilenzeni ebuthakathaka.

Umonakalo wezinzwa obangelwa yi-pontine myelinolysis emaphakathi uvame ukuhlala isikhathi eside. Lesi sifo singadala ukukhubazeka okukhulu kwesikhathi eside (okungapheli).

Izinkinga zingafaka:

• Ukwehla kwamandla okuxhumana nabanye
• Ukwehla kwekhono lokusebenza noma lokuzinakekela
• Ukungakwazi ukunyakaza, ngaphandle kokucwayiza amehlo ("kukhiyelwe" isifo)
• Ukulimala okungapheli kwesistimu yezinzwa

Asikho isiqondiso sangempela sokuthi ungaluthola nini usizo lwezokwelapha, ngoba i-ODS ayivamile emphakathini jikelele.

Esibhedlela, ukwelashwa okuhamba kancane, okulawulwayo kwezinga eliphansi le-sodium kunganciphisa ubungozi bokulimala kwezinzwa emaphoyiseni.Ukwazi ukuthi eminye imithi ingashintsha kanjani amazinga e-sodium kungavimbela ileveli ekushintsheni ngokushesha okukhulu.

I-ODS; Ukudilizwa kwePentine central

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo

U-Weissenborn K, uLockwood AH. I-encephalopathies enobuthi ne-metabolic. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 84.

I-Yaqoob MM, iMcCafferty K. Ibhalansi yamanzi, uketshezi nama-electrolyte. Ku: Uphaphe A, uRandall D, iWaterhouse M, ama-eds. Imitholampilo kaKumar noClarke. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2021: isahluko 9.