Ikhanda le-Cluster

Ikhanda le-cluster luhlobo olungavamile lwekhanda.Ubuhlungu bekhanda obusemaceleni obunye obungabandakanya ukudabuka kwamehlo, ijwabu leso elixegayo, nekhala eligcwele. Ukuhlaselwa kuthatha imizuzu eyi-15 kuye emahoreni ama-3, kwenzeka nsuku zonke noma cishe nsuku zonke amasonto noma izinyanga. Ukuhlaselwa kwehlukaniswa yizikhathi ezingenazinhlungu ezihlala okungenani inyanga eyodwa noma ngaphezulu.

Amakhanda e-Cluster angadideka nezinye izinhlobo ezivamile zekhanda ezifana ne-migraines, i-sinus headache, ne-tension headache.

Odokotela abazi kahle ukuthi yini ebangela ikhanda le-cluster. Kubonakala sengathi zihlobene nokukhishwa okungazelelwe komzimba kwe-histamine (ikhemikhali emzimbeni ekhishwe ngesikhathi sokuphendula okweqile) noma i-serotonin (ikhemikhali elenziwa ngamangqamuzana ezinzwa) endaweni yethambo ebusweni elibizwa ngokuthi i-trigeminal nerve. Inkinga endaweni encane esisezansi kobuchopho ebizwa nge-hypothalamus ingahle ibandakanyeke.

Amadoda amaningi kunabesifazane ayathinteka. Ikhanda lingenzeka nganoma yisiphi isikhathi, kepha livame kakhulu kuma-20s kuya eminyakeni yobudala ephakathi. Bajwayele ukugijima emindenini.

Ukuphathwa yikhanda kweCluster kungabangelwa:

• Ukuphuza utshwala nogwayi
• Ukuphakama okuphezulu (ukuhamba ngezinyawo nokuhamba ngomoya)
• Ukukhanya okukhanyayo (kufaka phakathi ilanga)
• Ukuzivocavoca (ukuvivinya umzimba)
• Ukushisa (isimo sezulu esishisayo noma okugeza okushisayo)
• Ukudla okuphezulu kuma-nitrites (ubhekeni nenyama elondoloziwe)
• Imithi ethile
• Cocaine

Ikhanda lekhanda liqala njengekhanda elibuhlungu, elizumayo. Ikhanda elibuhlungu livame ukushaya amahora amabili kuya kwamathathu ngemuva kokulala. Kepha kungenzeka futhi uma uphapheme. Ikhanda livame ukwenzeka nsuku zonke ngasikhathi sosuku. Ukuhlaselwa kungahlala izinyanga. Bangashintshana nezikhathi ngaphandle kwezinhlungu zekhanda (i-episodic) noma bangaqhubeka unyaka noma ngaphezulu ngaphandle kokuma (okungamahlalakhona).

Ubuhlungu bekhanda le-Cluster imvamisa:

• Ukushisa, ukubukhali, ukugwaza, noma ukuzinza
• Bezizwa ohlangothini olulodwa lobuso kusuka entanyeni kuya ethempelini, imvamisa kufaka iso
• Ngesikhathi sayo esibi kakhulu phakathi kwemizuzu emi-5 kuye kwayi-10, lapho ubuhlungu obuqine kakhulu buhlala imizuzu engama-30 kuye emahoreni amabili

Lapho iso nekhala ohlangothini olufanayo nobuhlungu bekhanda kuthinteka, izimpawu zingafaka:

• Ukuvuvukala ngaphansi noma ezungeze iso (kungathinta womabili amehlo)
• Ukudabuka ngokweqile
• Iso elibomvu
• Ijwabu leso le-Droopy
• Iphunga eligijimayo noma ikhala eligcwele ohlangothini olufanayo nobuhlungu bekhanda
• Ubomvu, ubuso obucwilile, nokujuluka okukhulu

Umhlinzeki wakho wokunakekelwa kwezempilo angaxilonga lolu hlobo lwekhanda ngokwenza ukuhlolwa komzimba nokubuza ngezimpawu zakho nomlando wezokwelapha.

Uma ukuhlolwa komzimba kwenziwa ngesikhathi sokuhlaselwa, ukuhlolwa kuvame ukuveza i-Horner syndrome (ukudonsa kwejwabu leso elilodwa noma umfundi omncane). Lezi zimpawu ngeke zibe khona ngezinye izikhathi. Azikho ezinye izinguquko zesistimu yezinzwa (neurologic) ezizobonakala.

Ukuhlolwa, okufana neMRI yekhanda, kungadingeka ukukhipha ezinye izimbangela zekhanda.

Ukwelashwa kwekhanda leqoqo kuhlanganisa:

• Imithi yokwelapha ubuhlungu lapho kwenzeka
• Imithi yokuvikela ikhanda

UKULAPHA AMAKHANDA E-CLUSTER UMA KUQHUBEKA

Umhlinzeki wakho angancoma ukwelashwa okulandelayo lapho kuvela ikhanda:

• Imithi yeTriptan, njenge sumatriptan (Imitrex).
• Imithi elwa nokuvuvukala (i-steroid) efana ne-prednisone. Ukuqala ngomthamo omkhulu, bese wehlisa kancane ngaphezu kwamasonto amabili kuya kwamathathu.
• Ukuphefumula nge-100% (okumsulwa) oksijini.
• Imijovo ye-dihydroergotamine (DHE), engamisa ukuhlaselwa kweqoqo phakathi kwemizuzu engu-5 (Isexwayiso: lo muthi ungaba yingozi uma uthathwe nge-sumatriptan).

Ungadinga okungaphezu kweyodwa kwalezi zindlela zokulawula ikhanda lakho. Umhlinzeki wakho kungenzeka ukuthi uzame imithi eminingi ngaphambi kokunquma ukuthi yikuphi okukusebenzela kangcono.

Imithi yezinhlungu kanye nama-narcotic akuvame ukuqeda izinhlungu zekhanda le-cluster ngoba kuthatha isikhathi eside ukusebenza.

Ukwelashwa ngokuhlinzwa kunganconywa kuwe lapho zonke ezinye izindlela zokwelapha zehlulekile. Enye yezindlela zokwelapha yi-neurostimulator. Lo mshini uletha amasiginali kagesi amancane emithanjeni ethile enjenge-occipital nerve ekhanda. Umhlinzeki wakho angakutshela okuningi ngokuhlinzwa.

UKUVIMBELA AMAKHANDA AKHULU E-CLUSTER

Gwema ukubhema, ukusebenzisa uphuzo oludakayo, ukudla okuthile, nezinye izinto ezibangela ikhanda lakho. Idayari yekhanda ingakusiza ukukhomba okubangela ikhanda lakho. Uma uphathwa yikhanda, bhala phansi okulandelayo:

• Imini nesikhathi ubuhlungu baqala
• Okudlile nokuphuzile emahoreni angama-24 adlule
• Ulele kangakanani
• Obukwenza futhi ubukuphi lapho ubukhona khona ngaphambi kokuba kuqale ubuhlungu
• Laphela ikhanda isikhathi esingakanani nokuthi yini eyenze layeka

Buyekeza idayari yakho nomhlinzeki wakho ukukhomba izimbangela noma iphethini ekhanda lakho. Lokhu kungakusiza wena nomhlinzeki wakho ukudala uhlelo lokwelashwa. Ukwazi izimbangela zakho kungakusiza ukuzigweme.

Ukuphathwa yikhanda kungazimela noma ungadinga ukwelashwa ukuzivikela. Le mithi elandelayo ingasetshenziswa ukwelapha noma ukuvimbela izimpawu zekhanda:

• Imithi yokungezwani komzimba
• Izidambisi
• Imithi yengcindezi yegazi
• Umuthi wokuquleka

Ukuphathwa yikhanda kweCluster akusongeli impilo. Imvamisa azibangeli izinguquko zaphakade ebuchosheni. Kepha zihlala isikhathi eside (ezingapheli), futhi zihlala zibuhlungu ngokwanele ukuthi zingaphazamisa umsebenzi nokuphila.

Shayela ku-911 uma:

• Uhlangabezana "nekhanda elibi kakhulu empilweni yakho."
• Unezinkinga zokukhuluma, umbono, noma ukunyakaza noma ukulahlekelwa ibhalansi, ikakhulukazi uma ungakaze ube nalezi zimpawu ngekhanda ngaphambili.
• Ikhanda liqala kungazelelwe.

Hlela i-aphoyintimenti noma shayela umhlinzeki wakho uma:

• Iphethini yakho yekhanda noma ubuhlungu buyashintsha.
• Ukwelashwa okwake kwasebenza akusasizi.
• Unemiphumela engemihle evela emithini yakho.
• Ukhulelwe noma ungakhulelwa. Eminye imithi akufanele iphuzwe ngesikhathi sokukhulelwa.
• Udinga ukuthatha imithi yezinhlungu ngaphezu kwezinsuku ezi-3 ngeviki.
• Ikhanda lakho linzima kakhulu lapho ulele phansi.

Uma ubhema, manje yisikhathi esihle sokuyeka. Ukusetshenziswa kotshwala nokunye ukudla okubangela ikhanda leqoqo kungadinga ukugwenywa. Imithi ingavimbela ikhanda le-cluster kwezinye izimo.

Ikhanda le-Histamine; Ikhanda - i-histamine; I-neuralgia eguqukayo; Ikhanda - iqoqo; Ikhanda likaHorton; Ikhanda le-Vascular - iqoqo; Ikhanda leqoqo le-Episodic; Isifo sekhanda esingapheli

• Ukuphathwa ikhanda - ukuthi yini okufanele uyibuze udokotela wakho

• Ubuchopho
• I-Hypothalamus
• Imbangela yekhanda
• Ubuhlungu bekhanda leqoqo

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UHoffmann J, Meyi A. Ukuxilongwa, i-pathophysiology, kanye nokuphathwa kwekhanda leqoqo. ILancet Neurol. 2018; 17 (1): 75-83. I-PMID: 29174963 www.ncbi.nlm.nih.gov/pubmed/29174963.

I-Rozental JM. Ikhanda elibuhlungu, uhlobo lwekhanda olungapheli, nezinye izinhlobo zekhanda ezingalapheki. Ku: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, ama-eds. Okubalulekile Kwemithi Yezinhlungu. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2018: isahluko 20.