Isifo sokuwa ezinganeni

Isifo sokuwa ukuphazamiseka kobuchopho lapho umuntu ephindaphindwe ukuqubuka ngokuhamba kwesikhathi.

Ukuquleka kungukushintsha okungazelelwe kokusebenza kwamandla kagesi namakhemikhali ebuchosheni. Ukuquleka okukodwa okungenzeki futhi AKUSONA isifo sokuwa.

Isifo sokuwa kungenzeka ngenxa yesimo sezokwelapha noma ukulimala okuthinta ubuchopho. Noma imbangela ingaziwa.

Izimbangela ezivamile zesifo sokuwa zihlanganisa:

• Ukulimala kwengqondo okubuhlungu
• Ukulimala noma isibazi ngemuva kokutheleleka kobuchopho
• Ukukhubazeka kokuzalwa okubandakanya ubuchopho
• Ukulimala kobuchopho okwenzeka ngesikhathi sokuzalwa noma esiseduze
• Izinkinga ze-Metabolic ezikhona lapho kuzalwa (njenge-phenylketonuria)
• Isimila sobuchopho seBenign, imvamisa sincane kakhulu
• Imithambo yegazi engajwayelekile ebuchosheni
• Unhlangothi
• Ezinye izifo ezilimaza noma ezichithe izicubu zobuchopho

Ukuquleka kwesithuthwane kuvame ukuqala phakathi kweminyaka yobudala eyi-5 nengama-20. Kodwa kungenzeka nganoma yisiphi isikhathi. Kungaba nomlando womndeni wesifo sokuwa noma sokuwa.

Ukuquleka okuncane kuyisifo sokudlikizela kwengane ebangelwa umkhuhlane. Esikhathini esiningi, ukuquleka ngesifo esibi akusona isibonakaliso sokuthi ingane inesifo sokuwa.

Izimpawu ziyahlukahluka kuye ngengane. Ezinye izingane zingavele zigqolozele. Abanye bangazanyazanyiswa ngamandla futhi bangabe besaphaphama. Ukuhamba noma izimpawu zokuquleka kungaxhomeka engxenyeni yobuchopho ethintekile.

Umhlinzeki wezokunakekelwa kwempilo yengane yakho angakutshela kabanzi ngohlobo oluthile lokubanjwa ingane yakho engaba nakho:

• Ukungabikho (petit mal) ukuthathwa: Ukugqolozela
• Ukubanjwa kwe-tonic-clonic (i-grand mal) ejwayelekile: Kuhlanganisa wonke umzimba, kufaka phakathi i-aura, imisipha eqinile, kanye nokulahlekelwa ukuqapha
• Ukubanjwa okuncane (okugxile): Kungabandakanya noma yiziphi izimpawu ezichazwe ngenhla, kuya ngokuthi ubuchopho buqala kuphi ebuchosheni

Isikhathi esiningi, ukuquleka kuyefana nokwangaphambi kwaso. Ezinye izingane zinomuzwa ongajwayelekile ngaphambi kokuquleka. Ukuzwa kungahle kube ukushoshozela, ukuhogela iphunga elingekho empeleni, ukuzwa ukwesaba noma ukukhathazeka ngaphandle kwesizathu noma ukuba nomuzwa wokuthi sekusondele (ukuzwa ukuthi kukhona okwenzekile ngaphambili). Lokhu kubizwa ngokuthi i-aura.

Umhlinzeki uzo:

• Buza ngomlando wezempilo nomndeni wengane yakho ngokuningiliziwe
• Buza ngesiqephu sokuquleka
• Yenza ukuhlolwa kwengane yakho ngokomzimba, kufaka phakathi ukubheka okuningiliziwe ebuchosheni nasesimisweni sezinzwa

Umhlinzeki uzo-oda i-EEG (electroencephalogram) ukuhlola ukusebenza kukagesi ebuchosheni. Lokhu kuhlolwa kuvame ukukhombisa noma yimuphi umsebenzi kagesi ongajwayelekile ebuchosheni. Kwezinye izimo, ukuhlolwa kukhombisa indawo ebuchosheni lapho kuqala khona ukuqubuka. Ubuchopho bungabonakala bujwayelekile ngemuva kokuquleka noma phakathi kokuquleka.

Ukuthola isifo sokuwa noma ukuhlela ukuhlinzwa kwesifo sokuwa, ingane yakho ingadinga:

• Gqoka irekhoda ye-EEG izinsuku ezimbalwa phakathi nemisebenzi yansuku zonke
• Hlala esibhedlela lapho umsebenzi wobuchopho ungabukwa khona kumakhamera evidiyo (ividiyo EEG)

Umhlinzeki futhi anga-oda ezinye izivivinyo, 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. Kancane kakhulu, ukuskena kwe-PET kobuchopho kuyadingeka ukusiza ukuhlela ukuhlinzwa.

Ukwelashwa kwesifo sokuwa kuhlanganisa:

• Imithi
• Izinguquko zendlela yokuphila
• Ukuhlinzwa

Uma isifo sokuwa kwengane yakho kungenxa yesimila, imithambo yegazi engajwayelekile, noma ukuphuma kwegazi ebuchosheni, kungadingeka ukuhlinzwa.

Imithi yokuvikela ukuquleka ibizwa ngama-anticonvulsants noma imishanguzo yokulwa nesifo sokuwa. Lokhu kunganciphisa inani lokuhlaselwa yisikhathi esizayo.

• Le mithi iphuzwa ngomlomo. Uhlobo lomuthi olunqunyiwe luxhomeke ohlotsheni lokubanjwa kwengane yakho.
• Umthamo ungadinga ukuguqulwa ngezikhathi ezithile. Umhlinzeki anga-oda ukuhlolwa kwegazi njalo ukubheka imiphumela engemihle.
• Ngaso sonke isikhathi qiniseka ukuthi ingane yakho iphuza umuthi ngesikhathi futhi njengoba kuqondisiwe. Ukuphuthelwa umthamo kungadala ukuthi ingane yakho iquleke. Ungayeki noma ushintshe imithi ngokwakho. Khuluma nomhlinzeki kuqala.

Izidakamizwa eziningi zesifo sokuwa zingathinta impilo yethambo lengane yakho. Khuluma nomhlinzeki wengane yakho mayelana nokuthi ingane yakho iyawadinga yini amavithamini nezinye izithako.

Isifo sokuwa esingalawulwa kahle ngemuva kokuzama imishanguzo eminingi yokulwa nesifo sengculaza 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. Qiniseka ukuthi uxoxa ngalezi zinketho nomhlinzeki wengane yakho ngaphambi kokuzama.

Isithuthwane ngokuvamile yisifo esihlala impilo yonke noma esingelapheki. Izinkinga ezibalulekile zokuphatha zifaka:

• Ukuthatha imithi
• Ukuhlala uphephile, njengokuthi ungalokothi ubhukuda wedwa, ukuwa phansi kwekhaya lakho njalonjalo
• Ukulawula ukucindezeleka nokulala
• Ukugwema ukusebenzisa kabi utshwala nezidakamizwa
• Ukuqhubeka esikoleni
• Ukuphatha ezinye izifo

Ukuphatha lezi zindlela zokuphila noma zezokwelapha ekhaya kungaba yinselele. Qiniseka ukuthi ukhuluma nomhlinzeki wengane yakho uma unezinkinga.

Ingcindezi yokuba ngumnakekeli wengane enesithuthwane kungasizwa ngokujoyina iqembu elisekelayo. Kula maqembu, amalungu abelana ngokuhlangenwe nakho okuvamile nezinkinga.

Iningi lezingane ezinesifo sokuwa ziphila impilo ejwayelekile. Izinhlobo ezithile zesithuthwane ebuntwaneni ziyaphela noma zithuthuke ngeminyaka, imvamisa iba seminyakeni yentsha noma yama-20. Uma ingane yakho ingenakho ukuquleka iminyaka embalwa, umhlinzeki angase ayeke imithi.

Ezinganeni eziningi, isifo sokuwa yisimo sempilo yonke. Kulezi zimo, imithi idinga ukuqhubeka.

Izingane ezinezinkinga zokukhula ngaphezu kwesifo sokuwa zingabhekana nezinselelo kukho konke ukuphila kwazo.

Ukwazi kabanzi ngalesi simo kuzokusiza ukuthi unakekele kangcono isithuthwane sengane yakho.

Izinkinga zingafaka:

• Kunzima ukufunda
• Ukuphefumulela ukudla noma amathe emaphashini ngesikhathi sokudlikiza, okungadala i-aspiration pneumonia
• Ukushaya kwenhliziyo okungajwayelekile
• Ukulimala ngokuwa, ukuqhuma, noma ukulunywa okuzimele ngesikhathi sokudlikiza
• Ukulimala kobuchopho unomphela (isifo sohlangothi noma omunye umonakalo)
• Imiphumela emibi yemithi

Shayela ku-911 noma inombolo ephuthumayo yendawo uma:

• Lesi yisikhathi sokuqala lapho ingane yakho iquleka
• Ukuquleka kwenzeka enganeni engagqokile isongo le-ID yezokwelapha (elinemiyalo echaza okufanele yenziwe)

Uma ingane yakho iqulekile phambilini, shayela u-911 noma inombolo yendawo ephuthumayo yendawo nganoma yisiphi salezi zimo eziphuthumayo:

• Ukubanjwa kukude kunengane evamise ukuba nayo noma ingane inenombolo engajwayelekile yokuquleka
• Ingane iphinde yaquleka kaningi ngaphezu kwemizuzu embalwa
• Ingane ibanjwe yisifo sokuquleka okuphindaphindiwe lapho ukwazi noma ukuziphatha okujwayelekile kungatholakali phakathi kwabo (status epilepticus)
• Ingane iyalimala ngesikhathi sokudlikiza
• Ingane inenkinga yokuphefumula

Shayela umhlinzeki uma ingane yakho inezimpawu ezintsha:

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

Xhumana nomhlinzeki noma ngabe ingane yakho ijwayelekile ngemuva kokuthi ukumiswa sekuyekile.

Ayikho indlela eyaziwayo yokuvimbela isithuthwane. Ukudla okufanele nokulala kunganciphisa amathuba okuquleka ezinganeni ezinesithuthwane.

Nciphisa ubungozi bokulimala ekhanda ngesikhathi semisebenzi eyingozi. Lokhu kunganciphisa amathuba okulimala ebuchosheni okuholela ekuqulekeni nasekuhluthweni.

Ukuphazamiseka kwengqondo - izingane; Ukudlikizela - isithuthwane ebuntwaneni; Isifo sokuwa sasebuntwaneni esiphikisayo; I-anticonvulsant - isithuthwane ebuntwaneni; Isidakamizwa se-antiepileptic - isithuthwane ebuntwaneni; I-AED - isithuthwane ebuntwaneni

UDwivedi R, uRamanujam B, uChandra PS, et al. Ukuhlinzwa kwesifo sokuwa okungazweli emthini ezinganeni. N Engl J Med. 2017; 377 (17): 1639-1647. PMID: 29069568 kushicilelwe.ncbi.nlm.nih.gov/29069568/.

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UKanner AM, u-Ashman E, uGloss D, et al. Isifinyezo sokubuyekeza umhlahlandlela wokuzijwayeza: ukusebenza nokubekezeleleka kwemithi emisha yokulwa nesifo sokuwa I: ukwelashwa kwesifo sokuwa okusha: umbiko we-American Epilepsy Society kanye ne-Guideline Development, Dissemination, kanye ne-Implementation Subcommittee ye-American Academy of Neurology. Isifo sokuwa. I-2018; 18 (4): 260-268. I-PMID: 30254527 https://pubmed.ncbi.nlm.nih.gov/30254527/.

UMikati MA, Tchapyjnikov D. Ukuquleka ebuntwaneni. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 611.

Pearl PL. Sibutsetelo sokuquleka nesifo sokuwa ezinganeni. Ku: Swaiman K, Ashwal S, Ferriero DM, et al, abahleli. I-Swaiman's Pediatric Neurology: Izimiso kanye Nokuzijwayeza. Umhlaka 6. IPhiladelphia, PA: Elsevier; I-2017: isahluko 61.