I-Acute Disseminated Encephalomyelitis (ADEM): Okufanele Ukwazi

-Delile

• Ziyini izimpawu?
• Yini ebangela i-ADEM?
• Kutholakala kanjani?
• Ilashwa kanjani?
• Ngabe i-ADEM ihluke kanjani kwi-MS?
• Ziyefana kanjani
• Bahluke kanjani
• Yini engingayilindela?
• Ngabe i-ADEM ingavinjelwa?

Ukubuka konke

I-ADEM ifushane nge-encephalomyelitis esatshalaliswa kakhulu.

Lesi simo sezinzwa sihilela ukuqhuma okukhulu kokuvuvukala ohlelweni lwezinzwa oluphakathi. Kungabandakanya ubuchopho, umgogodla, futhi kwesinye isikhathi izinzwa ze-optic.

Ukuvuvukala kungalimaza i-myelin, into evikelayo efaka imicu yezinzwa kulo lonke uhlelo lwezinzwa oluphakathi.

I-ADEM yenzeka emhlabeni wonke nakuzo zonke izinhlanga. Kwenzeka kaningi ezinyangeni zasebusika nezentwasahlobo.

Cishe umuntu oyedwa kwabangu-125,000 kuye kwangama-250,000 athuthukisa i-ADEM unyaka nonyaka.

Ziyini izimpawu?

Abantu abangaphezu kwamaphesenti angama-50 abane-ADEM bathola ukugula emasontweni amabili edlule. Lesi sifo kuvame ukuba yisifo segciwane lesandulela ngculaza, kepha kungaba yinoma yiluphi uhlobo lokutheleleka.

Izimpawu zivame ukufika ngokuzumayo futhi zingafaka:

• imfiva
• ikhanda
• intamo elukhuni
• ubuthakathaka, ukuba ndikindiki, nokuthinteka kwezingalo noma imilenze
• izinkinga zokulinganisela
• ukozela
• ukufiphala noma umbono ophindwe kabili ngenxa yokuvuvukala kwe-optic nerve (optic neuritis)
• ubunzima bokugwinya nokukhuluma
• Izinkinga zesinye noma zamathumbu
• ukudideka

Akujwayelekile, kepha i-ADEM ingaholela ekubanjweni noma ekuqulekeni.

Isikhathi esiningi, izimpawu zihlala ezinsukwini ezimbalwa futhi ziyathuthuka ngokwelashwa. Ezimweni ezinzima kakhulu, izimpawu zingathatha izinyanga ezimbalwa.

Yini ebangela i-ADEM?

Imbangela ngqo ye-ADEM ayaziwa.

I-ADEM ayivamile, futhi noma ngubani angayithola. Kungenzeka ukuthi ithinte izingane kunabantu abadala. Izingane ezingaphansi kweminyaka eyi-10 zimele amaphesenti angaphezu kwama-80 wamacala we-ADEM.

Imvamisa kwenzeka isonto noma amabili ngemuva kokutheleleka. Ukutheleleka ngamagciwane, igciwane nezinye izifo konke kuhlotshaniswe ne-ADEM.

Kwesinye isikhathi, i-ADEM iyakhula ngemuva kokugoma, imvamisa eyeyamasimungumungwane, imvukuzane nerubella. Impendulo evikela amasosha omzimba ibangela ukuvuvukala ohlelweni lwezinzwa oluphakathi. Kulezi zimo, kungathatha izinyanga ezintathu emva kokugoma ukuze kuvele izimpawu.

Kwesinye isikhathi, abukho ukugoma noma ubufakazi bokutheleleka ngaphambi kokuhlaselwa kwe-ADEM.

Kutholakala kanjani?

Uma unezimpawu ze-neurologic ezihambisana ne-ADEM, udokotela wakho uzofuna ukwazi ukuthi ngabe ubugula emasontweni ambalwa edlule. Bazophinde bafune umlando ophelele wezokwelapha.

Asikho isivivinyo esisodwa esingahlonza i-ADEM. Izimpawu zilingisa ezinye zezimo okufanele zikhishwe. Ukuxilongwa kuzosuselwa kwizimpawu zakho ezithile, ukuhlolwa komzimba, nokuhlolwa kokuxilongwa.

Izivivinyo ezimbili ezingasiza ekuxilongweni yilezi:

I-MRI: Iskena esivela kulokhu kuhlolwa okungavumelekile singakhombisa ushintsho ezintweni ezimhlophe ebuchosheni nasentanyeni yomgogodla. Izilonda noma ukulimala kwendaba emhlophe kungahle kube ngenxa ye-ADEM, kepha futhi kungakhombisa ukutheleleka kobuchopho, isimila noma i-multiple sclerosis (MS).

Ukubhoboza i-Lumbar (umpompi womgogodla): Ukuhlaziywa kuketshezi lwakho lomgogodla kunganquma ukuthi ngabe izimpawu zibangelwa ukutheleleka. Ukuba khona kwamaprotheni angajwayelekile abizwa ngama-oligoclonal bands kusho ukuthi i-MS yiyona etholakala kakhulu.

Ilashwa kanjani?

Umgomo wokwelashwa ukunciphisa ukuvuvukala ohlelweni lwezinzwa oluphakathi.

I-ADEM ivame ukuphathwa ngemithi ye-steroid efana ne-methylprednisolone (Solu-Medrol). Lo muthi ufakwa ngemithambo yegazi izinsuku ezinhlanu kuya kweziyisikhombisa. Ungadinga futhi ukuthatha i-oral steroids, efana ne-prednisone (Deltasone), okwesikhashana. Ngokuya ngesincomo sikadokotela wakho, lokhu kungaba noma kuphi kusuka ezinsukwini ezimbalwa kuze kufike kumaviki ambalwa.

Ngenkathi usebenzisa ama-steroids, kuzodingeka ukuthi ubhekwe ngokucophelela. Imiphumela emibi ingafaka ukunambitheka kwensimbi, ukuvuvukala kobuso, nokugungxula. Ukuthola isisindo nobunzima bokulala nakho kungenzeka.

Uma ama-steroids engasebenzi, enye indlela i-immune globulin (IVIG) efakwa emithanjeni. Iphinde inikezwe ngemithambo yegazi cishe izinsuku ezinhlanu. Imiphumela emibi engaba khona ibandakanya ukutheleleka, ukusabela okweqile, nokuphefumula okuncane.

Ezimweni ezinzima, kukhona ukwelashwa okubizwa nge-plasmapheresis, okuvame ukuthi kudinge ukuhlala esibhedlela. Le nqubo ihlunga igazi lakho ukuze isuse amasosha omzimba ayingozi. Kungadingeka ukuthi iphindwe kaningana.

Uma ungaphenduli kunoma yikuphi kwalokhu ukwelashwa, i-chemotherapy ingacatshangelwa.

Ukulandela ukwelashwa, udokotela wakho angafuna ukwenza i-MRI yokulandelela ukuze aqiniseke ukuthi ukuvuvukala kulawulwa.

Ngabe i-ADEM ihluke kanjani kwi-MS?

I-ADEM ne-MS zifana ngokuphawulekayo, kodwa esikhathini esifushane kuphela.

Ziyefana kanjani

Zombili lezi zimo zibandakanya impendulo engavamile yesistimu yomzimba ethinta i-myelin.

Zombili zingadala:

• ubuthakathaka, ukuba ndikindiki, nokuthinteka kwezingalo noma imilenze
• izinkinga zokulinganisela
• ukufiphala noma ukubona kabili
• Izinkinga zesinye noma zamathumbu

Ekuqaleni, kungaba nzima ukukuhlukanisa kwi-MRI. Kokubili kubangela ukuvuvukala nokubulawa komzimba ohlelweni oluphakathi lwezinzwa.

Zombili zingelashwa ngama-steroids.

Bahluke kanjani

Ngaphandle kokufana, lezi yizimo ezimbili ezihluke kakhulu.

Omunye umkhondo wokuxilongwa ukuthi i-ADEM ingadala umkhuhlane nokudideka, okungajwayelekile kwi-MS.

I-ADEM ivame ukuthinta abesilisa, kuyilapho i-MS ivame kakhulu kwabesifazane. I-ADEM nayo inamathuba amaningi okuthi yenzeke ebuntwaneni. I-MS ivame ukutholakala lapho usukhulile.

Umehluko ophawuleka kakhulu ukuthi i-ADEM cishe ngaso sonke isikhathi isehlakalo esingalodwa. Iningi labantu abane-MS banokuhlaselwa okuphindaphindiwe kokuvuvukala kwesistimu yezinzwa ephakathi. Ubufakazi balokhu buyabonakala ekulandeleni okulandelanayo kwe-MRI.

Lokho kusho ukuthi ukwelashwa kwe-ADEM nakho kungenzeka kube yinto yesikhathi esisodwa. Ngakolunye uhlangothi, i-MS yisimo esingelapheki esidinga ukuphathwa kwezifo okuqhubekayo. Kunezinhlobonhlobo zokwelashwa okuguqula izifo ezenzelwe ukunciphisa ukuqhubeka.

Yini engingayilindela?

Ezimweni ezingavamile, i-ADEM ingaba yingozi. Abantu abangaphezu kwamaphesenti angama-85 abane-ADEM balulama ngokuphelele emasontweni ambalwa. Iningi labanye liyalulama kungakapheli izinyanga ezimbalwa. Ukwelashwa kwama-steroid kunganciphisa isikhathi sokuhlaselwa.

Inani elincane labantu lishiywa nezinguquko ezincane zokuqonda noma zokuziphatha, njengokudideka nokozela. Abantu abadala bangaba nesikhathi esinzima sokululama kunezingane.

Amaphesenti ayisishiyagalombili esikhathi, i-ADEM ingumcimbi wesikhathi esisodwa.Uma ibuya, udokotela wakho angafuna ukwenza ukuhlolwa okwengeziwe ukuqinisekisa noma ukukhipha i-MS.

Ngabe i-ADEM ingavinjelwa?

Ngoba imbangela ngqo ayicaci, ayikho indlela yokuvikela eyaziwayo.

Hlala ubika izimpawu zakho zemizwa kudokotela wakho. Kubalulekile ukuthola ukuxilongwa okufanele. Ukwelapha ukuvuvukala kwesistimu yezinzwa emaphakathi kusenesikhathi kungasiza ukuvimbela izimpawu ezinzima noma ezihlala njalo.