Okudingeka Ukwazi NgeCatonia

-Delile

• Yiziphi izinhlobo ezahlukahlukene ze-catatonia?
• Yini ebangela i-catatonia?
• Imithi
• Izimbangela ezingokwemvelo
• Yiziphi izinto ezinobungozi be-catatonia?
• Ziyini izimpawu zecatatonia?
• I-catatonia ejabulile
• I-catatonia ebulalayo
• Ukufana nezinye izimo
• I-catatonia itholakala kanjani?
• Uphathwa kanjani i-catatonia?
• Imithi
• Ukwelashwa kwe-Electroconvulsive (ECT)
• Uyini umbono we-catatonia?
• Ingabe i-catatonia ingavinjelwa?

Yini i-catatonia?

ICatatonia ukuphazamiseka kwengqondo, okusho ukuthi kufaka ukuxhumana phakathi kokusebenza kwengqondo nokunyakaza. ICatatonia ithinta ikhono lomuntu lokuhamba ngendlela ejwayelekile.

Abantu abane-catatonia bangathola izimpawu ezahlukahlukene. Uphawu oluvame kakhulu ubuthongo, okusho ukuthi umuntu akakwazi ukunyakaza, ukukhuluma, noma ukuphendula kwisikhuthazi. Kodwa-ke, abanye abantu abane-catatonia bangabonisa ukunyakaza ngokweqile nokuziphatha okuthukuthele.

ICatatonia ingahlala noma kuphi kusuka emahoreni ambalwa kuye emasontweni, ezinyangeni, noma eminyakeni. Ingaphinde yenzeke kaningi amasonto kuya eminyakeni ngemuva kwesiqephu sokuqala.

Uma i-catatonia iwuphawu lwenkomba engakhonjwa, ibizwa ngokuthi i-extrinsic. Uma kungekho sizathu esinganqunywa, kuthathwa njengokungena ngaphakathi.

Yiziphi izinhlobo ezahlukahlukene ze-catatonia?

Uhlelo lwakamuva lweDiagnostic and Statistical Manual of Mental Disorders (DSM-5) alusayihlukanisi i-catatonia ngezinhlobo. Kodwa-ke, ochwepheshe abaningi bezempilo yengqondo basengabeka i-catatonia ezinhlotsheni ezintathu: ukubambezeleka, ukujabula, nokubi.

I-catatonia ebuyiselwe emuva ifomu le-catatonia ejwayelekile kakhulu. Kubangela ukunyakaza okuhamba kancane. Umuntu one-catatonia ekhubazekile angabuka esikhaleni futhi kaningi akakhulumi. Lokhu kwaziwa nangokuthi i-akinetic catatonia.

Abantu abane-catatonia ejabule babonakala "beshesha," bengazinzi, futhi bekhathazekile. Kwesinye isikhathi bahlanganyela ekuziphatheni okuzilimazayo. Leli fomu laziwa nangokuthi i-hyperkinetic catatonia.

Abantu abane-catatonia ebulalayo bangathola i-delirium. Kaningi banomkhuhlane. Bangase babe nokushaya kwenhliziyo okusheshayo nomfutho wegazi ophakeme.

Yini ebangela i-catatonia?

Ngokuya nge-DSM-5, izimo eziningana zingadala i-catatonia. Kubandakanya:

• ukuphazamiseka kwe-neurodevelopmental (ukuphazamiseka okuthinta ukuthuthukiswa kwesistimu yezinzwa)
• ukuphazamiseka kwengqondo
• ukuphazamiseka kwe-bipolar
• iziyaluyalu zokudangala
• ezinye izimo zezokwelapha, njengokushoda kwe-cerebral folate, izifo ezingajwayelekile zomzimba, kanye nokuphazamiseka okungajwayelekile kwe-paraneoplastic (okuhlobene nezicubu zomdlavuza)

Imithi

ICatatonia ingumphumela ongandile wemithi ethile esetshenziselwa ukwelapha izifo zengqondo. Uma usola ukuthi umuthi ubangela i-catatonia, funa usizo lwezokwelapha ngokushesha. Lokhu kubhekwa njengesimo esiphuthumayo sezokwelapha.

Ukuhoxa kwemithi ethile, njenge-clozapine (Clozaril), kungadala i-catatonia.

Izimbangela ezingokwemvelo

Ucwaningo lokucwaninga luye lwasikisela ukuthi abanye abantu abane-catatonia engapheli bangaba nokungajwayelekile ebuchosheni.

Abanye ochwepheshe bakholelwa ukuthi ukuba nama-neurotransmitter ngokweqile noma ukungabi nawo kubangela i-catatonia. Ama-Neurotransmitters amakhemikhali obuchopho aphatha imiyalezo esuka ku-neuron eyodwa iye kwesinye.

Omunye umbono uthi ukuncipha okungazelelwe kwe-dopamine, i-neurotransmitter, kubangela i-catatonia. Enye inkolelo ukuthi ukunciphisa i-gamma-aminobutyric acid (GABA), enye i-neurotransmitter, kuholela esimweni.

Yiziphi izinto ezinobungozi be-catatonia?

Abesifazane banengozi enkulu yokuthola i-catatonia. Ingozi yanda ngokukhula.

Yize ngokomlando i-catatonia ihlotshaniswa ne-schizophrenia, odokotela bengqondo manje bahlukanisa i-catatonia njengesifo sayo, esenzeka kumongo wokunye ukuphazamiseka.

Kulinganiselwa ukuthi amaphesenti ayi-10 eziguli ezigula kakhulu zengqondo zithola i-catatonia. Amaphesenti angama-20 eziguli ze-catatonic anezifo zokuxilongwa kwe-schizophrenia, kuyilapho amaphesenti angama-45 enezifo zokuxilongwa kwemizwelo.

Abesifazane abanesifo sokudangala kwangemva kokubeletha (PPD) bangathola i-catatonia.

Ezinye izinto eziyingozi ukusetshenziswa kwe-cocaine, ukugxila kasawoti osegazini, kanye nokusetshenziswa kwemithi efana ne-ciprofloxacin (Cipro).

Ziyini izimpawu zecatatonia?

ICatatonia inezimpawu eziningi, ezivame kakhulu kuzo zifaka:

• ubuwula, lapho umuntu engakwazi ukunyakaza, angakwazi ukukhuluma, futhi kubonakala sengathi ubheke emkhathini
• ukuma noma "ukuguquguquka kwe-waxy," lapho umuntu ehlala endaweni efanayo isikhathi eside
• ukungondleki kahle nokuphelelwa amanzi emzimbeni ngenxa yokuntula ukudla noma ukuphuza
• echolalia, lapho umuntu aphendula khona engxoxweni ngokuphinda kuphela lokho akuzwile

Lezi zimpawu ezijwayelekile zingabonakala kubantu abane-catatonia ekhubazekile.

Ezinye izimpawu ze-catatonia zifaka:

• catalepsy, okuluhlobo lokuqina kwemisipha
• i-negativism, okuwukungabikho kwempendulo noma ukuphikisana nokuvuselelwa kwangaphandle
• echopraxia, okulingisa ukunyakaza komunye umuntu
• ukuthukuthela
• ukufiphala

I-catatonia ejabulile

Izimpawu eziqondene ne-catatonia ejabulile zifaka ukunyakaza okweqile, okungavamile. Lokhu kufaka phakathi:

• ukuyaluza
• ukungahlaliseki
• ukunyakaza okungenanjongo

I-catatonia ebulalayo

I-catatonia ebulalayo ibangela izimpawu ezinzima kakhulu. Kubandakanya:

• i-delirium
• imfiva
• ukuqina
• ukujuluka

Izimpawu ezibalulekile ezifana nengcindezi yegazi, izinga lokuphefumula, nokushaya kwenhliziyo kungashintsha. Lezi zimpawu zidinga ukwelashwa ngokushesha.

Ukufana nezinye izimo

Izimpawu zeCatatonia zifaka ezinye zezimo, kufaka phakathi:

• i-psychosis ebukhali
• i-encephalitis, noma ukuvuvukala kwezicubu zobuchopho
• i-neuroleptic malignant syndrome (NMS), ukusabela okungajwayelekile futhi okungathi sína emithini elwa ne-psychips
• isimo se-nonconvulsive epilepticus, uhlobo lokudlikiza okukhulu

Odokotela kumele bazikhiphe lezi zimo ngaphambi kokuba bathole i-catatonia. Umuntu kufanele akhombise okungenani izimpawu ezimbili eziyinhloko ze-catatonia amahora angama-24 ngaphambi kokuba udokotela athole i-catatonia.

I-catatonia itholakala kanjani?

Akukho sivivinyo esiqondile se-catatonia esikhona. Ukuthola i-catatonia, ukuhlolwa komzimba nokuhlolwa kufanele kuqala kukhiphe ezinye izimo.

I-Bush-Francis Catatonia Rating Scale (BFCRS) isivivinyo esivame ukusetshenziselwa ukuxilonga i-catatonia. Lesi sikali sinezinto ezingama-23 ezitholwe kusuka ku-0 kuye ku-3. Isilinganiso esingu- “0” sisho ukuthi isibonakaliso asikho. Isilinganiso "3" sisho ukuthi uphawu lukhona.

Ukuhlolwa kwegazi kungasiza ukukhipha ukungalingani kwe-electrolyte. Lokhu kungadala ushintsho ekusebenzeni kwengqondo. I-embolism ye-pulmonary, noma i-clot yegazi emaphashini, ingaholela ezimpawu ze-catatonia.

Ukuhlolwa kwegazi kwe-fibrin D-dimer nakho kungasiza. Ucwaningo lwamuva lubonisa ukuthi i-catatonia ihlotshaniswa namazinga aphakeme we-D-dimer. Kodwa-ke, izimo eziningi (ezinjenge-pulmonary embolism) zingathinta amazinga e-D-dimer.

Ukuhlolwa kwe-CT noma kwe-MRI kuvumela odokotela ukuthi babuke ubuchopho. Lokhu kusiza ukukhipha isimila ebuchosheni noma ukuvuvukala.

Uphathwa kanjani i-catatonia?

Imithi noma i-electroconvulsive therapy (ECT) ingasetshenziselwa ukwelapha i-catatonia.

Imithi

Imithi imvamisa iyindlela yokuqala yokwelapha i-catatonia. Izinhlobo zezidakamizwa ezingabekwa zifaka phakathi i-benzodiazepines, izidambisi zemisipha, futhi kwezinye izimo, i-tricyclic antidepressants. I-Benzodiazepines imvamisa iyimithi yokuqala enqunyiwe.

I-Benzodiazepines ifaka i-clonazepam (iKlonopin), i-lorazepam (i-Ativan), ne-diazepam (i-Valium). Le mithi inyusa i-GABA ebuchosheni, esekela umbono wokuthi ukunciphisa i-GABA kuholela e-catatonia. Abantu abanezikhundla eziphezulu kuma-BFCRS bavame ukuphendula kahle ekwelashweni kwe-benzodiazepine.

Eminye imishanguzo ethize engahle inqunywe, ngokuya ngecala lomuntu ngamunye, ifaka:

• i-amobarbital, i-barbiturate
• i-bromocriptine (i-Cycloset, i-Parlodel)
• i-carbamazepine (Carbatrol, Epitol, Tegretol)
• i-lithium carbonate
• i-hormone yegilo
• i-zolpidem (Ambien)

Ngemuva kwezinsuku ze-5, uma kungekho mpendulo emithini noma uma izimpawu ziba zimbi, udokotela angancoma ezinye izindlela zokwelashwa.

Ukwelashwa kwe-Electroconvulsive (ECT)

Ukwelashwa kwe-Electroconvulsive (ECT) kuyindlela ephumelelayo yokwelapha i-catatonia. Lokhu kwelashwa kwenziwa esibhedlela ngaphansi kweso lezokwelapha. Kuyinqubo engenabuhlungu.

Lapho umuntu esehlaliswe phansi, umshini okhethekile wethula ugesi ebuchosheni. Lokhu kubangela ukuquleka ebuchosheni isikhathi esingangesikhathi somzuzu.

Kukholakala ukuthi ukuquleka kudala ushintsho kumanani ama-neurotransmitters ebuchosheni. Lokhu kungathuthukisa izimpawu ze-catatonia.

Ngokuya ngokubuyekezwa kwezincwadi zango-2018, i-ECT kanye ne-benzodiazepines yizona kuphela izindlela zokwelapha eziqinisekisiwe ukuthi zelapha i-catatonia.

Uyini umbono we-catatonia?

Ngokuvamile abantu baphendula ngokushesha ekwelashweni kwe-catatonia. Uma umuntu engayiphenduli imishanguzo enqunyiwe, udokotela anganikeza eminye imishanguzo kuze kuphele izimpawu.

Abantu abangena ku-ECT banamazinga aphezulu okubuyela emuva e-catatonia. Izimpawu zivame ukuvela futhi kungakapheli unyaka.

Ingabe i-catatonia ingavinjelwa?

Ngoba imbangela ngqo ye-catatonia ayaziwa kaningi, ukuvimbela akunakwenzeka.Kodwa-ke, abantu abane-catatonia kufanele bagweme ukuthatha imishanguzo eyeqile ye-neuroleptic, njenge-chlorpromazine. Ukusetshenziswa kabi kwemithi kungakhulisa izimpawu ze-catatonia.