Ðe alɔ̃madɔmadɔ hã nɔa ŋuwò enuenua? Na míasrɔ̃ nu tso nɔnɔme sia si me afɔku le ŋua? (Nɔnɔme si nye Epilepticus) .

Ðewohĩ èkpɔ mía xɔlɔ̃wo kple ƒometɔwo dometɔ aɖewo ƒe alɔ̃madɔmadɔ ɖe wo nɔewo yome. Alo ate ŋu axɔ alɔ̃madɔmadɔ ɖeka eye emegbe woagaxɔ bubu hafi woƒe susu nagaɖo wo ŋu. Esia nye nɔnɔme sesẽ aɖe. Egbea, míaƒo nu tso atikewɔwɔ ƒe nɔnɔme sia si me afɔku le eye wòdzɔna kpata si woyɔna be ``Status Epilepticus`` ŋu.

Nukae nye Status Epilepticus?

Kpuie ko la, Status Epilepticus (SE) nye nɔnɔme si me ame ƒe alɔ̃madɔmadɔ atraɖii, alo alɔ̃madɔmadɔ siwo kplɔ wo nɔewo ɖo, si me ɣeyiɣi si sɔ be wòagaɖo ŋu alo ahaya o. Nɔnɔme sia bɔ ɖe amesiwo ŋu asrãdɔ le me wu, gake amesiwo ŋu asrãdɔ mele o hã ate ŋu axɔ alɔ̃madɔmadɔ siawo ƒomevi atraɖii le atikewɔwɔ ƒe nɔnɔme vovovowo ta.

Esia nye atikewɔwɔ kpata si ate ŋu ade ame ƒe agbe afɔku me eye wòhiã be woakpɔ egbɔ enumake.

Ne wò alo ame aɖe si gbɔ nèle la ƒe alɔ̃madɔmadɔ si xɔ wu miniti atɔ̃, alo ne èxɔ alɔ̃dɔdɔ ɖe wo nɔewo yome eye mègakpɔ ŋudzedze bliboe o la, ƒo ka na 1990 (ambulance) alo wò nutoa me xexlẽdzesi kpata enumake. Esia le vevie ŋutɔ, elabena zi alesi nèxɔ atike kaba la, zi nenemae emetsonua nyonae.

Ameka dzie nɔnɔme sia gblẽ nu le wu?

Amesiame ate ŋu axɔ alɔ̃dɔdɔ, eye status epilepticus (SE) hã mele eme o. Ke hã, anɔ eme be ame aɖewo axɔe. Esiawo dometɔ aɖewoe nye:

• Ƒe: Ðevi sue siwo mexɔ ƒe ɖeka haɖe o kple ame tsitsi siwo xɔ wu ƒe 60 ate ŋu axɔ dɔléle sia. Ke hã, ate ŋu adzɔ le ƒe ɖesiaɖe me. Ƒe eve siawo le afɔku me wu le atikewɔwɔ ƒe nɔnɔme bubu siwo ate ŋu ana woaxɔ status epilepticus (SE) ta (kpɔ Nusiwo gbɔ wòtso kple Dzesiwo).
• Ŋutsu alo nyɔnu nyenye: Ŋutsuwo ate ŋu axɔ nɔnɔme sia vie.
• Asrãdɔ ƒe amesinɔnɔ: Asrãdɔ le ame akpa gãtɔ siwo ŋu status epilepticus (SE) le. Wokpɔe be ɖevi suewo ƒe 16% va ɖo 38% kple ame tsitsi siwo ade 42% va ɖo 50% xɔ asrãdɔ.

Aleke gbegbee nɔnɔme sia bɔe?

Status epilepticus (SE) menye dɔléle si bɔ o, gake enye atikewɔwɔ kpata siwo bɔ wu siwo ku ɖe ahɔhɔ̃a ŋu la dometɔ ɖeka. Eŋutinunyalawo bu akɔnta be ame 7 va ɖo 40 le ame 100,000 ɖesiaɖe me xɔa dɔlélea ƒe sia ƒe. Ema fia be le kpɔɖeŋu me, le United States la, wokpɔa dɔlékui siwo ade 23,000 va ɖo 131,800 ƒe sia ƒe. Alɔ̃madɔmadɔ katã ƒe 2% lɔƒo va zua status epilepticus (SE), eye alɔ̃madɔmadɔ yeye siwo ade 23% va zua nɔnɔme sia.

Aleke status epilepticus kpɔa ŋusẽ ɖe ŋutilã dzii?

Togbɔ be status epilepticus (SE) dzea egɔme tso wò ahɔhɔ̃ me hã la, ate ŋu akpɔ ŋusẽ ɖe ɖoɖo vovovowo dzi le wò ŋutilã katã me. Nu siaBe míase alesi esia dzɔnae gɔme la, ekpena ɖe ame ŋu be míase nusi alɔ̃dɔdɔ nye gɔme vie.

Ŋusẽ si wòkpɔna ɖe ahɔhɔ̃a dzi

Lãmetsiŋusẽ ƒe lãmenugbagbevi siwo le wò ahɔhɔ̃ me, siwo woyɔna be ahɔhɔ̃mekawo, mate ŋu atɔ dzo ɣeyiɣi didi madzemadzee o. Abe alesi ko elektrɔnikmɔ̃ ate ŋu atɔ dzo ne elektrikŋusẽ sɔ gbɔ ɖe eme ene la, nenema ke status epilepticus (SE) ƒe ʋuʋudedi si dzi womeɖu o ate ŋu agblẽ nu le wò ahɔhɔ̃mekawo ŋu. Zi geɖe la, nusiwo dome gblẽ sia nɔa anyi ɖaa. Esia fia be ɖewohĩ màgate ŋu aɖu wò ahɔhɔ̃ ƒe akpa siwo gblẽ la dzi o.

Ŋusẽ si wòkpɔna ɖe ŋutilã ƒe ɖoɖo bubuwo dzi

Le status epilepticus (SE) me la, wò ŋutilã bliboa ƒe lãmekawo ate ŋu aʋuʋu le mɔ si dzi womate ŋu aɖu o nu, si keke ta. Esia wɔnɛ be wò ŋutilã ƒe dzoxɔxɔ dzina ɖe edzi eye ɖeɖi tea wò lãmekawo ŋu. Wò ŋutilã dzea agbagba be yeaxe fe ɖe eta to atikewo dodo ɖe wò ʋukawo me me. Gake ɣeyiɣi kpui aɖe koe esia kpena ɖe ame ŋu.

Ne status epilepticus (SE) nɔa anyi didi la, ate ŋu akpɔ ŋusẽ ɖe ɖoɖo siwo gbɔna dzi le wò ŋutilã me:

• Dzi: Ne atikewo ƒe tɔtrɔ le ʋua me nɔa anyi didi akpa la, ate ŋu agblẽ nu le ame ŋu le esi teƒe be wòakpe ɖe ame ŋu. Esia ate ŋu ana dzi naƒo ɖe ɖoɖo nu alo agblẽ nu le dzia gɔ̃ hã ŋu. Alɔ̃madɔmadɔ aɖewo ate ŋu ana dzia nagbɔdzɔ (bradycardia) alo atɔ keŋkeŋ gɔ̃ hã (asystole).
• Lãmetsiwo: Lãmetsiwo ate ŋu agblẽ ne èle nu wɔm atraɖii, abe ne èdoa vevie nu wògbɔa eme le kamedede me ene. Esia ate ŋu ana wò lãmekawo kple lãmeka falɛfalɛ bubuwo naxɔ abi. Le nɔnɔme sesẽwo me la, nugbegblẽ sia ate ŋu ana wò lãmekawo navuvu gɔ̃ hã.
• Ayikuwo: Nusiwo dona tso lãmeka siwo gblẽ ƒe gbagbã me nye aɖi. Wò ayikuwo ate ŋu aɖe nusiawo ƒe agbɔsɔsɔ sue aɖe ɖa, gake ne agbɔsɔsɔa dzi ɖe edzi la, ayikuawo ate ŋu agbɔdzɔ eye ate ŋu ana ayiku nawɔ dɔ nyuie.
• Gbɔgbɔ: Status epilepticus (SE) hã ate ŋu ado kplamatse wò gbɔgbɔ ƒe ŋutete. Esia ate ŋu ana oxygen nagbɔdzɔ ɖe ahɔhɔ̃a kple ŋutilãa me, si ate ŋu ana ame naku mlɔeba. Ame siwo ŋu status epilepticus (SE) le hã ate ŋu akɔ tsi tso woƒe dɔgbo me ayi woƒe lãkusiwo me, si ate ŋu ana woaxɔ aklãdɔ kple dɔlékuiwo.
• Lãmetsi ƒe dzoxɔxɔ si dzina ɖe edzi: Abe alesi wòle le asrã sesẽ gome ene la, status epilepticus (SE) ate ŋu ana wò ŋutilã ƒe dzoxɔxɔ nadzi ɖe edzi va ɖo afisi afɔku le. Esia ate ŋu agblẽ nu le wò ŋutilã ƒe dɔwɔwɔwo katã ŋu, vevietɔ ahɔhɔ̃a.

Nukawoe nye dzesiawo?

Status epilepticus (SE) ƒe dzesiwo nɔ te ɖe ahɔhɔ̃a ƒe akpa si wògblẽ nu le dzi. Esi wònye be alɔ̃madɔmadɔ dzɔna le ahɔhɔ̃a ƒe akpa vovovowo ta la, alɔ̃madɔmadɔ ƒomevi vovovowoe li. Le esia nu la, status epilepticus (SE) ƒe hatsotso sue vovovowo li. Woawoe nye:

• Ʋuʋudedi ƒe nɔnɔme epilepticus `(Aʋawɔwɔ SE)`:Esia ƒe dzesi enye ŋutilã ƒe akpa eveawo ƒe ʋuʋu kple ʋuʋu si dzi womeɖu o. Generalized tonic-clonic seizures nye alɔ̃madɔmadɔ ƒomevi vevitɔ si ate ŋu ahe nɔnɔme sia vɛ.
• Nonconvulsive status epilepticus `(Nonconvulsive SE)`: Le esia me la, lãmekawo ƒe ʋuʋu, ʋuʋu, alo lãmekawo ƒe ʋuʋu si dzi womeɖu o menɔa anyi o. Gake lãmeka sue aɖewo ate ŋu aʋuʋu. Le kpɔɖeŋu me, alɔ alo mo ƒe akpa aɖe ƒe ʋuʋu sue aɖe, abe ʋuʋu blewuu gbugbɔgawɔ ene. `(Nonconvulsive SE)` sia ateŋu atso alɔ̃madɔmadɔ ƒomeviwo abe `(Absence seizures)` kple `(Focal seizures)` siwo gblẽa nu le ahɔhɔ̃a ƒe akpa sue aɖe ko ŋu.

Nukawoe nye susu siwo tae wòle alea ɖo?

Nu ɖeka kolia si gbɔ status epilepticus (SE) tsonae nye alɔ̃madɔmadɔ. Mɔ vevi eve li siwo dzi alɔ̃madɔmadɔ ate ŋu ato:

• Alɔ̃madɔmadɔ si doa dziku na ame: Nɔnɔme alo nu bubuwo gbɔe esiawo tsona. Le kpɔɖeŋu me, asrã sesẽ, ahanono alo atike muamewo ɖeɖeɖa, sukli ƒe ɖiɖi le ʋu me, ʋusɔgbɔdɔ, ahɔhɔ̃ me dɔdzẽ, kple tagbɔdɔ. Esia ƒomevi nyea 25% va ɖo 30% le alɔ̃madɔmadɔ katã me. Ne ahɔhɔ̃a ƒe gbegblẽ gbɔe alɔ̃madɔmadɔ tso la, woyɔnɛ be alɔ̃madɔmadɔ si ƒe dzesiwo nu sẽ, eye afɔku le eme be wòava zu status epilepticus.
• Alɔ̃madɔmadɔ si meʋãna o: Alɔ̃madɔmadɔ siawo menye atikewɔwɔ me nɔnɔme alo nusi gbɔ wòtso ƒe dzesi o. Wodzɔna ne woʋã ame ƒe ahɔhɔ̃ bɔbɔe be wòaxɔ alɔ̃dɔdɔ le eɖokui si. Alɔ̃madɔmadɔ siwo dzɔna le ŋkeke adre me tso esime wòxɔ abi le ta alo ʋusɔgbɔdɔ hã dzena le hatsotso sia me.

Nusiwo koŋ gbɔ alɔ̃dɔdɔ tsona

Susu geɖewo li siwo tae alɔ̃dɔdɔ ate ŋu adzɔ ɖo. Ƒe aɖewo ƒe hatsotso aɖewo le afɔku gã aɖe me be woaxɔ status epilepticus (SE) le susu aɖewo koŋ ta. Esiawoe nye:

• Asrã, vevietɔ asrã sesẽ: Woyɔa esiawo be ``Asrã ƒe alɔ̃madɔmadɔ'' eye woawoe nye nu vevitɔ si hea alɔ̃dɔdɔ vɛ na ɖevi siwo mexɔ ƒe ɖeka haɖe o.
• Ʋusɔgbɔdɔ, ʋuka siwo me ʋu sina tona, kple ʋu si dona le ahɔhɔ̃a me: Kuxi ɖesiaɖe si le ʋu ƒe sisi ƒe dɔwɔwɔ ŋu si gblẽa nu le ahɔhɔ̃a ŋu alo doa kplamatse ahɔhɔ̃a ƒe dɔwɔwɔ ate ŋu ana ame natsi dzodzodzoe. Ʋusɔgbɔdɔ kple kuxi siwo do ƒome kplii, abe ʋuka me ʋu ƒe sisi kple ahɔhɔ̃ me ʋu ene, ye nye nusiwo koŋ gbɔ alɔ̃madɔmadɔ tsona na amesiwo xɔ wu ƒe 60.

Susu bubuwo tae:

• Ahɔhɔ̃ me dɔdzẽ (siwo dome kansa hã le).
• Oxygen ƒe anyimanɔmanɔ na ahɔhɔ̃a (Cerebral hypoxia).
• Ta ƒe abi sesẽ `(Ahɔhɔ̃ ƒe ʋuʋu sesẽ kple ahɔhɔ̃ ƒe abi si wɔ nuku ŋutɔ)`.
• Dɔléle siwo gblẽa ahɔhɔ̃a vivivi, le kpɔɖeŋu me Alzheimer ƒe dɔléle alo ŋkume ƒe tagbɔdɔ.
• Atike vɔ̃ɖiwo kple aha sesẽ (esia lɔ atikewo, modzakaɖetikewo, kple caffeine gɔ̃ hã ɖe eme).
• Asiɖeɖe le atike muamewo alo ahanono ŋu.
• Eclampsia nye alɔ̃madɔmadɔ si ʋusɔgbɔdɔ hena vɛ le fufɔɣi.
• Elektrikŋusẽ ƒe kuxiwo, vevietɔ hyponatremia, calcium alo magnesium ƒe anyimanɔmanɔ.
• Kekeli si le keklẽm alo esi le keklẽm ƒe seselelãme.
• Domenyiŋusẽfianu ƒe dɔlélewo (dɔléle siwo ƒe dome wonyi tso dzilawo gbɔ le wo dzidzi me).
• Lãmetsiŋusẽ ƒe tɔtrɔ (le kpɔɖeŋu me, catamenial epilepsy, si gblẽa nu le amesiwo ŋu dzinukpɔkpɔ le ŋu, ate ŋu ana ame naxɔ alɔ̃ geɖe le dzinukpɔkpɔ ƒe ɣeyiɣi aɖewo me).
• Dɔlékuiwo (vevietɔ dɔlékui siwo dɔlékuiwo, dɔlékuiwo, dɔlékuiwo, alo fungiwo, abe tagbɔdɔ alo taɖuame ene hena vɛ).
• Dzoxɔxɔ si dɔlélenutsiŋutete ƒe dɔlélewo hena vɛ (ne wò dɔlélenutsiŋutete dze wò ŋutɔ wò ahɔhɔ̃ dzi).
• Lãmetsiŋusẽ ƒe kuxiwo, vevietɔ sukli si sɔ gbɔ ɖe ʋu me (Hyperglycemia) alo sukli si bɔbɔ ɖe ʋu me (Hypoglycemia).
• Kuxi siwo le ahɔhɔ̃ ƒe wɔwɔme ŋu (vevietɔ esiwo nɔa anyi le vidzidzi me).
• Sepsis (ʋu me aɖi).
• Aɖi kple aɖi (abe carbon monoxide ƒe aɖi alo ga kpekpewo ƒe aɖi ene).

Aleke wokpɔa Status Epilepticus ƒe dɔlélea?

Ðɔkta ate ŋu anɔ te ɖe amea ƒe alɔ̃madɔmadɔ ƒe dzesiwo, ɣeyiɣi didi si alɔ̃madɔmadɔa xɔ, kple nenye be ɣeyiɣi si sɔ be wòahaya le alɔ̃madɔmadɔ si wu zi ɖeka dome dzi anya dɔléle si nye status epilepticus (SE) gbã. Gake ele vevie hã be nànya nusita amea xɔ alɔ̃madɔmadɔ si na wòxɔ status epilepticus (SE) la. Zi geɖe la, esia lɔa mɔnu vovovowo ɖe eme.

Dodokpɔ kawoe wowɔna tsɔ dea dzesi nɔnɔme sia?

Elektroencephalogram (EEG) dodokpɔe nye mɔ nyuitɔ si dzi woato anya alɔ̃dɔdɔ ɖesiaɖe, si me status epilepticus (SE) hã le. Le dodokpɔ sia me la, wotsɔa nusiwo dea dzesi nu siwo ŋu wotsɔ gel si léna ɖe nu ŋu, si kplɔa elektrikŋusẽ ɖo la dea wò ta ŋu. Gel sia kpena ɖe nusiwo dea dzesi nu ŋu be woakpɔ elektrikŋusẽ si le wò ahɔhɔ̃ me.

Ðɔktawo ate ŋu anya alɔ̃dɔdɔ to ŋkuléle ɖe ale si wò ahɔhɔ̃a wɔa dɔe ŋu. Ne ame aɖe ƒe alɔ̃madɔmadɔ yi edzi, alo ne exɔ alɔ̃ zi geɖe ɖe wo nɔewo yome la, ɖɔkta ate ŋu akpɔe be status epilepticus (SE) le eŋu. EEG le vevie ŋutɔ na amesi ŋu nonconvulsive status epilepticus (Nonconvulsive SE) le.

Ke hã, ele be ɖɔkta hã nakpɔe ɖa be amea ƒe alɔ̃madɔmadɔ nye ``Dziku'' alo ``Womedo dziku o.'' Esia bia dodokpɔ kple dodokpɔ vovovowo. Le kpɔɖeŋu me:

• Ʋudodokpɔ: Esiawo ate ŋu ade dzesi nu geɖe, abe lãmenugbagbeviwo ƒe dɔwɔwɔ kple ʋu ƒe dɔwɔwɔ ƒe masɔmasɔ, dɔlélenutsiŋutete ƒe kuxiwo, aɖinuwo, kple aɖiwo ene.
• CT scan (Kɔmpiuta dzi Tomography - CT scan) dodokpɔ.
• MRI (Magnetic Resonance Imaging - MRI) dodokpɔ.
• Spinal tap / Akɔta ƒe ʋuʋu.

Wò ɖɔkta ate ŋu aɖo aɖaŋu na wò hã be nàwɔ dodokpɔ bubuwo. Esia ate ŋu anɔ te ɖe nu geɖe dzi, abe ne abi aɖe le ŋuwò, wò atikewɔwɔ ŋutinya, alɔ̃madɔmadɔ ƒomevi si nèxɔ, kple bubuwo ene. Wò ɖɔkta (alo ame aɖe si nètia be wòawɔ atikewɔwɔ ŋuti nyametsotsowo na wò) agblɔ dodokpɔ siwo nyo na wò, kple nusitae na wò.

Aleke wowɔa atike nɛ? Ðe woate ŋu adaea?

Wozãa mɔnu vovovowo ƒe ƒuƒoƒo tsɔ daa status epilepticus (SE). Esia le alea elabena status epilepticus (SE) ate ŋu ahe kuxi sesẽwo alo esiwo ate ŋu ade ame ƒe agbe afɔku me vɛ, siwo gblẽa nu le ŋutilã bliboa ŋu. Mɔnu siawo dometɔ aɖewoe nye:

• Atikewo.
• Intubation (mɔ̃ si wotsɔ dea ʋu me.
• Nusiwo gbɔ wòtso (ne woli) dada.
• Atikewɔwɔ kpeɖeŋutɔ.

Ne status epilepticus (SE) mewɔ nu ɖe ​​atikewɔwɔ ŋu o la, woyɔnɛ be refractory SE. Gake atikewɔmɔnu aɖewo gakpɔtɔ li.

Atikewo

Atikewo zazã le vevie be nàdzudzɔ alɔ̃madɔmadɔ ƒe dɔwɔwɔ le wò ahɔhɔ̃ me. Atikewo ate ŋu ada kuxi bubuwo hã, abe dzi ƒe tsotso ƒe kuxiwo ene, siwo ate ŋu ado mo ɖa le status epilepticus (SE) ta.

Atike siwo wozãna wu tsɔ dzudzɔa alɔ̃madɔmadɔe nye:

• Benzodiazepines (Benzos): Atike siawo wɔa dɔ to mɔxexe ɖe wò ahɔhɔ̃mekawo ƒe elektrikŋusẽ ƒe dɔwɔwɔ nu eye wodzudzɔa alɔ̃madɔmadɔ. Zi geɖe la, wodoa wo to atike si wodona ɖe wò ŋutilã me tẽ, alo to ka si wodona ɖe ʋuka me (IV) dzi. Wole abe atike si wotsɔna ƒua gbe ɖe no me alo gel ene. Woate ŋu ana wo to nu me alo to dɔgboa me (gel kple dɔgbo ƒe lãkusiwo xɔa wo bɔbɔe wu). Esiawo ƒe akpa gãtɔ nye atike gbãtɔwo. Gake wodzra ɖewo ɖo be woazã ne atike bubuwo mewɔ dɔ o.
• Atike siwo tsia alɔ̃madɔmadɔ nu: Benzodiazepines ɖeɖe ate ŋu atɔ te alɔ̃madɔmadɔ le ɣeyiɣiawo ƒe 50% lɔƒo ko. Le 50% bubuawo me la, alɔ̃madɔmadɔ gadzea egɔme ake ne atike gbãtɔa vɔ. Eyata atike siawo ate ŋu akpe ɖe ame ŋu be alɔ̃madɔmadɔ nagadzɔ ake ɣeyiɣi didi o. Atike siwo tsia alɔ̃madɔmadɔ nu hã trɔa alesi wò ahɔhɔ̃ wɔa dɔe, si wɔnɛ be elektrikŋusẽ si le wò ahɔhɔ̃ me dzi ɖena kpɔtɔna. Wonaa atike siawo abe IV ene.
• Atike si naa alɔ̃dɔdɔ amewo katã: Le dɔléle siwo nu sẽ wu me la, ɖɔktawo zãa atike si naa alɔ̃dɔdɔ tsɔ dea ame aɖe alɔ̃madɔmadɔ si atikewɔmɔnuwo hena vɛ me. Esia kpɔa amea ƒe ahɔhɔ̃ kple ŋutilã ta tso nusiwo nɔnɔme si nye status epilepticus (SE) gblẽna le eŋu si yia edzi la me.

Intubation (mɔ̃ si wotsɔ dea ʋu me

Intubation nye mɔ̃ si wotsɔ dea ame ƒe yaƒoƒomɔ̃ (bronchi ) me. Tube la kpɔa egbɔ be amea ƒe yaƒoƒomɔ̃a gakpɔtɔ le ʋuʋu ɖi. Enaa atikewɔlawo hã te ŋu gbɔa ya na wò to asigɛ siwo wotsɔ gbɔa agbe ame alo yagbɔgbɔmɔ̃ zazã me.

Nusiwo gbɔ wòtsona la dada

Ne alɔ̃madɔmadɔ si do dziku na ame aɖe la, atike si gbɔ wòtso la dada sɔ gbɔ ɣeaɖewoɣi be wòatɔ te alɔ̃madɔmadɔa. Le kpɔɖeŋu me, alɔ̃madɔmadɔ si atikewo, aɖinuwo, aha sesẽ alo atike muamewo zazã, alo lãmenugbagbeviwo ƒe dɔwɔwɔ ƒe kuxiwo abe sodium alo potassium ƒe agbɔsɔsɔ si sɔ gbɔ alo esi mesɔ gbɔ o ene hena vɛ.

Atikewɔwɔ siwo xea mɔ na alɔ̃madɔmadɔ

Mɔ bubue nye be woaxe mɔ ɖe alɔ̃madɔmadɔ nu, si ana woaxe mɔ na status epilepticus (SE) be wòagadzɔ ake o. Mɔnu siwo wozãna wu tsɔ xea mɔ na alɔ̃madɔmadɔ (alo ɖea woƒe sesẽme alo zi gbɔ zi geɖe dzi kpɔtɔna ya teti) dometɔ aɖewoe nye:

• Atikewo.
• Amekoko na asrãdɔ.
• Tɔtrɔ le nuɖuɖu me (vevietɔ carbohydrate si mebɔ o alo esi me carbohydrate mele o ``Ketogenic diets'').
• Lãmetsiŋusẽ ƒe dɔwɔwɔ (abe ahɔhɔ̃ ƒe ʋuʋu goglo alo vagus lãmekawo ƒe ʋuʋu ene).

Atikewɔwɔ bubuwo

Le wò nya kple nɔnɔme tɔxɛwo nu la, atikewɔwɔ kple dɔdamɔnu bubuwo ate ŋu anɔ anyi. Wò ɖɔkta (alo ame aɖe si ŋu woɖe mɔ ɖo be wòawɔ atikewɔwɔ ŋuti nyametsotsowo na wò) ate ŋu akafu atikewɔmɔnu si nyo na wò eye wòaɖe nusitae me.

Nukawoe nye atikewɔwɔa ƒe kuxiwo alo nugbegblẽ le ame ŋu?

Kuxi alo nugbegblẽ siwo ate ŋu ado tso atikewɔwɔ na status epilepticus (SE) me nɔ te ɖe nu geɖe dzi. Esiawo dometɔ aɖewoe nye:

• Ŋkuɖodzinu ƒe dɔmawɔmawɔ nyuie.
• Susu ƒe lãmesẽkuxiwo (abe blanuiléle kple/alo dzimaɖitsitsi ene).
• Atikewɔwɔ tɔxɛ si wowɔ na wò.
• Nusi gbɔ alɔ̃madɔmadɔa tso (ne ɖɔktawo ate ŋu ake ɖe eŋu).
• Wò atikewɔwɔ ŋutinya kple atikewɔwɔ me nɔnɔme ɖesiaɖe si nɔ ŋuwò do ŋgɔ.

Wò ɖɔktae nye ame nyuitɔ kekeake si aɖe kuxi siwo ate ŋu ado tso eme kple eƒe nugbegblẽ le ame ŋu me, eye ate ŋu ana aɖaŋuɖoɖowo hã wò le alesi nàxe mɔ ɖe wo nu alo aɖe wo dzi akpɔtɔ ne anya wɔ ŋu.

Aleke mawɔ akpɔ ɖokuinye dzi alo akpɔ dzesiawo gbɔ?

Status epilepticus (SE) nye atikewɔwɔ kpata si ate ŋu ade ame ƒe agbe afɔku me. Ame siwo ŋu dɔléle sia le mate ŋu akpɔ wo ɖokui dzi alo atɔ te alɔ̃dɔdɔa tẽ o. Mɔ ɖeka kolia si le dedie si dzi woato anya dɔlélea ahadae enye be woayi xɔ si me wowɔa dɔ kpata le - alo atikewɔƒe bubu si kpɔa nudzɔdzɔ kpatawo gbɔ - si me dɔwɔnu kple nuzazã siwo hiã le. Le susu siawo ta la, nɔnɔme sia nyea susu si ta nàƒo ka na 1990 (Emergency Medical Service) alo wò nutoa me ƒe xexlẽdzesi kpata eye nàdi atikewɔƒe enumake ɣesiaɣi.

Ɣeyiɣi didi kae wòxɔna hafi wòhayana le atikewɔwɔ vɔ megbe?

Ɣeyiɣi si woatsɔ ahaya tso status epilepticus (SE) me kple edada nɔ te ɖe nu geɖe dzi. Nu vevitɔ kekeake siwo dea dzesi ɣeyiɣi si nàhayae nye nusi na wò nɔnɔme si nye epilepticus kple ɣeyiɣi didi si wòxɔ. Wò ɖɔktae nye ame nyuitɔ si agblɔ ɣeyiɣi si me nàhaya le wò nyaa me na wò.

Aleke woawɔ aɖe status epilepticus ƒe afɔkua dzi akpɔtɔ?

Nu geɖe li siwo gbɔ alɔ̃dɔdɔ tsona, eye wo dometɔ geɖe nye esiwo womate ŋu agblɔ ɖi o. Eyata mɔ aɖeke meli si dzi woato axe mɔ ɖe alɔ̃madɔmadɔ kple status epilepticus (SE) nu keŋkeŋ o. Gake mɔ aɖewo li siwo dzi nàto aɖe afɔku si le wò alɔ̃dɔdɔ me dzi akpɔtɔ. Esia wɔwɔ aɖe mɔnukpɔkpɔ si li be alɔ̃madɔmadɔ nava zu status epilepticus (SE) dzi akpɔtɔ. Nu aɖewo siwo nàte ŋu awɔ atsɔ aɖe afɔku si le wò alɔ̃dɔdɔ me dzi akpɔtɔe nye esi:

• Na xɔnametikewo nanɔ asiwò: Le amesiwo nya be alɔ̃madɔmadɔ le yewo ŋu gome la, "xɔnametike" ƒe amesinɔnɔ ate ŋu ana tɔtrɔ gã aɖe nava. Le kpɔɖeŋu me, benzodiazepines siwo va le no me atike si wotsɔna ƒua gbe me. Ame aɖe ate ŋu ana esiawo wò be nàdzudzɔ alɔ̃madɔmadɔ. Kpɔɖeŋu bubue nye kpe gbadzɛ si ʋẽna le nu me. Àte ŋu ano esia le alɔ̃madɔmadɔ dome be nàtɔ te alɔ̃madɔmadɔ siwo kplɔ wo nɔewo ɖo. Ne ame bubu aɖe le alɔ̃madɔmadɔ lém la, na atikekui si woŋlɔ nɛ ne alɔ̃dɔdɔa nu tso vɔ.
• Ðu nuɖuɖu si da sɔ eye nàlé wò kpekpeme ɖe te: Dɔléle geɖe siwo do ƒome kple wò ʋu ƒe sisi kple dzi ƒe lãmesẽ, vevietɔ ʋusɔgbɔdɔ, ate ŋu agblẽ nu le wò ahɔhɔ̃ ƒe akpa aɖewo ŋu. Esia nye nu vevi aɖe si hea alɔ̃madɔmadɔ vɛ na amesiwo xɔ wu ƒe 60. Wò nuɖuɖu dzi kpɔkpɔ ate ŋu akpe ɖe ŋuwò hã be nàxe mɔ ɖe alɔ̃madɔmadɔ si elektrikŋusẽ ƒe kuxiwo hena vɛ nu (le kpɔɖeŋu me, sodium si sɔ gbɔ akpa alo esi mesɔ gbɔ o). Ame aɖewo ate ŋu ahiã nuɖuɖu si me carb mesɔ gbɔ ɖo o alo esi me carb mele o be woaxe mɔ ɖe alɔ̃madɔmadɔ nu. Ðɔkta ate ŋu afia mɔ wò ahakpe ɖe ŋuwò le nuɖuɖu siawo me.
• Da dɔlékuiwo: Ele vevie ŋutɔ be woada ŋku kple to me dɔlékuiwo. Dɔlékuiwo ate ŋu akaka ɖe ahɔhɔ̃a me eye/alo ahe asrã sesẽ vɛ. Esiawo evea siaa ate ŋu ana ame naxɔ alɔ̃.
• Do dedienɔnɔ ƒe nuzazãwo: Ta ƒe abixɔxɔ nye nu vevi aɖe si nana ame ƒe lãme ʋuʋuna. Dedienɔnɔnuwo, abe gakuku kple zikpuimeka ene dodo ɣesiaɣi si wòhiã, ate ŋu akpe ɖe ame ŋu be woaxe mɔ ɖe abi siwo ate ŋu ana ame naʋuʋu ame la nu.
• Ƒo asa na ahanono, atikewo, kple modzakaɖetikewo zazã ɖe mɔ gbegblẽ nu: Esiawo zazã ɖe mɔ gbegblẽ nu ate ŋu ana ame natsi dzimaɖi. Azɔ hã, ne nu siawo zu numame na wò la, àte ŋu axɔ alɔ̃dɔdɔ kokoko ne èdzudzɔ wo zazã.
• Dzra wò lãmesẽnyawo ɖo: Nɔnɔme siwo nɔa anyi didi dzi kpɔkpɔ ate ŋu akpe ɖe ŋuwò nàxe mɔ ɖe alɔ̃madɔmadɔ nu, vevietɔ esiwo tso sukli ƒe agbɔsɔsɔ si le ʋu me, abe suklidɔ ƒomevi 1 kple suklidɔ ƒomevi 2 ene gbɔ. Ne asrãdɔ le ŋuwò la, atike siwo tsia alɔ̃madɔmadɔ nu nono hã nye wò dɔlélea dzi kpɔkpɔ ƒe akpa aɖe.

Nukae mate ŋu akpɔ mɔ na ne status epilepticus dze dzinye?

Ne status epilepticus `(SE)` le ŋuwò la, mègatsia dzodzodzoe o elabena alɔ̃madɔmadɔa gblẽa wò ahɔhɔ̃ ƒe dɔwɔwɔ me. Le alɔ̃madɔmadɔ me la, wò ahɔhɔ̃ megawɔa dɔ nyuie o, si wɔnɛ be mète ŋu sea nusi le dzɔdzɔm gɔme alo ɖonɛ koŋ wɔa naneke o. Dɔwɔwɔ ɖe wò ŋutilã dzi tututu nɔ te ɖe alɔ̃madɔmadɔ ƒomevi si na nɔnɔme si nye epilepticus `(SE)` la dzi. Ame siwo ŋu status epilepticus `(SE)` le hã ate ŋu ade abi wo ɖokui ŋu to gege alo ƒoƒo ɖe nusiwo te ɖe wo ŋu me.

Ɣeyiɣi didi kae status epilepticus nɔa anyi?

Status epilepticus (SE) nɔa anyi aɖabaƒoƒo atɔ̃ ya teti. Zi alesi alɔ̃madɔmadɔ nɔa anyi didi la, zi nenemae wòate ŋu atɔ le eɖokui si o. Esia fia be anɔ eme godoo be status epilepticus (SE) anɔ anyi vaseɖe esime ame naku le nɔnɔme sia ƒe ŋusẽkpɔɖeamedzi ta.

Nukae nye nɔnɔme sia ƒe mɔkpɔkpɔ?

Status epilepticus (SE) nye atikewɔwɔ kpata elabena zi geɖe la, ewua ame ne womewɔ atike nɛ o. Gake atikewɔmɔnu siwo woate ŋu azã la nyo ɖe edzi ŋutɔ. Egbea la, status epilepticus (SE) ɖeɖe dzaa wua ame le 0.5% va ɖo 2% ko me.

Zi geɖe la, ɖevi suewo kple vidzĩ siwo xɔ status epilepticus (SE) tso dzoxɔxɔ ƒe alɔ̃madɔmadɔ me la ƒe nukpɔsusu nyuitɔ kekeake. Gake ne edzɔ kple dɔléle sesẽ aɖe abe ʋusɔgbɔdɔ ene la, ku ƒe afɔkua (tso status epilepticus (SE) alo dɔléle bubuwo ta) dzina ɖe edzi. Esia tae agbetsitsi ƒe agbɔsɔsɔ le status epilepticus (SE) me le sue le ame tsitsi siwo xɔ wu ƒe 60 dome ɖo.

Aleke mawɔ alé be na ɖokuinye? (Be woaxe mɔ ɖe alɔ̃madɔmadɔ nu) .

Ne status epilepticus (SE) ƒe ŋutinya le ŋuwò la, mɔxexe ɖe alɔ̃madɔmadɔ nue nye nu vevitɔ kekeake si nàte ŋu awɔ atsɔ akpɔ ɖokuiwò dzi. Afɔɖeɖe vevitɔ kekeake siwo nàte ŋu aɖe atsɔ axe mɔ ɖe alɔ̃madɔmadɔ nue nye:

• Dzra xɔnametikewo ɖe asi: Ne atike siwo wò ɖɔkta ŋlɔ na wò kpata le asiwò la, ke tsɔ wo ɖe asi ɣesiaɣi. Mègadzo le aƒeme wo manɔmee o. Dzra agbalẽvi si dzi woŋlɔ wò nɔnɔmea kple atike ɖesiaɖe si nèhiã alo nusiwo ŋu nèlɔ̃a nu le ɖo, alo bu atikewɔwɔ ŋuti nyatakakawo ƒe asigɛ dodo ŋu. Esia ate ŋu aɖe vi be nàkpe ɖe kpekpeɖeŋunala gbãtɔwo ŋu nenye be èhiã atikewɔlawo ƒe kpekpeɖeŋu eye ame aɖeke si nya wò nɔnɔmea mele gbɔwò o.
• No wò atikewo abe alesi woŋlɔe ene: Wò atike siwo tsia asrãdɔ nu nono ate ŋu akpe ɖe ŋuwò nàɖe wò alɔ̃madɔmadɔ ƒe dzidziɖedzi kple eƒe sesẽ dzi akpɔtɔ. Esia le vevie be woaxe mɔ ɖe status epilepticus (SE) nu. Ne èse le ɖokuiwò me be yeƒe lãme sẽ alo mèxɔ alɔ̃ o ɣeyiɣi didi aɖe hã la, mele be nàdzudzɔ wò atikewo nono gbeɖe o. Ðeko wòle be nàdzudzɔ wo nono kple wò ɖɔkta ƒe aɖaŋuɖoɖo.
• Ƒo nu kple wò ɖɔkta tso tiatia siwo nàte ŋu awɔ ŋu: Ne èdi be yeaɖe yeƒe atikewo dzi akpɔtɔ alo atrɔ ɖe atike bubu ŋu la, wò ɖɔkta ate ŋu agblɔ na wò ne anya wɔ kple nusiwo nàte ŋu awɔ. Ne anya wɔ be nàdzudzɔ alo atrɔ la, wò ɖɔkta ate ŋu akpe ɖe ŋuwò nàwɔe dedie.
• Kpɔ wò ɖɔkta edziedzi: Wò ɖɔkta awɔ ɖoɖowɔɖi aɖe na wò be nàkpɔ. Ɣeyiɣi siawo le vevie ŋutɔ na wò nɔnɔmea dzi kpɔkpɔ kple atike alo atike nyuitɔ didi.
• Mègaŋe aɖaba ƒu dzesiwo dzi o: Wò ɖɔkta ate ŋu akpe ɖe ŋuwò nàde dzesi nuxlɔ̃amedzesiwo alo dzesi siwo ate ŋu ado mo ɖa hafi adze ame dzi. Ne ède dzesi tɔtrɔ aɖewo le wò alɔ̃madɔmadɔ ƒe dzesiwo alo wò atikewo ƒe dɔwɔwɔ ŋu la, ele be nàgblɔe na wò ɖɔkta.
• Ƒo asa na nusiwo hea alɔ̃madɔmadɔ vɛ: Ne nɔnɔme aɖewo le ŋuwò si nana be alɔ̃dɔdɔ ƒe afɔkua dzina ɖe edzi, abe akaɖi siwo le keklẽm alo alɔ̃madɔmadɔ ene la, ƒo asa na nu mawo ɣesiaɣi si wòanya wɔ.

Ɣekaɣie wòle be mayi Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU) ?

Status epilepticus `(SE)` nye atikewɔwɔ kpata. Ne status epilepticus `(SE)` le ŋuwò la, wò ŋutɔ màte ŋu aƒo ka na 911 (Emergency Medical Service) o, eyata ame bubu nawɔe ate ŋu ana tɔtrɔ gã aɖe nava. Ne status epilepticus `(SE)` le ŋuwò eye nèle afɔku me be yeagaxɔe ake la, ate ŋu aɖe vi be nàƒo nu kple wò ƒometɔwo, wò lɔlɔ̃tɔwo, dɔwɔhatiwo, kple xɔlɔ̃wo. Ne èna wonya ɣeyiɣi si me woadi kpekpeɖeŋu ate ŋu axɔ wò agbe alo ame bubu aɖe ƒe agbe.

Ne ame aɖe si gbɔ nèle la ƒe alɔ̃dɔdɔ si xɔ wu miniti atɔ̃, alo ne alɔ̃dɔdɔ wu zi ɖeka eye mehaya o la, ƒo ka na 1990 (Emergency Medical Service) alo wò nutoa me ƒe xexlẽdzesi kpata enumake. Zi alesi ame aɖe xɔ status epilepticus (SE) ƒe atike kaba la, zi nenemae mɔnukpɔkpɔ si li be nu nyui aɖe nado tso eme la nyona ɖe edzii.

Nukae mawɔ ne ame aɖe si le gbɔnye la xɔ alɔ̃dɔdɔ?

Ne ame aɖe si gbɔ nèle la le alɔ̃madɔmadɔ lém la, nu ʋɛ aɖewo li nàte ŋu awɔ abe alɔ̃madɔmadɔ ƒe kpekpeɖeŋu gbãtɔ ƒe akpa aɖe ene. Ne alɔ̃madɔmadɔ xɔ wu miniti atɔ̃, alo ne amea gaxɔ alɔ̃ bubu hafi wòhaya keŋkeŋ la, ƒo ka na 1990 (Emergency) alo wò nutoa me xexlẽdzesi kpata.

Nusiwo wòle be nàwɔ kple esiwo mele be nàwɔ o ne ame aɖe le alɔ̃madɔmadɔ lém la dometɔ aɖewoe nye esi:

Nusiwo nàwɔ:

• Kpɔe ɖa be ate ŋu agbɔ ya hã: Ðe awu si le kɔ nɛ la ɖa eye nàkpɔ egbɔ be ele gbɔgbɔm.
• Na nu siwo me afɔku le nate ɖa le eŋu: Esia lɔ nusiwo ate ŋu agbã alo adze anyi ahade abi eŋu ɖe eme. Ne edo ŋkumeɖobolo la, ɖe wo ɖa nyuie eye nàda wo ɖe teƒe si te ɖe eŋu.
• Trɔe ɖe `Xɔxɔxɔ ƒe nɔnɔme` me:Trɔ amea ɖe woƒe axadzi. Nɔnɔme sia kpena ɖe wo ŋu wokpɔa woƒe yaƒoƒomɔ̃a ta eye wòxea mɔ na wo be womegagbɔa tsiwo abe aɖuɖɔ alo ʋuʋudedi ene o. Dze agbagba nàna woƒe ta nasɔ kple woƒe akɔta (kple woƒe alɔ si wodo, akɔtaɖonu, alo nu bubu aɖe le woƒe ta te), ne menye nenema o la, woƒe kɔ ƒe dzogoe ate ŋu axe woƒe yaƒoƒomɔ̃ eye wòana gbɔgbɔ nasesẽ.
• Ðo ɣeyiɣi na alɔ̃dɔdɔa alesi nàte ŋui: Ɣeyiɣi didi si alɔ̃madɔmadɔa nɔ gbɔgblɔ na ɖɔkta ate ŋu anye nyatakaka vevi aɖe ŋutɔ. Ate ŋu akpe ɖe ame ŋu hã be woanya nenye be ehiã be woakpɔ egbɔ kpata.
• Nɔ wo gbɔ ne wole hayahayam tso alɔ̃madɔmadɔ me: Zi geɖe la, amesiwo ŋu alɔ̃madɔmadɔ le la tɔtɔna eye wovɔ̃na ne wole hayahayam tso woƒe alɔ̃madɔmadɔa me. Kpe ɖe wo ŋu woafa akɔ na wo ahana kakaɖedzi wo.
• Kpɔe ɖa be amea ƒe lãme sẽ ne eƒe susu gaɖo eŋu vɔ: Ne abi aɖe le eŋu le alɔ̃madɔmadɔa megbe la, kpɔe ɖa be ehiã be woakpɔ egbɔ hã. Ne amea ƒo ta, alo ne afɔku li be wòaxɔ abi le ta, kɔ, alo akɔta la, nusi le dedie wue nye be nàdi atikewɔƒe eye nàkpɔ egbɔ be abi gã aɖeke meli si màte ŋu akpɔ o.
• Di kpekpeɖeŋu ne amea mehaya le miniti 10-15 me o: Ne amea mehaya wu miniti 10-15 le alɔ̃madɔmadɔa nu tsotso megbe o, alo ne womewɔ naneke o la, ele be nàdi atikewɔla kpata. Esia ate ŋu anye dzesi be alɔ̃madɔmadɔa le edzi yim, ne ŋutilãa mele ʋuʋum o gɔ̃ hã.

Nusiwo mele be woawɔ o:

• Mègatsi dzodzodzoe o: Nɔ anyi kpoo. Ne ame bubu siwo ƒo xlã wò la le vɔvɔ̃m la, ƒo nu kpli wo le dziɖeɖi me alesi nàte ŋui eye nàdze agbagba afa akɔ na wo alesi nàte ŋui.
• Mèga ``xe mɔ`` na ame aɖe si le alɔ̃madɔmadɔ lém o: àte ŋu awɔ nuvevi amea alo ɖokuiwò.
• Mègatsɔ naneke de ame aɖe si ŋu alɔ̃madɔmadɔ le ƒe nu me o: Nyakpakpa geɖewo li ku ɖe alɔ̃madɔmadɔ kple asrãdɔ ŋu. Nyakpakpa ɖekae nye be ne wotsɔ nane si le abe alidziblanu alo gavi ene de ame aɖe ƒe nu me la, ana wòagami eƒe aɖe alo aɖu eƒe aɖe o. Mègawɔ esia o. Mele be nàtsɔ naneke ade ame aɖe si ŋu alɔ̃dɔdɔ le ƒe nu me gbeɖe o. Àte ŋu awɔ nuvevi wo alo wò ŋutɔ ɖokuiwò.

Nukae wòle be mawɔ ne mese le ɖokuinye me be alɔ̃madɔmadɔ le ŋunye?

Nuxlɔ̃amedzesiwo nɔa ame geɖe ŋu ne esusɔ vie woaxɔ alɔ̃madɔmadɔ. Ne èsusu be alɔ̃madɔmadɔ le ye ŋu la, àte ŋu awɔ nusiawo atsɔ adzra ɖo ahakpɔ ɖokuiwò ta:

• Na ɖokuiwò nanɔ dedie alesi nàte ŋui: Nɔ anyi alo mlɔ anyi ale be màdze anyi awɔ nuvevi ɖokuiwò o. Ne èle nane wɔm abe ʋukuku, mɔ̃ sesẽwo zazã, alo aʋawɔnuwo zazã ene la, ele be nàdzudzɔ ewɔwɔ hã.
• Yɔ ame aɖe si dzi nèka ɖo eye nàbia kpekpeɖeŋu: gblɔ afisi nèle kple alesi woawɔ ake ɖe ŋuwòe na wo.
• Ne màte ŋu aƒo nu kple ame aɖe si nènya o la, gblɔe na ame aɖe si te ɖe ŋuwò be: Di ame aɖe si le agbanɔamedzi alo ŋusẽ ƒe ɖoƒe aɖe eye nàgblɔ nɛ be yesusu be alɔ̃dɔdɔ le ye ŋu. Le kpɔɖeŋu me, àte ŋu agblɔe na kpovitɔ, dedienɔnɔdzikpɔla, nufiala, alo fiase me dɔwɔla.

Kpuie Kpuie Kple Gbedasi si Wotsɔ Yi Aƒeme

Status Epilepticus (SE) nye atikewɔwɔ kpata si ate ŋu ade ame ƒe agbe afɔku me si dzɔna ne alɔ̃dɔdɔ xɔ wu miniti atɔ̃, alo ne ɣeyiɣi si mesɔ gbɔ be wòahaya bliboe tso alɔ̃dɔdɔ me o. Afɔku me nɔnɔ na alɔ̃madɔmadɔ kple status epilepticus (SE), alo ŋkuléle ɖe wò lɔlɔ̃tɔ aɖe ŋu wòaxɔ alɔ̃madɔmadɔ ɣeyiɣi didi ate ŋu ahe dzimaɖitsitsi kple vɔvɔ̃ vɛ.

Gake ne wowɔ atike na ame geɖe kaba la, wotsia agbe eye wohayana tso nɔnɔme sia me. Ne woyi atikewɔwɔ, atikewo, kple atikewɔwɔ bubuwo dzi la, ame geɖe siwo ŋu dɔléle si nye status epilepticus (SE) le ŋutinya me ate ŋu ahaya eye woagatrɔ ɖe woƒe agbenɔnɔ ŋu.

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Ðo ŋku edzi be ne ame aɖe ƒe alɔ̃madɔmadɔ xɔ wu miniti 5 alo eƒe susu megava nɔ alɔ̃ dɔm le alɔ̃dɔdɔ dome o la, ƒo ka na 911 alo atikewɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ enumake!

` Alɔ̃madɔmadɔ, nɔnɔme epilepticus, asrã, ahɔhɔ̃, atikewɔwɔ kpata, dzesiwo, kpekpeɖeŋu gbãtɔ