Loaʻa i kāu mea aloha kēia mau hōʻailona ʻē? He paʻakikī anei ke ʻōlelo a i ʻole ke ale ʻana? E aʻo kākou e pili ana i (Pseudobulbar Palsy)!

Ua ʻike anei ʻoe i kekahi manawa e hoʻomaka koke ana kā mākou poʻe aloha e ʻakaʻaka me ke kumu ʻole, a hoʻomaka paha e uē me ka ʻole o ke kaumaha? A i ʻole e ʻōlelo haʻahaʻa lākou i ka wā e kamaʻilio ana, a i ʻole e paʻakikī ke ale i ka meaʻai? Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau mea i hui pū ʻia, hiki ke kumu o kahi maʻi i kapa ʻia ʻo 'Pseudobulbar Palsy' a mākou e kamaʻilio nei i kēia lā. ʻAʻole kēia he maʻi ʻokoʻa, akā he hōʻiliʻili o nā hōʻailona i hoʻokumu ʻia e kekahi mau maʻi neurological. No laila, e kamaʻilio kākou e pili ana i kēia me nā kikoʻī hou aku?

He aha ka Pseudobulbar Palsy?

I ka ʻōlelo maʻalahi, ʻo ka Pseudobulbar Palsy kahi hōʻiliʻili o nā hōʻailona neurological i hoʻokumu ʻia e ka hōʻino ʻana i kahi ʻāpana kikoʻī o ko mākou lolo i kapa ʻia ʻo ke ala corticobulbar. Kōkua kēia ala corticobulbar i ka hoʻomalu ʻana i nā ʻiʻo ma ko mākou poʻo a me ka maka. Ke hōʻino ʻia kēia, kū mai ʻekolu mau pilikia nui:

• ʻO ka paʻakikī o ka ʻōlelo ʻana, kapa mākou i kēia ma ke ʻano lapaʻau he 'dysarthria' .
• ʻO ka paʻakikī i ka ale ʻana i ka meaʻai a i ʻole nā ​​​​wai i kapa ʻia ʻo dysphagia .
• ʻO ka hiki ʻole ke kāohi i nā manaʻo o kekahi, e like me ka ʻakaʻaka koke ʻana a i ʻole ka uē ʻana, ua kapa ʻia ʻo "pseudobulbar affect."

ʻO ka mea nui, ʻaʻole kēia he maʻi hoʻokahi, akā he pilikia i hoʻokumu ʻia e nā maʻi neurological ʻē aʻe a i ʻole nā ​​​​​​kūlana cerebrovascular. I kekahi manawa kapa pū nā kauka iā ia he 'supranuclear bulbar palsy'.

He aha nā hōʻailona o kēia maʻi?

E like me ka mea i ʻōlelo ʻia ma mua, ʻo nā hōʻailona nui ʻekolu ka paʻakikī o ka ʻōlelo ʻana, ka paʻakikī o ka moni ʻana, a me ka hiki ʻole ke kāohi i nā manaʻo. Eia nō naʻe, hiki ke ʻike ʻia nā hōʻailona ʻē aʻe, e like me:

• Ka drooling a i ʻole ka salivation nui: I kekahi manawa hiki i ka lawai ke pakele mai ka waha me ka ʻole o kou ʻike.
• Nā loli i ke ʻano a me ke kani o ka ʻōlelo: ʻAʻole maopopo paha ka ʻōlelo. Hiki ke kani me he mea lā e ʻōlelo ana ʻoe ma kou ihu (leo ihu nui).
• Ka nāwaliwali o ke alelo a i ʻole ka lolo: Ua kapa ʻia kēia ʻo 'glossoplegia'. Hiki i kēia ke paʻakikī i ka ʻōlelo ʻana a me ka nau ʻana i ka meaʻai.
• Ka nāwaliwali o nā ʻiʻo o ka maka: Hiki i kekahi a i ʻole nā ​​ʻaoʻao ʻelua o ka maka ke lilo i mea ola ʻole.
• Paʻakikī ke nau ʻana i ka meaʻai: No ka mea, ʻaʻole hiki iā ʻoe ke nau pono i ka meaʻai, lilo ia i mea paʻakikī ke ale.
• ʻAkaʻaka a uē paha i hiki ʻole ke kāohi ʻia a kūpono ʻole paha: E noʻonoʻo i ka uē koke ʻana me ke kumu ʻole, a i ʻole ka ʻakaʻaka nui ʻana i kahi mea liʻiliʻi, a ʻaʻole hiki ke kāohi iā ia. Ua kapa ʻia kēia he "pseudobulbar affect."
• ʻOʻoleʻa a paʻa paha o nā ʻiʻo o ka ʻāwae: Ua kapa ʻia kēia he 'trismus'. Hiki ke paʻakikī ke wehe a pani i kou waha.
• Hoʻonui ʻia nā reflexes helehelena: No ka laʻana, hiki ke ʻā ʻia ka ʻāwae.

Ua hōʻike ʻia hoʻi e hiki i kahi 85% o nā keiki me Pseudobulbar Palsy ke loaʻa i nā kūlana e like me ke kīnā noʻonoʻo a me nā hopu ʻana .

Me kēia mau hōʻailona, ​​​​hiki ke ʻike ʻia nā hōʻailona ʻē aʻe ma muli o ka maʻi kumu i hoʻokumu ai i ka pseudobulbar palsy.

No ke aha lā kēia e hana nei? He aha nā kumu?

ʻO ke kumu nui o ka Pseudobulbar Palsy ka hōʻino ʻia ʻana o nā ʻaoʻao ʻelua o ke ala corticobulbar i loko o ko kākou lolo. ʻO ka hana o kēia ala ka hoʻomalu ʻana i nā ʻiʻo ma ke poʻo a me ka maka. Hāʻawi pū kēia ʻāpana i ka hoʻokomo ʻana i nā aʻalolo cranial e hāʻawi ana i nā leka e pono ai i kēia mau ʻiʻo.

No laila, aia kekahi mau kūlana e hiki ke hōʻino i kēia "corticobulbar tract." ʻO lākou kēia:

• Nā ʻeha poʻo koʻikoʻi (nā ʻeha lolo traumatic).
• Nā puʻupuʻu o ka lolo .
• Ka mumū a me nā maʻi e hoʻopilikia ana i ka lolo.
• Nā kūlana neurological mau loa .
• Nā maʻi e pili ana i nā kīʻaha koko o ka lolo, no ka laʻana "strokes" a me "vascular malformations".

ʻO kekahi mau kūlana neurological maʻamau a lōʻihi hoʻi e hana pinepine ai i ka pseudobulbar palsy:

• ʻO ka sclerosis ʻaoʻao Amyotrophic (ALS).
• ʻO ka maʻi o Parkinson .
• ʻO ka maʻi palupalu supranuclear holomua.
• ʻO ka sclerosis lehulehu ('Sclerosis lehulehu - MS').

Pehea ʻoe e ʻike ai i kēia?

Hoʻomaopopo pinepine nā kauka i ka Pseudobulbar Palsy ma muli o kāu mau hōʻailona. ʻO ke kī ma ʻaneʻi, ʻo ia ka ʻike ʻana i ke ʻano kumu e hoʻoulu ai i ke ʻano. Ua ʻike mua paha ʻoe e pili ana i ia mea, a i ʻole pono paha ʻoe e ʻike i kahi mea hou.

E nīnau ke kauka iā ʻoe e pili ana i kāu mau hōʻailona, ​​​​i ka wā i hoʻomaka ai, a me kāu mōʻaukala olakino piha, e like me inā ua loaʻa iā ʻoe kahi maʻi ma mua e like me ka hahau ʻana. A laila e hana lākou i kahi hoʻokolohua kino a me kahi hoʻokolohua neurological .

Ma muli o ka nui o nā kūlana e hiki ai ke hana i ka pseudobulbar palsy, hiki i kāu kauka ke paipai i nā hoʻokolohua like ʻole. ʻO kekahi o kēia mau mea:

• Nā hoʻāʻo koko .
• ʻO ka piula wai no ka wai cerebrospinal (ka nānā ʻana o ka CSF).
• Nā hoʻokolohua kiʻi, e like me ka MRI scan o ka lolo .
• He hoʻāʻo `EEG` (`EEG - electroencephalogram`), nāna e ana i ka hana uila o ka lolo.
• Nā hoʻokolohua 'Evoked Potential'(`Nā hoʻāʻo hiki ke hoʻāla ʻia`).
• Nā loiloi ʻōlelo a me ka noʻonoʻo .

E kōkua kēia mau hoʻokolohua iā mākou e ʻike pono i ke kumu o ka maʻi.

Pehea e mālama ʻia ai?

ʻAʻohe lāʻau lapaʻau pololei no ka Pseudobulbar Palsy. Akā, e paipai kāu hui lapaʻau i nā ʻano lāʻau lapaʻau like ʻole e hoʻokele i nā hōʻailona o ke kūlana. Eia kekahi, pono paha e mālama ʻia ke kūlana kumu.

No kēia, pono ʻoe i ke kōkua o kahi hui o nā kauka i haku ʻia me nā loea like ʻole. Eia kekahi o lākou:

• Kou kauka ʻohana ('Kauka mālama mua').
• Nā kauka lolo.
• Nā kauka ʻōlelo a me nā loea ʻōlelo.
• Nā mea lapaʻau hanu.
• Nā kauka noʻonoʻo a i ʻole nā ​​kauka lapaʻau noʻonoʻo.
• Nā limahana hana kaiaulu.
• Nā kauka lāʻau lapaʻau.

Lapaʻau no ka pilikia o ka ale ʻana (Dysphagia)

Aia nā ʻano lapaʻau like ʻole e loaʻa ana ma muli o ke koʻikoʻi o ka paʻakikī o ka moni ʻana. ʻO kekahi o lākou:

• Ke hoʻololi nei i nā kūlana ʻai, ke hoʻololi nei i nā mea ʻai, a me ka hoʻololi ʻana i ke ʻano o ka meaʻai. Eia kekahi laʻana, hiki iā ʻoe ke kuʻi maikaʻi i ka meaʻai a hoʻolilo iā ia i wai e maʻalahi ai ke ale.
• Nā hoʻomaʻamaʻa e hoʻoikaika i nā ʻiʻo e kōkua ai i ka moni ʻana ('Swallowing muscle training').
• ʻO ka physiotherapy, e like me ka hoʻoulu uila, magnetic a i ʻole ka hoʻoulu ʻana thermal.
• ʻO nā lāʻau lapaʻau, no ka laʻana, nā lāʻau lapaʻau e like me 'nifedipine' a me 'metoclopramide'.

E hoʻomanaʻo, inā ʻaʻole hiki iā ʻoe ke ʻai a inu pono paha, a inā paha ʻoe e pilikia ana i ka ʻū ʻia ʻana, e ʻōlelo paha kāu kauka e hānai iā ʻoe ma o kahi ʻōmole ('feeding tube') i hoʻokomo pololei ʻia i loko o kou ihu a ʻōpū paha .

Lapaʻau no ka pilikia o ka ʻōlelo

Inā pilikia ʻoe i ka ʻōlelo ʻana, hiki i ka hoʻōla ʻōlelo ke kōkua nui. ʻAʻole wale ke aʻo aku ka mea hoʻōla ʻōlelo iā ʻoe, akā, i kou ʻohana hoʻi pehea e kamaʻilio maikaʻi aku ai me ʻoe.

I ka wā o nā kau hoʻoponopono ʻōlelo, hiki iā ʻoe ke aʻo i nā mea e like me:

• Nā hoʻomaʻamaʻa e hoʻoikaika ai i ke alelo, nā lehelehe, a me nā ʻiʻo ʻauwae (inā hiki).
• Nā hoʻolālā no ka ʻōlelo ʻana me ka akāka, e like me ka hoʻolohi ʻana i kou wikiwiki o ka ʻōlelo ʻana a me ka hoʻohana ʻana i nā ʻiʻo kikoʻī e haʻi maopopo i nā leo a me nā huaʻōlelo.
• Nā ʻano e hōʻike ai i nā manaʻo me ka ʻole o nā huaʻōlelo, e like me ka ʻōlelo lima a i ʻole ke kākau ʻana.

Lapaʻau no ka hōʻike ʻana o ka naʻau i kāohi ʻole ʻia (`Pseudobulbar Affect - PBA`)

Nā lāʻau lapaʻau e kāohi ai i ka "Pseudobulbar Affect (PBA)", kahi kūlana e ʻakaʻaka a uē ai ʻoe me ke kāohi ʻoleHiki ke kōkua. Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me:

• ʻO Dextromethorphan/quinidine sulfate (Nuedexta®): Ua ʻāpono ka U.S. Food and Drug Administration (FDA) i kēia lāʻau lapaʻau ma ke ʻano he lāʻau lapaʻau mua i hoʻolālā kūikawā ʻia no ka mālama ʻana i ka PBA. Loaʻa iā ia kahi lāʻau lapaʻau kūkū a me kahi lāʻau haʻahaʻa o kahi lāʻau i hoʻohana mua ʻia e mālama i nā maʻi puʻuwai.
• Nā Antidepressants : ʻO nā lāʻau lapaʻau e like me nā antidepressants tricyclic, SSRIs (Selective serotonin reuptake inhibitors), a me SNRIs (Serotonin a me norepinephrine reuptake inhibitors) hiki ke kōkua i ka kaohi ʻana i nā hōʻailona o PBA.

Pehea lā kēia kūlana? Hiki ke ho'ōla ʻia?

ʻO ka wānana o kekahi me ka pseudobulbar palsy e hoʻoholo mua ʻia e ka maʻi kumu.

E noʻonoʻo, inā loaʻa iā ʻoe kēia maʻi ma muli o ka "stroke" a i ʻole ka "ʻeha o ka lolo traumatic", aia kahi hiki ke hoʻi mālie ka hana aʻalolo i ka maʻamau. ʻO ia hoʻi, hiki ke emi mālie nā hōʻailona o ka pseudobulbar palsy.

Eia nō naʻe, inā i hoʻokumu ʻia kēia ʻano e nā maʻi degenerative mau loa e like me ka multiple sclerosis (MS), ka maʻi Parkinson, a me ka ALS, he mea paʻakikī ke manaʻo i kahi lāʻau.

E hiki i kāu hui lapaʻau ke hāʻawi iā ʻoe i kahi manaʻo maopopo no ka mea e hiki mai ana no kou kūlana kikoʻī.

He aha nā pilikia ʻē aʻe e hiki ai i kēia ke hana?

Hiki i ka pseudobulbar palsy ke hana i nā pilikia e like me:

• ʻO ka niumonia aspiration: No ka mea he paʻakikī ke kāohi i nā ʻiʻo o ke alelo a me ka waha, hiki i kahi meaʻai liʻiliʻi a mea inu paha ke komo i loko o nā māmā, e hana ana i kahi maʻi i kapa ʻia ʻo ka niumonia aspiration. Hiki i kēia ke lilo i mea weliweli.
• ʻAi ʻole ka meaʻai a me ka make wai: Inā koʻikoʻi ka dysphagia, hiki ke loaʻa ka ʻai ʻole ka meaʻai a me ka make wai ma muli o ka hiki ʻole ke ʻai a inu pono. I nā hihia koʻikoʻi, pono paha kahi ʻōmole hānai.
• Nā kūlana olakino noʻonoʻo: Hiki i ka maʻi pseudobulbar ke loaʻa ka hopena nui i kou ola o kēlā me kēia lā. Hiki iā ʻoe ke hoʻokaʻawale ʻia e ka lehulehu ma muli o nā mea e like me ka paʻakikī o ka ʻōlelo ʻana a me nā pahū ʻana o ka manaʻo i kāohi ʻole ʻia. Hiki i kēia ke alakaʻi i nā pilikia olakino noʻonoʻo e like me ke kaumaha a me ka hopohopo .

He make anei ka Pseudobulbar Palsy?

ʻAʻole make pololei ka maʻi pseudobulbar palsy. Eia nō naʻe, ʻo ka maʻi kumu e hoʻokumu ai (e.g., ka maʻi lolo )`, `ALS`) hiki ke make. Eia kekahi, ʻo nā pilikia e like me ka `aspiration pneumonia` hiki ke hoʻoweliweli i ke ola inā ʻaʻole mālama pono ʻia.

Aia kekahi ala e pale aku ai i kēia?

ʻOiai he nui nā kumu e hiki ai ke hoʻoulu i ka pseudobulbar palsy, ʻaʻohe ala pololei e pale aku ai. Eia nō naʻe, ʻo ka hahai ʻana i nā hana olakino e hiki ke pale aku i nā kumu pilikia e like me ka "paralysis" hiki ke kōkua pololei ʻole.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe ʻo Pseudobulbar Palsy, pono ʻoe e hālāwai me kāu hui lapaʻau i kēlā me kēia manawa e hōʻoia i ka hana pono ʻana o kāu hoʻolālā lapaʻau.

Hiki i kēia kūlana ke loaʻa ka hopena nui i kou ola o kēlā me kēia lā, a hiki paha iā ʻoe ke manaʻo ua kaumaha ʻoe. I kēlā mau manawa , mai kānalua e ʻimi i ke kōkua mai kāu poʻe aloha, a me ke kākāʻōlelo olakino noʻonoʻo . E hoʻomanaʻo, aia mau kāu hui lapaʻau me ʻoe e ʻimi i ka hoʻolālā lapaʻau e kūpono loa iā ʻoe.

Leka Lawe-Home

ʻAe, e hoʻomanaʻo kākou i kēia ma ke ʻano he hōʻuluʻulu manaʻo o ka Pseudobulbar Palsy a mākou i kamaʻilio ai i kēia lā:

• ʻAʻole kēia he maʻi ʻokoʻa, akā he hōʻiliʻili o nā hōʻailona i hoʻokumu ʻia e ka hōʻino ʻana i kahi ʻāpana kikoʻī o ka lolo.
• ʻO nā hōʻailona nui ka paʻakikī i ka ʻōlelo ʻana, ka paʻakikī i ka moni ʻana, a me ka ʻakaʻaka a uē paha hiki ʻole ke kāohi.
• ʻO nā kumu e komo pū me nā maʻi neurological e like me ka maʻi lolo, ka maʻi Parkinson, MS, a i ʻole nā ​​​​​​ʻeha poʻo .
• ʻO ke kumu o ka lāʻau lapaʻau ka mālama ʻana i ke kūlana kumu a me ka kaohi ʻana i nā hōʻailona. Hiki i ka hoʻōla ʻōlelo, nā hoʻomaʻamaʻa ale ʻana, a me nā lāʻau lapaʻau ke kōkua me kēia.
• He mea nui loa ka ʻike koke ʻana i nā hōʻailona a ʻimi i ke kōkua lapaʻau.
• He mea waiwai nui kou aloha, kākoʻo, a me kou hoʻomaopopo ʻana i kahi mea e noho nei me kēia maʻi.

Inā ʻoe a i ʻole kekahi mea kokoke iā ʻoe e ʻike nei i kekahi o kēia mau hōʻailona, ​​e ʻoluʻolu e ʻike i ke kauka no ka ʻōlelo aʻo. ʻO ia ka mea maikaʻi loa hiki iā ʻoe ke hana.

ʻO ka maʻi pseudobulbar, nā maʻi lolo, nā pilikia ʻōlelo, nā pilikia ale, nā maʻi neurological, ka hoʻoponopono ʻana i ka naʻau, PBA