Omwana wo omuto atandika okuwuguka amangu ago? Kino kye tutegeeza mu Infantile Spasms? Ka tuzuule!

Wali olabye omwana wo omuto ng’akankana mu bwangu n’okukaluba? Kino osanga kibaawo emirundi egiwerako olunaku. Oyinza okuba nga weebuuza oba kino kya bulijjo oba embeera entongole ekwata abalongo. Ekyo kye tugenda okwogerako leero. Embeera eno eyitibwa `(Infantile Spasms)`. Ka tulabe kiki, lwaki kibaawo, obubonero ki, engeri y’okukizuula, n’obujjanjabi bwe buli.

Kino (Infantile Spasms) kye ki?

Mu ngeri ennyangu, `(Infantile Spasms)` kika kya bulwadde bw’okusannyalala obubeera mu baana abali wansi w’omwaka gumu, kwe kugamba, abali wansi w’emyezi 12 . Obulwadde bw'okusannyalala mbeera (`obuzibu bw'obusimu`) obuva ku buzibu obutali bwa bulijjo ku nkola y'amasannyalaze mu bwongo bw'omwana wo. Bino `(Infantile Spasms)` bwe bibaawo, omubiri gw'omwana naddala olubuto, omutwe, ensingo, emikono, n'amagulu, gunywezebwa mangu ne gulabika nga guwuubaala.

Okukonziba kuno kumala ekiseera kitono nnyo, nga sikonda emu oba bbiri . Naye zisobola okubaawo mu lunyiriri, ekitegeeza nti okukonziba okumu kujja ate oluvannyuma okulala oluvannyuma lwa sikonda 5 oba 10, oba mu `ekibinja`. Teebereza omwana ng’akuba ebikonde emirundi egiwerako mu lunyiriri. Ebiseera ebisinga, okukonziba kuno kujja oluvannyuma lw’abalongo okuzuukuka mu tulo .

Eky’ennaku kiri nti, abalongo bangi abatawaanyizibwa embeera eno bayinza okuba nga baalwawo dda enkula, oba bayinza okuzifuna oluvannyuma. Kwe kugamba, omwana alwawo okukola ebintu ebisaanira emyaka gye.

Njawulo ki eriwo wakati wa (Infantile Spasms) ne (West Syndrome)?

Kati oyinza okuba nga weebuuza ``West Syndrome'' eno kye ki. Oluusi abasawo nabo bakiyita bwe bati. ``West Syndrome'' kwe kukungaanya obubonero obuwerako. Ekyo kili:

• Tulina kino ``Infantile Spasms'' kye twogerako.
• Waliwo enkola etali ya bulijjo mu nkula y’amayengo g’amasannyalaze ag’obwongo eyitibwa `(Hypsarrhythmia)`. (Kino kizuulibwa okugezesebwa kwa `(EEG)`, tujja kukyogerako oluvannyuma).
• Waliwo okulwawo kw’enkulaakulana oba okufiirwa obusobozi obwaliwo emabegako (`developmental regression`).

Naye si buli mwana alina `(Infantile Spasms)` nti alina `(West Syndrome).` Kwe kugamba, kisoboka okuba ne `(Infantile Spasms)` awatali kulwawo kukula kwonna.

Njawulo ki eriwo wakati w’okusannyalala n’okukonziba?

Yee, kino kibuuzo kikulu nnyo. `(Infantile Spasms)` mu butuufu kika kya kukonziba. ``Okukonziba`` kwe kukola kw'amasannyalaze okw'amangu, okutafugibwa wakati w'obutoffaali bw'obwongo. Kino kiyinza okuvaako ebinywa okukaluba okumala akaseera, enkyukakyuka mu ntambula, enneeyisa, n’enkyukakyuka ezitali za bulijjo mu nneewulira. Okukonziba kwonna si kwe kumu.

Bw’ogeraageranya n’okukonziba kwa tonic-clonic oba grand mal kwe tutera okulowoozaako nga tulowooza ku kukonziba, okusannyalala kuno okw’abaana abawere kuba kumpi nnyo. Okusannyalala kw’abaana abawere kumala sekondi nga emu oba bbiri, naye kujja mu bibinja. Ebika by’okukonziba ebirala bisobola okumala wonna okuva ku sikonda 30 okutuuka ku ddakiika nga bbiri.

Njawulo ki eriwo wakati wa Infantile Spasms ne Startle Reflex?

Kino nakyo kintu ekitabula abazadde bangi, kubanga engeri ``Infantile Spasms'' gye zirabika eyinza okulabika ng'efaananako n'engeri abalongo gye batera okunyiganyiga.

Abalongo batera okukankana (era eyitibwa Moro reflex) bwe bawulira eddoboozi ery’omwanguka oba nga batambuzibwa mu bwangu. Olwo omwana asuula omutwe gwe emabega, n’ayanjuluza emikono n’amagulu, n’akyusa omutwe waggulu. Oluusi bayinza okukaaba, n’oluvannyuma ne basika emikono n’amagulu gaabwe okudda ku mubiri gwabwe.

Naye mu `(Infantile Spasms)` tewali nsonga ya bweru bwetyo . Kwe kugamba, okusannyalala tekubaawo olw’eddoboozi oba ekintu ekirala. Ekirala kiri nti `(Infantile Spasms)` zijja mu bikunta . Kwe kugamba, omu n’ajja, oluvannyuma omulala, n’omulala. Okusannyalala okwa bulijjo tekuwangaala bbanga ddene bwe lityo. Ate era, okuzimba bwe kubaawo, amaaso g’omwana gayinza okwekulukuunya, oba okulabika ng’azibye ennyindo . Bino tebitera kubeerawo mu kusannyalala okwa bulijjo.

Okusannyalala kw’abaana abawere kutandikira ku myaka emeka?

Okusinziira ku basawo, ebitundu 90% ebya `(Infantile Spasms)` bizuulibwa mu baana abali wansi w'emyezi 12, kwe kugamba, mu baana abali wansi w'omwaka gumu. Businga kubeera wakati w'emyaka ena n'emyezi musanvu . Wabula oluusi abaana abasukka mu myezi 12 nabo basobola okufuna okusannyalala okw’ekika kino. Mu mbeera eyo, esengekebwa nga `(Epileptic Spasms)`.

Embeera eno ya bulijjo etya?

Eno si mbeera ya bulijjo nnyo, naye era si ya butabeerawo. Kiteeberezebwa nti abaana nga omu ku buli 2,000 ku 4,000 ayinza okukosebwa embeera eno (Infantile Spasms).

Bubonero ki obw’okusannyalala kw’abaana abawere?

Okukonziba kuno bwe kujja, omubiri gw’omwana wo gukaluba mangu oba okuwuguka. Kimala sekondi ntono zokka. Omwana ayinza okukoona omugongo gwe, n’afukamira emikono gye, amagulu ge, n’omutwe gwe mu maaso. Nga bwe twagambye emabegako, okukonziba kuno kujja mu kibinja, ekimu oluvannyuma lw’omulala, nga kuwummulamu sikonda 5-10.

Oluvannyuma lw’okukuba ekigwo oba okukuba ebikonde ebitonotono, omwana ayinza okutabuka n’akaaba. Naye ekyo tekibaawo bulijjo.

Oluusi bino `(Infantile Spasms)` bijja mu ngeri ey'obukuusa ennyo . Tuyinza n’obutabategeera mangu. Obubonero obwo obutategeerekeka bwe buno:

• Okuyiringisiza amaaso go.
• Obulumi mu lubuto.
• Entambula z’akalevu.
• Okumwenya.
• Omutwe nga gunyeenya omutwe.

Singa okukankana kuva ku kintu ekitali kya bulijjo mu bwongo bw’omwana, emirundi mingi kiyinza okukosa oludda olumu lwokka olw’omubiri. Oba omutwe oba amaaso gayinza okulabika ng’agasimbuddwa ku ludda olumu.

Ekisinga obukulu nti ekigwo kino kisinga kubaawo ng'omwana azuukuse mu tulo . Butera nnyo kubaawo ng’omwana yeebase.

Nga tewannayita bbanga ddene ng’ebikonde bino bitandise, ojja kusobola okulaba enkyukakyuka endala mu mwana wo:

• Ebintu ebikulu mu nkulaakulana ng’okuyiringisibwa, okutuula, okufukamira, n’okukuba enduulu bibula.
• Enkolagana n’abalala ekendeera, era n’okuseka kukendeera .
• Bulijjo abeera ku bunkenke, oba bulijjo asirika.

Bwe kiba kisoboka, kwata vidiyo y’omwana wo ng’afunye ebizimba bino. Olwo osobola okuziraga omusawo w’abaana. Kikulu okutegeera ``Infantile Spasms'' zino nga bukyali. Bw’oba ​​olowooza omwana wo alina ebizimba bino, laba omusawo amangu ddala nga bwe kisoboka.

Emirundi emeka okusannyalala kw’abaana abawere kuyinza okubaawo?

Omwana asobola okukonziba emirundi 100 olunaku. Naye buli mwana akosebwa mu ngeri ya njawulo. N’olwekyo, bw’olaba omwana wo ng’afuna okukonziba, ne bwe kiba nti omulundi gumu oba ebiri gwokka olunaku, kirungi okwogera n’omusawo amangu ddala nga bwe kisoboka .

Biki ebivaako okusannyalala kw’abaana abawere?

Waliwo ebintu bingi ebiyinza okuvaako okusannyalala kw’abaana abawere. Bannasayansi bazudde embeera z’ebyobulamu ezisoba mu 200 eziyinza okuzireeta. Kyokka, mu mbeera nga kimu kya kusatu, abasawo tebasobola kuzuula kituufu ekivaako.

Stroke eno eyinza okuva ku butabeera bulungi mu kitundu ekitono eky’obwongo bw’omwana, oba eyinza okuva ku buzibu obuli mu bwongo bwonna.

Ezimu ku nsonga enkulu ze zino:

• Obwongo okwonooneka oba okukwatibwa yinfekisoni: Stroke eno eyinza okuva ku kika kyonna eky’obuvune ku bwongo. Ebisinga okuvaako bye bino: `(Hypoxic-ischemic encephalopathy)` (ekitegeeza nti obwongo tebufuna mukka gwa oxygen oba omusaayi gumala okumala ebbanga ddene), `(Meningitis)` (meningitis), ne `(Perinatal stroke)` (ekitegeeza stroke ebaawo mu makkati g'olubuto lw'omwana ne mu mwezi ogusooka oluvannyuma lw'okuzaalibwa).
• Ebizibu by’okukula kw’obwongo: Kino kiyinza okuva ku buzibu obuwerako mu busimu obw’omu makkati (obwongo n’omugongo) obubaawo ng’omwana akula mu lubuto. Okugeza, embeera nga `(Focal cortical dysplasia)`, `(Lissencephaly)`, `(Holoprosencephaly)` ne `(Aicardi syndrome)`. Era kiyinza okuva ku misuwa egitali gya bulijjo mu bwongo bw’omwana (`(Arteriovenous malformations)`).
• Enkyukakyuka mu buzaale: Kati bannassaayansi bakwataganya enkyukakyuka nnyingi mu buzaale n’okusannyalala kw’abaana abawere. Ebimu ku byokulabirako mulimu Trisomy 21 (Down syndrome), Tuberous sclerosis, Miller-Dieker syndrome, n’obuzibu bw’obutaba na CDKL5.
• Embeera z’enkyukakyuka mu mubiri: Ensobi ezizaalibwa mu nkyukakyuka y’emmere (IEM) nazo zisobola okuleeta embeera eno. Zino mbeera za buzaale eziziyiza amakubo g’enkyukakyuka mu mubiri agamenya emmere gye tulya n’efulumya amaanyi. Tekitera nnyo, obutaba na vitamiini B6 nakyo kiyinza okuleeta embeera eno.

Obulwadde bwa Infantile Spasms buzuulibwa butya?

Omusawo w’omwana wo ajja kukubuuza ku bubonero bw’omwana wo n’ebyafaayo by’obujjanjabi, era ajja kukukebera n’omubiri.

Olwo omwana wo ayinza okusindikibwa ew’omusawo w’obusimu bw’abaana oba omusawo w’okusannyalala. Bagenda kukola ekyuma ekiyitibwa electroencephalogram (EEG) okukakasa oba omwana alina okusannyalala kw’abaana abawere. Bayinza n’okukola ebigezo ebirala okuzuula ekivaako.

Okuva bwe kiri nti wayinza okubaawo ebikumi n’ebikumi ebivaako `Infantile Spasms`, kiyinza okuba ekizibu katono eri abasawo okuzuula ekivaako.

Biki ebikebera okuzuula obulwadde?

Omusawo okusinga akola okukebera kwa ``Electroencephalogram - EEG'' okukakasa oba ``Infantile Spasms'' ziriwo.

EEG epima era n’ewandiika obubonero bw’amasannyalaze mu bwongo bw’omwana wo. EEG bwe bakolebwa, omukugu ateeka obupande obutonotono obw’ebyuma (electrodes) ku mutwe gw’omwana. Electrodes zino ziyungibwa ku kyuma. Ekyuma kino kiwa omusawo amawulire agakwata ku mirimu gy’obwongo bw’omwana. Kirungi singa omwana aba n’okukonziba mu kiseera kya EEG era obudde wakati w’okukonziba osobola okubuwandiikibwa. Abasawo banoonya enkola ya EEG entongole eyitibwa hypsarrhythmia. Omuze guno gwa njawulo nnyo. Eno y’ensonga lwaki kitera okuba eky’angu eri abasawo okuzuula obulungi obulwadde bw’okusannyalala kw’abaana abawere.

Omusawo ayinza okulagira okwongera okukeberebwa okuzuula ekivaako okukankana kuno:

• Magnetic resonance imaging (MRI) scan of the brain: MRI scan kigezo ekitaliimu bulumi ekiyinza okukola ebifaananyi ebitegeerekeka obulungi ennyo eby’ebitundu n’ebizimbe mu bwongo bw’omwana wo. MRI ekozesa magineeti ennene, amayengo ga leediyo, ne kompyuta okukola ebifaananyi bino ebikwata ku nsonga eno mu bujjuvu. Tekozesa X-rays. MRI esobola okuyamba omusawo okuzuula ekivaako omwana wo okukonziba.
• Okukebera obuzaale n’enkyukakyuka mu mubiri: Singa MRI y’omwana wo eba ya bulijjo, omusawo ajja kutera okukola okukebera okulala, gamba ng’okukebera obuzaale n’enkyukakyuka mu mubiri, okugezaako okuzuula ekivaako okukonziba. Ebiseera ebisinga okukebera kuno kwetaagisa sampuli y’omusaayi, omusulo oba amazzi g’omugongo.

Obulwadde bw’okusannyalala mu baana abawere bujjanjabwa butya?

Waliwo ebigendererwa bibiri ebikulu eby’obujjanjabi. Ekimu kwe kuyimiriza oba okufuga okusannyalala . Ekirala kwe kujjanjaba ekivaako okusannyalala , bwe kiba kisoboka.

Obujjanjabi obukulu obuweebwa okukomya oba okuddukanya okukonziba bwe buno:

• Obusimu obuyitibwa adrenocorticotropic hormone (ACTH): .ACTH busimu obukolebwa endwadde yo ey’omubiri (pituitary gland). Kikwata nnyo ku ngeri omubiri gwo gye gukwatamu situleesi. ACTH bw'efuluma, endwadde z'ekibumba zisikirizibwa okukola "obusimu bwa situleesi" obuyitibwa cortisol. ACTH, ekozesebwa okujjanjaba okukonziba, busimu obukolebwa mu ngeri ey’ekikugu. Kiweebwa ng’empiso. Dozi ezisooka ziweebwa mu ddwaaliro. Olwo omusawo ajja kulondoola n’obwegendereza omwana wo okulaba oba alina ebizibu byonna ebiyinza okuvaamu. Okuva empiso za ACTH bwe zigenda okumala wiiki nga mukaaga, omusawo ajja kukulagira engeri y’okuwa omwana empiso eno awaka.
• Prednisolone ow’omu kamwa: Eddagala lino likolebwa mu busimu obuyitibwa corticosteroid hormone obukolebwa endwadde z’ekibumba. Kikola bulungi okujjanjaba okusannyalala kw’abaana abawere. Kiyinza okukozesebwa nga ACTH kizibu okufuna.
• Vigabatrin (`Vigabatrin - Sabril®`): Lino ddagala eriweweeza ku kukonziba. Buweebwa mu kamwa ng’empeke oba amazzi.

Singa omwana wo taddamu bujjanjabi buno obw’obusimu oba Vigabatrin, waliwo obujjanjabi obulala:

• Endya ya ketogenic.
• Eddagala eddala eriziyiza okukonziba.
• Singa ekivaako `Infantile Spasms` kiba kizibu mu kifo kimu mu bwongo (`focalized lesion`), okulongoosa obulwadde bw'okusannyalala kirungi.

Okusannyalala kw’abaana abawere oluusi kuyinza okuba okuzibu okujjanjaba. Abaana abamu bayinza okwetaaga okuddamu obujjanjabi oba obujjanjabi obw’okubiri. Mu bujjanjabi bwonna, emirimu gy’obwongo bw’omwana giyinza okwetaaga okulondoolebwa nga bakeberebwa EEG enfunda eziwera okulaba oba obujjanjabi bukola.

Omusawo bw’aba asobola okuzuula ekivaako omwana okusika omuguwa, balina okujjanjaba ekivaako ekyo bwe kiba kisoboka. Kino kiyinza okuzingiramu okulongoosa oba obujjanjabi obugendereddwamu embeera y’obuzaale oba ey’okukyusakyusa emmere.

Okulwawo kw’enkula n’okudda emabega bitera okubeera mu Infantile Spasms. Ttiimu y’abasawo b’omwana ejja kuwa amagezi ku bujjanjabi obugenda okuyamba mu nkula nga bwe kisoboka.

Biki ebiva mu bujjanjabi bw’okusannyalala kw’abaana abawere?

Waliwo ebizibu ebiwerako ebiyinza okuva mu bujjanjabi bw’obusimu obuyitibwa adrenocorticotropic hormone (ACTH):

• Puleesa (Peesa).
• Okunafuwa kw’abaserikale b’omubiri (`(Immunosuppression)`).
• Okuzimba (ebiseera ebisinga mu maaso).
• Obutawummula n’okunyiiga.
• Amabwa mu lubuto ne/oba mu byenda.
• Okufulumya glucose mu musulo.

Ebizibu ebiyinza okuva mu bujjanjabi bwa `Vigabatrin`:

• Okufunda kw’ekifo ky’okulaba okutakyuka.
• Obusungu.

Olw’ebizibu bino, omusawo w’omwana wo ajja kwogera naawe okuzuula obujjanjabi obusinga obulungi. Era bajja kulondoola omwana wo obulungi okulaba oba ebizibu bino bibaawo.

Kiki ekitegeeza nti obulwadde bw’okusannyalala kw’abaana abawere?

Ebiseera eby’omu maaso eby’embeera eno, oba `okuteebereza`, bisinziira ku nsonga eziwerako:

• Ekivaako `(Okusannyalala kw'abaana abawere)`.
• Ekivaako kisobola okujjanjabibwa?
• Engeri omwana gye yazuulibwamu amangu n’obujjanjabi ne butandika.
• Oba omwana atuuse ku nkulaakulana nga tannatandika kukuba bikonde.

Abaana nga 50% abalina okusannyalala kw’abaana abawere bayinza okuba n’obuzibu obw’ekiseera ekiwanvu mu nkula n’obusimu. Okusannyalala ne bwe kukoma, abaana bangi bayinza okufuna ebika ebirala eby’okukonziba n’okusannyalala.

Kyokka, singa kizuulibwa era ne kijjanjabwa mangu era mu ngeri ennungi, endowooza okutwalira awamu eyinza okuba ennungi . Abaana abaatuukiriza ebikulu mu nkula nga tebannatandika kukonziba basobola okukula mu ngeri eya bulijjo.

Nlabirira ntya omwana wange alina okusannyalala kw’abaana abawere?

Omwana wo bw'aba alina ``Infantile Spasms'', olina okugoberera ebiragiro by'omusawo okumuyamba:

• Eddagala lyonna liwe nga bwe liragiddwa.
• Laba okwekenneenya enkulaakulana n‟obujjanjabi.
• Genda mu kulambula kwonna okw’abasawo okugoberera.

Okusannyalala kw’abaana abawere kuyinza okuleeta obuzibu mu kutegeera, mu busimu, ne/oba mu kuwulira. Abaana bangi abalina Infantile Spasms balina obuzibu mu nkula era bayinza okwetaaga obuyambi mu mirimu gya buli lunaku obulamu bwabwe bwonna.

Ttiimu y’abasawo b’omwana wo esobola okuddamu ebibuuzo byo n’okukuwa obuyambi. Era bayinza okukulambika okugenda mu bibiina ebiwagira mu kitundu kyo oba ku yintaneeti.

Ddi lwe nnina okulaba omusawo w’omwana wange ku kusannyalala kw’abaana abawere?

Singa omwana wo azuuliddwa n’obulwadde bwa Infantile Spasms, ajja kwetaaga okulaba ttiimu yaabwe ey’abasawo buli kiseera okukakasa nti obujjanjabi bukola. Era bajja kwetaaga okukeberebwa mu ngeri ya electroencephalogram (EEG) okulondoola emirimu gy’obwongo mu bujjanjabi bwonna.

Bw’oba ​​olowooza nti omwana wo alina obulwadde bwa Infantile Spasms, naye nga tannazuulibwa, kikulu nnyo okulaba omusawo amangu ddala nga bwe kisoboka .

Kya bulijjo okuwulira nga weeraliikirira ng’omwana wo teyeeyisa mu ngeri ya bulijjo oba nga tatuukiriza bikulu by’akula. Ggwe osinga okumanya omwana wo . Bw’oba ​​olowooza nti omwana wo alina okusannyalala - okuwulira okw’amangu, okukaluba, okunyiganyiga, emirundi mingi mu bikunta - yogerako n’omusawo amangu ddala nga bwe kisoboka. Bwe kiba kisoboka, kwata vidiyo y’okusannyalala. Osobola okukiraga omusawo. Okutegeera amangu ``Infantile Spasms'' kiyinza okuvaamu ebivaamu ebirungi .

Ebintu bye tusaanidde okujjukira okuva mu mboozi eno (Take-Home Message)

Okay, kale bino bye bintu ebitonotono by’olina okukuuma mu birowoozo okuva ku bye twogeddeko:

• Infantile Spasms kika kya bulwadde bw’okusannyalala obw’amaanyi obubeera mu baana abali wansi w’emyezi 12.
• Singa omwana wo asikaasikanya mangu n’akaluba naddala mu bikunta ng’azuukuse , tokitwala nga kitono .
• Kino kyawukana ku mbeera y’omwana eya bulijjo ey’okukankana.
• Bwe kiba kisoboka, kwata vidiyo y’okukonziba okulage omusawo .
• Okuzuula amangu n’okujjanjaba omwana kiyinza okukosa ennyo enkula y’omwana mu biseera eby’omu maaso.
• Bw’olaba enkyukakyuka yonna mu nneeyisa y’omwana wo, mu kamwenyumwenyu, oba enkula ye, yogerako n’omusawo wo ku ekyo nakyo.
• Kino kiyinza okuba ekizibu ennyo eri abazadde bombi. Kale, ng’ogoberera ddala ebiragiro by’omusawo, weefunire obuwagizi. Tofaayo, abasawo bajja kukuyamba.

` Okusannyalala kw’abaana abawere, okusannyalala, okunyiganyiga kw’omwana, okukonziba, West Syndrome, okusannyalala kw’abaana abawere, EEG, MRI