Ka tuyige ku Neuromuscular Disorders mu ngeri ennyangu.

Oluusi owulira nga tolina maanyi, kizibu okusitula omukono oba ekigere, oba ebitundu byo ne bizirika ng’otambula, n’ebinywa byo ne binafuwa mpolampola? Bino si bintu bya kimpowooze byokka. Mpozzi emabega w'obubonero buno waliwo endwadde z'obusimu n'ebinywa ze tugenda okwogerako leero, kwe kugamba, embeera eyitibwa ``Neuromuscular Disorders''. Teweeraliikiriranga, tewali kyakutya nga omaze okuwulira bino. Ka twogere ku buli kimu mu ngeri entegeerekeka era ennyangu.

Obuzibu bw’emisuwa (Neurmuscular Disorders) kye ki?

Mu ngeri ennyangu, kino kibinja kya ndwadde ezikwata ebitundu by’obusimu bwaffe naddala obusimu obw’okumpi ( obusimu obufuluma mu bwongo n’omugongo), ebinywa oba empuliziganya wakati w’obusimu buno. Lowooza ku kino, entambula z’omubiri gwaffe zibaawo ng’obubaka obuva mu bwongo buyita mu busimu okukola ebinywa. Singa wabaawo ensobi awalala mu nkola eyo, endwadde zino zisobola okubaawo.

Embeera zino zitera okuleeta obunafu bw’ebinywa , okubula oba okubula kw’ebinywa (muscle atrophy) , n’enkyukakyuka mu kuwulira (nga okuzirika oba okuwunya). Kyokka n’obubonero obulala buyinza okulabika, okusinziira ku kika ky’obulwadde.

Endwadde zino ze ziruwa? Zikwata zitya ku mibiri gyaffe?

Obuzibu bw’emisuwa si bulwadde bumu. Zino kibinja kya ndwadde era buli kibinja kirimu embeera ez’enjawulo. Ziyinza okukosa ebitundu bino wammanga eby’enkola yaffe ey’obusimu:

• Obutoffaali bw’amayembe ag’omu maaso ag’omugongo
• Ebikoola by’obusimu (era mulimu n’ebikoola by’omugongo ebiyitibwa ganglia) .
• Emikutu gy’obusimu `(Plexuses)` (e.g. `(brachial plexus)` - ekwatagana n’ebibegabega, `(lumbosacral plexus)` - ekwatagana n’ensingo)
• Obusimu obuyitibwa peripheral nerves
• Enkolagana y’obusimu obuyitibwa neuromuscular junction
• Ebiwuzi by’ebinywa

Kati katutunuulire endwadde ezikwata buli kimu ku bitundu bino mu bujjuvu katono.

Endwadde ezikwatagana n’obutoffaali bw’obusimu obukola emirimu (Anterior horn cells) obw’omugongo

Zino zitera okuba endwadde ezigenda zikula nga zisaanyaawo obusimu obukola emirimu gy'omubiri . Obusimu obuyitibwa Motor neurons kika kya butoffaali mu bwongo bwaffe n’omugongo obutuyamba okutambula, gamba ng’okutambula, okwogera n’okussa. Obutoffaali buno butambuza obubaka okuva ku bwongo okutuuka mu binywa.

Okusingira ddala, ``obutoffaali bw’amayembe ag’omu maaso`` butoffaali bwa busimu obukola emirimu mu kintu enzirugavu eky’omugongo. Zikulu nnyo mu kutambula kw’ebinywa byaffe eby’amagumba. Obutoffaali buno bwe busaanawo, ebinywa bifiirwa obusimu (denervation) ne binafuwa.

Endwadde enkulu ezibeera mu kiti kino ze zino:

• ALS (Amyotrophic Lateral Sclerosis - ALS) oba obulwadde bwa Lou Gehrig
• Okukendeera kw’ebinywa by’omugongo (SMA) .
• Okukendeera kw’ebinywa by’omugongo (spinal-bulbar muscular atrophy) (SBMA) oba obulwadde bwa Kennedy
• Polio

Ebizibu ebiva ku Plexus (Plexopathies) .

Obusimu obuva mu mugongo gwaffe ku mitendera egy’enjawulo butuuka n’okwegatta ne bukola omukutu omuzibu, oba plexus . Tulina ekitundu ekiyitibwa brachial plexus mu mikono gyaffe egya waggulu, ate lumbar plexus oba lumbosacral plexus mu mikono gyaffe egya wansi, nga zino zisangibwa mu bulago bwaffe.

Obusimu buno busobola okwonooneka, okunyigirizibwa oba okuzimba, ekiyinza okuvaako obulumi, okuzirika, okuwunya, n’okunafuwa mu mukono oba ekigere ekikoseddwa.

Endwadde ezikwatagana n’ebikoola by’obusimu

Ebikoola by’obusimu matabi mampi ag’obusimu bw’omugongo. Obusimu bw’omugongo buva mu mugongo (amagumba) okumpi n’omugongo gwaffe. Buli busimu bw’omugongo bulina emirandira gy’obusimu obukola emirimu n’emirandira gy’obusimu obuwulira. Ebikoola by’obusimu bw’omubiri (motor nerve roots) bye bubaka okuva mu bwongo n’omugongo we butambulira okutuuka mu binywa nga buyita mu busimu obw’okumpi.

Ebikoola by’obusimu bino bwe binyigirizibwa ebitundu ebibyetoolodde, obulumi n’okuzirika bisobola okubaawo mu bitundu by’omubiri eby’enjawulo. Kino kiyitibwa `radiculopathy` . Ebikoola by’obusimu bw’omubiri bwe binyigirizibwa, ebinywa binafuwa.

Waliwo ebika by’obulwadde bwa radiculopathy okusinziira ku kifo obusimu bw’omugongo we bunyigirizibwa:

• Obulwadde bw’omumwa gwa nnabaana (cervical radiculopathy).
• Okuva wakati okutuuka waggulu mu kifuba (`(thoracic radiculopathy)`)
• Lumbar oba lumbosacral radiculopathy (ekwatagana n’ensingo n’omugongo ogwa wansi) .

Endwadde ezikwatagana n’obusimu obuyitibwa peripheral nerves

Obulwadde bw’obusimu obw’okumpi (peripheral neuropathy ) kigambo kya bulijjo ekitegeeza obulwadde bwonna obukosa obusimu obw’ebweru w’obwongo n’omugongo (obusimu obw’okumpi). Waliwo ebika n’ebivaako kino ebiwerako. Singa obusimu obw’okumpi tebukola bulungi, tetusobola kutambuza binywa byaffe. Eno y’ensonga lwaki endwadde zino nazo ziri mu kibinja ekinene eky’endwadde z’obusimu.

Obulwadde bw’obusimu obuyitibwa peripheral neuropathies busobola okukwata ebitundu by’omubiri ebimu byokka, oba buyinza okukwata omubiri gwonna. Ekika ky’obulwadde bw’obusimu obuyitibwa peripheral neuropathy obusinga okutawaanya emikono n’ebigere naddala engalo. Okugeza abantu abamu abalina ssukaali baba n’okuziyira mu bigere, nga balinga abatasobola kuwulira ttaka. Ekyo kyakulabirako kya kino.

Bino bye bimu ku byokulabirako:

• Okwonooneka kw’obusimu obuva ku ssukaali
• Olw'okunywa omwenge ekisusse (Obuzibu bw'okukozesa omwenge) .
• Endya embi
• Embeera eyitibwa `Amyloidosis`
• Ebivaako obuzaale oba eby’obuzaale (e.g. Charcot-Marie-Tooth disease) .
• Ebivaako abaserikale b’omubiri oba ebizimba (e.g., `(Chronic Inflammatory Demyelinating Polyneuropathy - CIDP)`, `(Obulwadde bwa Guillain-Barré)`)
• Okukwatibwa ebintu eby’obutwa (e.g., eddagala ery’obutwa nga amazzi agayonja, eddagala eritta ebiwuka) .

Endwadde z’okukwatagana kw’obusimu obuyitibwa neuromuscular junction

Ekiyungo ky’obusimu obuyitibwa neuromuscular junction (NMJ) kye kiyungo (synapse) wakati w’enkomerero y’obusimu obukola emirimu n’ekinywa. Okusobola okuwuliziganya n’ekinywa, obusimu obukola emirimu bufulumya eddagala eriyitibwa acetylcholine okuyita mu nkulungo eno. Singa wabaawo ekikyamu mu mpuliziganya eno, endwadde ezeekuusa ku kukwatagana kw’obusimu obuyitibwa neuromuscular junction zibaawo.

Endwadde enkulu ezikwata ekiwanga kino ze zino:

• `Botulism` (embeera eyinza okubaawo olw'obutwa mu mmere) .
• `Obulwadde bwa Lambert-Eaton obuyitibwa myasthenic syndrome (LEMS)`
• `Obulwadde bwa Myasthenia Gravis`

Endwadde z’ebinywa (Myopathies) .

Myopathies ndwadde ezikwata butereevu ku binywa byaffe eby’amagumba (ebinywa ebinywerera ku magumba gaffe). Endwadde zino zoonoona obuwuzi bw’ebinywa n’okunafuya ebinywa. Waliwo ebika by’obulwadde bw’emisuwa ebiwerako. Ebimu bya buzaale (obuzaale oba bwa nsikirano). Abamu basobola okukula nga bakuze.

Naye obuvune obutereevu nga okukutuka, okusika, oba okunyiga ekinywa tebugwa mu kiti kino ekya ``myopathies''.

Obulwadde bw’okusannyalala kw’ebinywa

Muscular dystrophy kibinja kya ndwadde ezisukka mu makumi asatu ezikosa enkola y’ebinywa olw’obuzaale (obusikira). Ebimu ku bika ebikulu bye bino:

• Duchenne muscular dystrophy (DMD) - Kino kye kika ekisinga okubeerawo.
• ``Obulwadde bw'ebinywa bya Becker (BMD)''.
• `Obulwadde bwa myotonic dystrophy`
• ``Obulwadde bw'ebinywa by'amaaso (OPMD)''.

Obulwadde bw’obusimu obuziyiza endwadde n’okuzimba

Zino ndwadde ezitaataaganya emirimu gy’ebinywa olw’obulema mu baserikale baffe bennyini. Eby’okulabirako:

• `Obulwadde bw'olususu`
• `Obulwadde bwa polymyositis`
• ``Obulwadde bw'emisuwa obuyitibwa necrotizing myopathy obuyita mu busimu obuziyiza endwadde''.

Endwadde endala eziyitibwa Myopathies

Endwadde z’ebinywa ziyinza okubaawo olw’ensonga endala ez’enjawulo:

• Obutakwatagana mu masanyalaze : Okugeza, ekirungo kya calcium ekingi mu musaayi (hypercalcemia) oba potassium omungi mu musaayi (hyperkalemia) kiyinza okuleeta obuzibu mu binywa.
• Endocrine myopathies : Obutakwatagana mu busimu obutaataaganya enkola y’ebinywa. Okugeza nga,Bino biyinza okuva ku buzibu ku nseke za thyroid, parathyroid glands , oba adrenal glands .
• Metabolic myopathies : Bino biva ku bulema mu buzaale obulagira ebinywa okukola enziyiza. Eby’okulabirako: endwadde z’okutereka glycogen, obuzibu mu kutereka amasavu.
• Mitochondrial myopathies : Bino biva ku bulema mu mitochondria, ebitundu by’obutoffaali ebikola amaanyi.
• Okusannyalala buli luvannyuma lwa kiseera : Kino kibinja kya ndwadde z’obusimu ezisikira. Mu kino, ebinywa buli luvannyuma lwa kiseera binafuwa era nga tebisobola kukwatagana.
• Toxic myopathies: Bino biva ku butwa oba eddagala eritaataaganya ensengekera oba enkola y’ebinywa.

Endwadde ki ezisinga okutawaanya obusimu n’ebinywa?

Mu butuufu, obulwadde bw’obusimu obuyitibwa peripheral neuropathy bwe businga okubeera mu mbeera zino. Ekyo kiri bwe kityo kubanga kirina ebika bingi eby’enjawulo n’ebivaako. Abanoonyereza bateebereza nti abantu abasukka mu bukadde 20 mu Amerika balina obulwadde bw’obusimu obuyitibwa peripheral neuropathy.

Naye abantu bangi tebalowooza ku `(peripheral neuropathies)` nga `(neuromuscular disorders)`, kubanga balina ekika eky'enjawulo. Naye, `(endwadde z’obusimu)` ffenna ze tuwuliddeko, naye nga mu butuufu tezitera kubaawo, ze `(ALS) ` ne `Muscular Dystrophy` .

Bubonero ki obutera okulabika ku ndwadde zino?

Obubonero bw’endwadde z’obusimu bw’omubiri buyinza okwawukana, okusinziira ku kika ky’obulwadde ekigere. Kyokka obubonero obutera okulabika obukwatagana n’ebinywa mulimu:

• Obunafu bw’ebinywa (okukaluubirirwa okusitula omukono oba okugulu, obutasobola kusitula bintu bizito) .
• Muscle atrophy ( okusaasaana kw’ebinywa n’okuggwaawo) .
• Okunyiga ebinywa (fasciculations), okuzimba oba okusannyalala
• Obulumi mu binywa
• Okukaluba kw’ebinywa (Spasticity) .
• Okukaluubirirwa okutambula
• Ebizibu by’okutebenkeza n’okukwasaganya emirimu
• Ebikowe by’amaaso oba ebitundu ebirala ebya ffeesi okugwa
• Obuzibu mu kwogera (dysarthria) olw’obunafu bw’ebinywa by’olulimi oba mu kamwa/ffeesi
• Okukaluubirirwa okumira (dysphagia) olw’obunafu bw’ebinywa by’ennyindo
• Okukaluubirirwa okussa olw’obunafu bw’ekinywa kya diaphragm

Obubonero obulala buyinza okuli:

• Obukoowu
• Okuzirika
• Okuwulira okutali kwa bulijjo ng’enseenene okutambula oba ppini n’empiso (paresthesia) .

Ekikulu: Bw’oba ​​olina obubonero buno obumu oba obusingawo mu lunyiriri naddala ng’ebinywa binafuye mu bwangu oba mpolampola, kakasa nti ogenda ew’omusawo.

Lwaki endwadde zino zibeerawo? Biki ebivaako?

Waliwo ebintu bingi ebivaako endwadde z’obusimu. Kyokka, ebimu biba bya buzaale . Kino kitegeeza nti ziyinza okuva ku buzaale obusikira okuva mu bazadde oba enkyukakyuka ey’ekifuulannenge mu buzaale (mutation). Endwadde zino ziyinza okuva ku bulema mu buzaale bumu oba obulema mu buzaale obuwerako.

Endwadde ezimu ez'obusimu ( neuromuscular diseases ) ndwadde z'abaserikale b'omubiri . Kino kitegeeza nti abaserikale baffe bennyini balumba obutoffaali bwaffe. Ebirala biyinza okuva ku kabenje, obutaba na mmere nnungi, obuzibu mu nkyukakyuka y’emmere, okubeera n’obutwa oba okuzimba. Oluusi, tewali kivaako kiyinza kuzuulibwa.

Omusawo azuula atya endwadde zino?

Bw’olaba omusawo, ajja kukubuuza ku byafaayo by’obujjanjabi bwo, oba waliwo omuntu yenna mu maka go abadde n’embeera eno, eddagala ly’omira, n’obubonero bw’olina. Oluvannyuma, bajja kukola okukeberebwa kw’omubiri okwa bulijjo n’okukeberebwa kw’obusimu . Ekigezo kino kiyinza okunoonya obuzibu ku bwongo, omugongo, n’obusimu obw’okumpi (nga mw’otwalidde n’ebinywa).

Oyinza n’okusindikibwa ew’omusawo w’obusimu okwongera okukeberebwa. Ebimu ku bigezo ebirala ebiyinza okuyamba okukakasa embeera zino mulimu:

• Electromyography (EMG) : Kino kikebera obulamu n’enkola y’ebinywa byo eby’amagumba n’obusimu obubifuga.
• Okukebera okutambuza obusimu : Kino kigezesa enkola y’obusimu bwo obw’okumpi.
• Okukebera omusaayi : Bino bisobola okukebera ebintu eby’enjawulo, gamba ng’obutabeera bulungi mu enzyme n’obubonero bw’embeera z’abaserikale b’omubiri.
• Okukebera ebifaananyi : Ebigezo nga MRI , CT scan , ne neuromuscular ultrasound bisobola "okulaba" oba waliwo obuzibu bwonna ku bwongo, omugongo, ne/oba obusimu.
• Muscle biopsy: Mu kukebera kuno , kaggyibwako akatundu akatono ak’ebinywa byo era omusawo w’endwadde n’abikebera wansi wa microscope okulaba oba waliwo ebitali bya bulijjo.
• Okukebera obuzaale : Okukebera kuno kuyamba okukakasa endwadde ezimu ez’obusimu obuyitibwa genetic neuromuscular diseases.

Enzijanjaba ki eziwonya endwadde zino?

Obujjanjabi bw’endwadde z’obusimu bwawukana nnyo okusinziira ku kika ky’obulwadde ekigere. Okutwalira awamu, endwadde z’obusimu ezisinga obungi tezisobola kuwona ddala. Kyokka waliwo obujjanjabi n’obujjanjabi ebiyinza okuyamba okukendeeza ku bubonero, okukomya okukula kw’obulwadde oba okukendeeza ku kukula kwabwo. Enteekateeka yo ey’obujjanjabi eyinza okuli:

• Eddagala
• Obujjanjabi bw’omubiri n’obujjanjabi bw’emirimu
• Obujjanjabi bw’okwogera
• Obujjanjabi bw’endya
• Ebyuma ebiyamba ebiyamba okutambula
• Enkola endala ez’obujjanjabi, omuli n’okulongoosa

Ebiseera ebisinga, omusawo w’obusimu (naddala omukugu mu by’obusimu) y’ajja okuba omusawo wo omukulu ow’okulabirira embeera zino. Wabula okusinziira ku kika ky’embeera, oyinza okwetaaga obuyambi okuva mu bakugu abalala n’abakola ku by’obulamu. Mu bino biyinza okuli:

• Abajjanjabi b’omubiri n’abajjanjabi b’emirimu
• Abasawo b’endwadde z’enkizi
• Abasawo b’amawuggwe n’abasawo b’okussa
• Abakugu mu by’endwadde
• Abasawo abalongoosa
• Abasawo b’amagumba
• Abakugu mu by’endwadde z’okwogera n’olulimi
• Abakugu mu by’emmere
• Abakugu mu by’empisa
• Abakola ku nsonga z’abantu

Kiki ky’oyinza okusuubira ng’obeera n’obulwadde obw’ekika kino?

Endwadde nnyingi ez’obusimu n’ebinywa zimala ebbanga ddene (ezitawona) . Kino kitegeeza nti zisobola okuwangaala obulamu bwonna. Wadde nga tewali ddagala, eddagala n’obujjanjabi obulala bisobola okuyamba okufuga obubonero, okukomya okukula kw’obulwadde oba okukendeeza ku buzibu. Omusawo asobola okukuwa endowooza ennungi ku ky’osuubira, okusinziira ku mbeera yo entongole.

Endwadde z’obusimu (neurmuscular diseases) kitundu kigazi eky’embeera ezisinga okukosa enkola y’obusimu n’ebinywa eby’okumpi. Bw’ofuna obunafu bw’ebinywa mu bwangu oba mu ngeri etategeerekeka, yogerako n’omusawo. Asobola okwekenneenya obubonero bwo n’akuwa amagezi okukeberebwa okuzuula ekivaako.

N’ekisembayo, ekisinga obukulu (Obubaka bw’okutwala awaka) .

Totya kuwulira linnya lya Neuromuscular Disorders. Embeera zino nnyingi zisobola okufugibwa nga zizuuliddwa nga bukyali, okuzijjanjaba obulungi, n’okuziddukanya. Ekikulu kiri nti, bw’oba ​​olina obubonero obutali bwa bulijjo (naddala obunafu bw’ebinywa, okuzirika, okukaluubirirwa okutambula), .Tozibuusa maaso era noonya mangu abasawo amagezi.

Jjukira nti toli wekka. Waliwo abasawo abakugu, abajjanjabi, n’ebibiina ebiyamba abasobola okukuyamba okukola ku mbeera zino. Okufuna amawulire amatuufu n’okukola nga bukyali lye kkubo erisinga obulungi erikutuusa ku bulamu obulungi.

` Endwadde z’obusimu, endwadde z’ebinywa, Obuzibu bw’obusimu, ALS, Obuzibu bw’ebinywa, Obulwadde bw’obusimu obw’okumpi, Myasthenia Gravis