Omwagalwa wo alina obubonero buno obw’ekyewuunyo? Kizibu okwogera oba okumira? Ka tuyige ku (Pseudobulbar Palsy)!

Wali okirabye nti oluusi abaagalwa baffe batandika mangu okuseka awatali nsonga, oba okutandika okukaaba nga tebawulira nnaku? Oba bavuma ebigambo byabwe nga boogera, oba bafuna obuzibu okumira emmere? Bw’oba ​​olina ekimu oba ebisingawo ku bintu bino awamu, kiyinza okuba nga kiva ku mbeera eyitibwa ‘Pseudobulbar Palsy’ gye tugenda okwogerako leero. Mu butuufu buno si bulwadde bwa njawulo, wabula okukuŋŋaanyizibwa kw’obubonero obuva ku ndwadde ezimu ez’obusimu. Kale, ka twogere ku nsonga eno mu bujjuvu?

Obulwadde bwa Pseudobulbar Palsy kye ki?

Mu ngeri ennyangu, Pseudobulbar Palsy kwekuŋŋaanyizibwa kw’obubonero bw’obusimu obuva ku kwonooneka kw’ekitundu ekimu eky’obwongo bwaffe ekiyitibwa corticobulbar tract. Enkola eno eya corticobulbar tract eyamba okufuga ebinywa mu mutwe ne mu maaso gaffe. Kino bwe kyonoonese, ebizibu ebikulu bisatu bibaawo:

• Obuzibu mu kwogera, mu by’obusawo kino tukiyita `dysarthria` .
• Okukaluubirirwa okumira emmere oba amazzi kiyitibwa dysphagia .
• Obutasobola kufuga nneewulira z'omuntu, gamba ng'okuseka oba okukaaba mu bwangu, kiyitibwa ``pseudobulbar affect.''

Ekikulu nti buno si bulwadde bumu, wabula buzibu obuva ku ndwadde endala ez’obusimu oba embeera z’emisuwa gy’obwongo. Oluusi abasawo era bakiyita ‘supranuclear bulbar palsy’.

Bubonero ki obulaga embeera eno?

Nga bwe kyayogeddwako emabegako, obubonero obukulu obusatu bwe buzibu okwogera, okukaluubirirwa okumira, n’obutasobola kufuga nneewulira. Kyokka n’obubonero obulala buyinza okulabibwa, gamba nga:

• Okukulukuta amalusu oba okufulumya amalusu ekisusse: Oluusi amalusu gasobola okufuluma mu kamwa nga totegedde wadde.
• Enkyukakyuka mu ngeri y’okwogera n’eddoboozi: Okwogera kuyinza obutategeerekeka bulungi. Kiyinza n’okuwulikika ng’oyogera ng’oyita mu nnyindo (overly nasal tone).
• Obunafu bw’olulimi oba okusannyalala: Kino kiyitibwa `glossoplegia`. Kino kiyinza okukaluubiriza okwogera n’okukamula emmere.
• Okunafuwa kw’ebinywa bya ffeesi: Oludda olumu oba zombi eza ffeesi luyinza obutaba na bulamu.
• Obuzibu okukamula emmere: Olw’okuba tosobola kukamula mmere bulungi, kifuuka kizibu okumira.
• Okuseka oba okukaaba okutafugibwa oba okutasaana: Kuba akafaananyi ng’okaaba mu bwangu awatali nsonga, oba okuseka mu ddoboozi ery’omwanguka olw’ekintu ekitono, n’otosobola kukifuga. Kino kiyitibwa ``pseudobulbar affect.''
• Okukaluba oba okunywezebwa kw’ebinywa by’akawanga: Kino era kiyitibwa `trismus`. Kiyinza okukuzibuwalira okuggulawo n’okuziba akamwa.
• Okwongera ku bikolwa mu maaso: Okugeza, okuwuuma kw’akawanga kuyinza okubaawo.

Era kigambibwa nti abaana nga 85% abalina obulwadde bwa Pseudobulbar Palsy bayinza okufuna embeera nga obulemu ku magezi n’okukonziba .

Ng’oggyeeko obubonero buno, obubonero obulala nabwo buyinza okulabika okusinziira ku bulwadde obusirikitu obuleeta pseudobulbar palsy.

Lwaki kino kigenda mu maaso? Ensonga ze ziruwa?

Ekisinga okuvaako obulwadde bwa Pseudobulbar Palsy kwe kwonooneka enjuyi zombi ez’omukutu gwa corticobulbar mu bwongo bwaffe. Omulimu gw’ekitundu kino kwe kufuga ebinywa ebiri mu mutwe ne mu maaso. Ekitundu kino era kiwa ebiyingizibwa mu busimu bw’omutwe obuwa obubaka obwetaagisa eri ebinywa bino.

Kale, waliwo embeera eziwerako eziyinza okwonoona ``corticobulbar tract eno.'' Zino ze zino:

• Obuvune obw’amaanyi ku mutwe (obuvune obw’amaanyi ku bwongo).
• Ebizimba by'ekikolo ky'obwongo .
• Okuzimba n’okukwatibwa yinfekisoni ezikosa obwongo.
• Embeera z’obusimu ezitawona .
• Endwadde ezikwata ku misuwa gy’omusaayi mu bwongo, okugeza ``strokes`` ne ``vascular malformations``.

Ezimu ku mbeera z’obusimu ezimanyiddwa ennyo, ezimaze ebbanga nga zitera okuvaako obulwadde bwa pseudobulbar palsy mulimu:

• Obulwadde bw’okusannyalala mu bitundu by’omubiri ebiyitibwa amyotrophic lateral sclerosis (ALS).
• Obulwadde bwa Parkinson .
• Obulwadde bwa supranuclear palsy obugenda mu maaso .
• Obulwadde bw’okusannyalala okungi (`Obulwadde bw’okusannyalala emirundi mingi - MS`).

Kino okitegeera otya?

Abasawo batera okuzuula obulwadde bwa Pseudobulbar Palsy okusinziira ku bubonero bwo. Ekikulu wano kwe kuzuula embeera enzijuvu ereeta embeera eyo. Oyinza okuba nga wakimanya dda, oba oyinza okuba ng’olina okumanya ekipya.

Omusawo ajja kukubuuza ku bubonero bwo, ddi lwe bwatandika, n’ebyafaayo byo byonna eby’obujjanjabi, gamba ng’okumanya oba wali obadde n’embeera edda ng’okusannyalala. Oluvannyuma bagenda kukeberebwa omubiri n'okukeberebwa obusimu .

Okuva bwe kiri nti waliwo embeera eziwerako eziyinza okuvaako obulwadde bwa pseudobulbar palsy, omusawo ayinza n’okukuwa amagezi okukeberebwa okw’enjawulo. Ebimu ku bino mulimu:

• Okukebera omusaayi .
• Taapu y’omugongo ey’amazzi g’omu bwongo (CSF analysis).
• Okukebera ebifaananyi, nga MRI scan y’obwongo .
• Ekigezo kya `EEG` (`EEG - electroencephalogram`), ekipima emirimu gy'amasannyalaze egy'obwongo.
• Ebigezo bya `Evoked Potential`(`Evoked ebigezo ebiyinza okubaawo`).
• Okukebera okwogera n'okutegeera .

Ebigezo bino bijja kutuyamba okumanya ddala ekivaako.

Kijjanjabwa kitya?

Tewali bujjanjabi butereevu ku bulwadde bwa Pseudobulbar Palsy. Mu kifo ky’ekyo, ttiimu y’abasawo bo ejja kukuwa amagezi ku bujjanjabi obw’enjawulo okusobola okuddukanya obubonero bw’embeera eno. Okugatta ku ekyo, embeera eno eyinza okwetaagisa okujjanjabibwa.

Ku kino, ojja kwetaaga obuyambi bwa ttiimu y’abasawo nga mulimu abakugu ab’enjawulo. Mu bino mulimu:

• Omusawo wo ow'amaka (`Omusawo asookerwako`).
• Abakugu mu by’obusimu.
• Abakugu mu by’endwadde z’okwogera n’olulimi.
• Abajjanjabi b’okussa.
• Abakugu mu by’empisa oba abasawo b’eby’omutwe.
• Abakola ku nsonga z’abantu.
• Abakugu mu by’eddagala.

Obujjanjabi bw’okukaluubirirwa okumira (Dysphagia) .

Waliwo obujjanjabi obw’enjawulo obuliwo okusinziira ku buzibu bw’okumira. Ebimu ku byo mulimu:

• Okukyusa embeera y’okulya, okukyusa ebikozesebwa mu kulya, n’okukyusa obutakyukakyuka bw’emmere. Okugeza emmere osobola okugisika obulungi n’ogifuula ey’amazzi okusobola okwanguyirwa okumira.
• Dduyiro okunyweza ebinywa ebiyamba mu kumira (`Swallowing muscle training`).
• Obujjanjabi bw’omubiri, nga okusikirizibwa kw’amasannyalaze, magineeti oba ebbugumu.
• Eddagala, okugeza, eddagala nga `nifedipine` ne `metoclopramide`.

Jjukira nti bw’oba ​​tosobola kulya oba kunywa bulungi, oba ng’oli mu bulabe bw’okuziyira, omusawo ayinza okukuwa amagezi okukuliisa ng’oyita mu ttanka (`feeding tube`) eyingizibwa butereevu mu nnyindo oba mu lubuto .

Obujjanjabi bw’obuzibu mu kwogera

Bw’oba ​​olina obuzibu okwogera, obujjanjabi bw’okwogera buyinza okukuyamba ennyo. Omusawo w’okwogera tayigiriza ggwe wekka, wabula n’ab’omu maka go engeri y’okuwuliziganyaamu obulungi naawe.

Mu biseera by’okujjanjaba okwogera, osobola okuyiga ebintu nga:

• Dduyiro anyweza olulimi, emimwa, n’ebinywa by’akawanga (bwe kiba kisoboka).
• Obukodyo bw’okwogera obulungi, gamba ng’okukendeeza ku sipiidi yo ey’okwogera n’okukozesa ebinywa ebimu mu bugenderevu okufulumya amaloboozi n’ebigambo.
• Engeri y’okwolesa ebirowoozo awatali bigambo, gamba ng’olulimi lwa bakiggala oba okuwandiika.

Obujjanjabi bw‟okwolesebwa kw‟enneewulira okutafugibwa (`Pseudobulbar Affect - PBA`)

Eddagala erifuga ``Pseudobulbar Affect (PBA)'', embeera gy'oseka n'okukaaba nga tofugibwaKiyinza okuyamba. Omusawo ayinza okukuwa eddagala nga:

• Dextromethorphan/quinidine sulfate (Nuedexta®): Ekitongole kya U.S. Food and Drug Administration (FDA) kikkirizza eddagala lino ng’eddagala erisoose okukolebwa mu ngeri ey’enjawulo okujjanjaba PBA. Mulimu eddagala ly’okusesema n’eddagala eryali likozesebwa mu kujjanjaba obuzibu bw’omutima.
• Eddagala eriweweeza ku kweraliikirira : Eddagala nga eddagala eriweweeza ku kweraliikirira erya tricyclic, SSRIs (Selective serotonin reuptake inhibitors), ne SNRIs (Serotonin and norepinephrine reuptake inhibitors) nalyo liyinza okuyamba okufuga obubonero bwa PBA.

Embeera eno ejja kuba etya? Kisobola okuwona?

Enteebereza y’omuntu alina obulwadde bwa pseudobulbar palsy okusinga esalibwawo obulwadde obusirikitu.

Teebereza, singa walina embeera eno olw'okufuna ``stroke`` oba ``traumatic brain injury``, waliwo okusobola nti enkola y'obusimu ejja kudda mu mbeera eya bulijjo mpola. Kwe kugamba, obubonero bw’obulwadde bwa pseudobulbar palsy buyinza okukendeera mpolampola.

Wabula singa embeera eno eva ku mbeera ezitawona ezitawona nga multiple sclerosis (MS), obulwadde bwa Parkinson, ne ALS, ebiseera ebisinga kiba kizibu okusuubira okuwona.

Ttiimu yo ey’abasawo ejja kusobola okukuwa endowooza entegeerekeka ku kiki ebiseera eby’omu maaso bye bijja ku mbeera yo entongole.

Bizibu ki ebirala bino bye biyinza okuleeta?

Obulwadde bwa Pseudobulbar palsy busobola okuleeta ebizibu nga:

• Aspiration pneumonia: Olw’okuba ebinywa by’olulimi n’akamwa bizibu okufuga, emmere oba ekyokunywa ekitono kiyinza okuyingira mu mawuggwe ne kireetawo embeera eyitibwa aspiration pneumonia. Kino kiyinza okuba eky’akabi.
• Endya embi n’okubulwa amazzi mu mubiri: Singa obuzibu mu kulya buba bwa maanyi, endya embi n’okubulwa amazzi mu mubiri bisobola okubaawo olw’obutasobola kulya na kunywa bulungi. Mu mbeera enzibu, kiyinza okwetaagisa ekyuma ekigabula emmere.
• Embeera z’obulamu bw’obwongo: Obulwadde bwa Pseudobulbar palsy busobola okukosa ennyo obulamu bwo obwa bulijjo. Oyinza okuva mu bantu olw’ebintu ng’okukaluubirirwa okwogera n’okubutuka kw’enneewulira nga tofugibwa. Kino kiyinza okuvaako obuzibu bw'obwongo ng'okwennyamira n'okweraliikirira .

Obulwadde bwa Pseudobulbar Palsy bufa?

Obulwadde bwa Pseudobulbar palsy tebutta butereevu. Naye, obulwadde obusirikitu obubuleeta (e.g., okusannyalala ) .`, `ALS`) kiyinza okutta. Era, ebizibu nga `aspiration pneumonia` biyinza okuteeka obulamu mu matigga singa tebijjanjabwa bulungi.

Waliwo engeri y’okuziyiza kino?

Okuva bwe kiri nti waliwo ebintu bingi ebiyinza okuvaako obulwadde bwa pseudobulbar palsy, tewali ngeri ya butereevu ey’okubuziyiza. Naye okugoberera emize gy'ebyobulamu egisobola okuziyiza ensonga z'akabi nga ``okusannyalala'' kiyinza okuyamba mu ngeri etali ya butereevu.

Ddi lwe nnina okulaba omusawo?

Bw’oba ​​olina obulwadde bwa Pseudobulbar Palsy, olina okusisinkana ttiimu yo ey’abasawo buli kiseera okukakasa nti enteekateeka yo ey’obujjanjabi ekola bulungi.

Embeera eno esobola okukosa ennyo obulamu bwo obwa bulijjo, era oyinza okuwulira ng’ozitoowereddwa. Mu biseera ng’ebyo , tolwawo kunoonya buyambi okuva mu baagalwa bo, awamu n’omubuulirizi ku bulamu bw’obwongo . Jjukira nti ttiimu yo ey’abasawo bulijjo ebeera naawe okuzuula enteekateeka y’obujjanjabi esinga okukukwatako.

Obubaka Obutwala Awaka

Okay, kale kino tukijjukire nga mu bufunze Pseudobulbar Palsy gye twogeddeko leero:

• Buno si bulwadde bwa njawulo, wabula okukuŋŋaanyizibwa kw’obubonero obuva ku kwonooneka kw’ekitundu ky’obwongo ekigere.
• Obubonero obukulu bwe buzibu okwogera, okukaluubirirwa okumira, n’okuseka oba okukaaba nga tosobola kwefuga.
• Ebivaako mulimu endwadde z’obusimu ng’okusannyalala, obulwadde bwa Parkinson, MS, oba obuvune ku mutwe .
• Obujjanjabi bugendereddwamu okujjanjaba embeera evuddemu n’okufuga obubonero. Obujjanjabi bw’okwogera, okukola dduyiro w’okumira, n’eddagala bisobola okuyamba mu kino.
• Kikulu nnyo okutegeera amangu obubonero n’okunoonya amagezi g’abasawo.
• Okwagala kwo, obuwagizi n’okutegeera kwo bya muwendo nnyo eri omuntu abeera n’embeera eno.

Bw’oba ​​ggwe oba omuntu ali ku lusegere lwo afuna obubonero buno bwonna, olabe omusawo akuwe amagezi. Ekyo kye kintu ekisinga obulungi ky’osobola okukola.

` Pseudobulbar palsy, obuzibu mu bwongo, obuzibu mu kwogera, obuzibu mu kumira, endwadde z’obusimu, okulungamya enneewulira, PBA