Ese uwo ukunda afite ibi bimenyetso bidasanzwe? Ese biragoye kuvuga cyangwa kumira? Reka twige kuri (Pseudobulbar Palsy)!

Ese wigeze ubona ko rimwe na rimwe abakunzi bacu batangira guseka nta mpamvu, cyangwa bagatangira kurira batababaye? Cyangwa se baravuga amagambo mabi mu gihe bavuga, cyangwa bakagira ingorane zo kumira ibiryo? Niba ufite kimwe cyangwa byinshi muri ibi bintu hamwe, bishobora guterwa n'indwara yitwa 'Pseudobulbar Palsy' tugiye kuvugaho uyu munsi. Iyi si indwara yihariye mu by'ukuri, ahubwo ni uruhurirane rw'ibimenyetso biterwa n'indwara zimwe na zimwe zo mu bwonko. None se, reka tubiganireho mu buryo burambuye?

Indwara ya Pseudobulbar Palsy ni iki?

Muri make, Pseudobulbar Palsy ni uruhurirane rw'ibimenyetso by'imitsi biterwa no kwangirika k'igice runaka cy'ubwonko bwacu cyitwa corticobulbar. Iyi corticobulbar ifasha kugenzura imitsi yo mu mutwe no mu maso. Iyo byangiritse, havuka ibibazo bitatu by'ingenzi:

• Kutabivuga neza, mu buvuzi tubyita 'dysarthria' .
• Kugorwa no kumira ibiryo cyangwa ibinyobwa byitwa dysphagia .
• Kudashobora kugenzura amarangamutima y'umuntu, nko guseka cyangwa kurira mu buryo butunguranye, byitwa "pseudobulbar affect."

Igikuru ni uko iyi atari indwara imwe gusa, ahubwo ni ikibazo giterwa n'izindi ndwara z'imitsi cyangwa indwara z'imitsi yo mu bwonko. Hari igihe abaganga babyita 'supranuclear bulbar palsy'.

Ni ibihe bimenyetso by'iyi ndwara?

Nkuko byavuzwe mbere, ibimenyetso bitatu by'ingenzi ni ukunanirwa kuvuga, kugorwa no kumira, no kudashobora kugenzura amarangamutima. Ariko, hari n'ibindi bimenyetso bishobora kugaragara, nka:

• Kudomeka cyangwa gutonyanga cyane: Hari igihe amacandwe ashobora gusohoka mu kanwa utabizi.
• Impinduka mu mivugire n'ijwi: Imvugo ishobora kuba idasobanutse neza. Ndetse ishobora no kumvikana nk'aho uvugira mu mazuru yawe (ijwi ry'izuru rirenze urugero).
• Uburemere bw'ururimi cyangwa ubumuga: Ibi byitwa `glossoplegia`. Ibi bishobora gutuma kuvuga no guhekenya ibiryo bigorana.
• Intege nke z'imitsi yo mu maso: Uruhande rumwe cyangwa impande zombi z'isura zishobora kubura ubuzima.
• Kugorwa no guhekenya ibiryo: Kubera ko udashobora guhekenya ibiryo neza, biragora kumira.
• Guseka cyangwa kurira mu buryo butunguranye cyangwa budakwiriye: Tekereza kurira utunguranye nta mpamvu igaragara, cyangwa guseka cyane ikintu gito, kandi ntushobore kucyigenzura. Ibi byitwa "pseudobulbar affect."
• Gukomera cyangwa gufunga imitsi y'umusaya: Ibi kandi byitwa `trismus`. Bishobora kugorana gufungura no gufunga umunwa wawe.
• Ubushobozi bwo kongera imbaraga mu maso: Urugero, gukurura imisaya bishobora kubaho.

Bivugwa kandi ko hafi 85% by'abana bafite Pseudobulbar Palsy bashobora kurwara indwara nk'ubumuga bwo mu mutwe ndetse n'indwara zo mu mutwe .

Hamwe n'ibi bimenyetso, hari n'ibindi bimenyetso bishobora kugaragara bitewe n'indwara itera pseudobulbar palsy.

Kuki ibi bibaho? Impamvu ni izihe?

Impamvu nyamukuru itera Pseudobulbar Palsy ni ukwangirika kw'impande zombi z'inzira ya corticobulbar mu bwonko bwacu. Akamaro k'iyi nzira ni ukugenzura imitsi yo mu mutwe no mu maso. Iki gice gitanga kandi ibitekerezo ku mitsi yo mu mutwe itanga ubutumwa bukenewe kuri iyo mitsi.

Rero, hari indwara nyinshi zishobora kwangiza iyi "corticobulbar tract". Izo ni izi:

• Ibikomere bikomeye byo mu mutwe (ibikomere byo mu bwonko bikomeretsa).
• Ibibyimba byo mu bwonko .
• Ubwivumbure n'indwara bigira ingaruka ku bwonko.
• Indwara z'imitsi zidakira .
• Indwara zijyanye n'imitsi y'amaraso yo mu bwonko, urugero nka "stroke" na "ubumuga bw'imitsi".

Zimwe mu ndwara z’imitsi zikunze kugaragara kandi zimara igihe kirekire zitera pseudobulbar palsy zirimo:

• Ubushobozi bwo kuvura indwara ya Amiotrophic lateral sclerosis (ALS).
• Indwara ya Parkinson .
• Indwara y'ingufu za kirimbuzi ikomeza kwiyongera.
• Sclerosis nyinshi (`Sclerosis nyinshi - MS`).

Ubimenya ute?

Ubusanzwe abaganga bapima indwara ya Pseudobulbar Palsy bitewe n'ibimenyetso ufite. Ikintu cy'ingenzi hano ni ukumenya indwara itera iyi ndwara. Ushobora kuba usanzwe uyizi, cyangwa ushobora kuba ugomba kumenya ikintu gishya.

Muganga azakubaza ibimenyetso byawe, igihe byatangiriye, n'amateka yawe yose y'ubuzima, urugero niba warigeze kugira indwara nka stroke. Hanyuma azagukorera isuzuma ry'umubiri n'isuzuma ry'imitsi .

Kubera ko hari indwara nyinshi zishobora gutera pseudobulbar palsy, muganga wawe ashobora no kukugira inama yo gupima ibintu bitandukanye. Zimwe muri zo zirimo:

• Gupima amaraso .
• Gukoresha umugongo kugira ngo hamenyekane amazi yo mu bwonko (CSF analysis).
• Ibizamini byo gufata amashusho, nk'isuzuma rya MRI mu bwonko .
• Ikizamini cya `EEG` (`EEG - electroencephalogram`), gipima imikorere y'amashanyarazi y'ubwonko.
• Ibizamini bya `Evoked Potential`(`Ibipimo bishobora kuvuguruzwa`).
• Isuzumabumenyi n'imvugo .

Ibi bizamini bizadufasha kumenya neza impamvu.

Ivurwa ite?

Nta buryo bwo kuvura indwara ya Pseudobulbar Palsy buhari. Ahubwo, itsinda ry’abaganga rizagusaba uburyo butandukanye bwo kuvura kugira ngo umenye ibimenyetso by’iyi ndwara. Byongeye kandi, indwara isanzwe ishobora gukenera kuvurwa.

Kugira ngo ubigereho, uzakenera ubufasha bw'itsinda ry'abaganga rigizwe n'inzobere zitandukanye. Muri bo harimo:

• Umuganga w'umuryango wawe (`Umuganga w'ibanze`).
• Abaganga b'indwara z'imitsi.
• Abahanga mu by'indwara z'ururimi.
• Abavuzi b'indwara z'ubuhumekero.
• Inzobere mu by'imitekerereze cyangwa abaganga b'indwara zo mu mutwe.
• Abakozi bashinzwe imibereho myiza y'abaturage.
• Abahanga mu bya farumasi.

Uburyo bwo kuvura ikibazo cyo kumira nabi (Dysphagia)

Hari uburyo butandukanye bwo kuvura buterwa n'uburemere bw'ingorane yo kumira. Bumwe muri bwo burimo:

• Guhindura uburyo bwo kuriramo, guhindura ibikoresho byo kuriramo, no guhindura uburyo ibiryo bihagaze. Urugero, ushobora gusya neza ibiryo ukabigira amazi menshi kugira ngo byoroshye kumira.
• Imyitozo yo gukomeza imitsi ifasha mu kumira (`Imyitozo yo kumira imitsi`).
• Ubuvuzi bw'umubiri, nko gukangura amashanyarazi, ingufu za rukuruzi cyangwa ubushyuhe.
• Urugero , imiti nka `nifedipine` na `metoclopramide`.

Wibuke ko niba udashobora kurya cyangwa kunywa neza, cyangwa niba ufite ibyago byo kubyimba, muganga wawe ashobora kukugira inama yo kuguha ibiryo binyuze mu muyoboro (`umuyoboro wo kugaburira`) winjizwa mu mazuru cyangwa mu nda yawe .

Uburyo bwo kuvura ibibazo byo kuvuga

Niba ufite ikibazo cyo kuvuga, ubuvuzi bwo kuvuga bushobora kugufasha cyane. Umuganga w’indwara zo kuvuga ntabwo akwigisha wowe gusa, ahubwo anigisha n’umuryango wawe uburyo bwo kuvugana nawe neza.

Mu gihe cy'amasomo yo kuvura indwara zo mu mutwe, ushobora kwiga ibintu nk'ibi:

• Imyitozo ikomeza ururimi, iminwa, n'imikaya y'inka (niba bishoboka).
• Ingamba zo kuvuga neza kurushaho, nko kugabanya umuvuduko wawe wo kuvuga no gukoresha imitsi runaka nkana kugira ngo uvuge amajwi n'amagambo.
• Uburyo bwo kugaragaza ibitekerezo nta magambo, nko kuvuga amarenga cyangwa kwandika.

Uburyo bwo kuvura imyitwarire idahwitse mu marangamutima (`Pseudobulbar Affect - PBA`)

Imiti yo kurwanya ``Pseudobulbar Affect (PBA)'', indwara ituma useka kandi ukarira ubudatuzaBishobora gufasha. Muganga wawe ashobora kukwandikira imiti nk'iyi:

• Dextromethorphan/quinidine sulfate (Nuedexta®): Ikigo gishinzwe ibiribwa n'imiti muri Amerika (FDA) cyemeje uyu muti nk'umuti wa mbere wagenewe kuvura PBA. Urimo umuti w'inkorora n'umuti muto wakoreshwaga mbere mu kuvura indwara z'umutima.
• Imiti igabanya ububabare : Imiti nka tricyclic antidepressants, SSRIs (Selective serotonin reuptake inhibitors), na SNRIs (Serotonin na norepinephrine reuptake inhibitors) na yo ishobora gufasha mu kugenzura ibimenyetso bya PBA.

Ese iki kibazo kizaba kimeze gite? Ese gishobora gukira?

Iteganyagihe ry'umuntu urwaye pseudobulbar palsy riterwa ahanini n'indwara isanzwe.

Tekereza, uramutse ufite iyi ndwara bitewe na "stroke" cyangwa "ihungabana ry'ubwonko", hari amahirwe ko imikorere y'imitsi izagenda isubira ku buryo busanzwe buhoro buhoro. Ni ukuvuga ko ibimenyetso bya pseudobulbar palsy bishobora kugabanuka buhoro buhoro.

Ariko, niba iyi ndwara iterwa n'indwara zidakira zo mu bwonko nka multiple sclerosis (MS), Parkinson's disease, na ALS, akenshi biragoye kwitega gukira.

Itsinda ry'abaganga bawe rizashobora kuguha igitekerezo gisobanutse cy'ejo hazaza heza ku kibazo cyawe.

Ni izihe ngorane zindi ibi bishobora gutera?

Indwara ya pseudobulbar palsy ishobora gutera ingorane nka:

• Umusonga wo mu kanwa: Kubera ko imitsi y'ururimi n'umunwa bigorana kuyigenzura, ibiryo cyangwa ibinyobwa bike bishobora kwinjira mu bihaha, bigatera indwara yitwa umusonga wo mu kanwa. Ibi bishobora guteza akaga.
• Imirire mibi no kubura amazi: Iyo dysphagia ikabije, imirire mibi no kubura amazi bishobora guterwa no kudashobora kurya no kunywa neza. Mu bihe bikomeye, umuyoboro wo kugaburira ushobora gukenerwa.
• Indwara zo mu mutwe: Indwara ya Pseudobulbar palsy ishobora kugira ingaruka zikomeye ku buzima bwawe bwa buri munsi. Ushobora kwigunga bitewe n'ibintu nko kugorwa no kuvuga no gushyuhagura amarangamutima. Ibi bishobora gutera ibibazo by'ubuzima bwo mu mutwe nko kwiheba no guhangayika .

Ese indwara ya Pseudobulbar Palsy yica?

Pseudobulbar palsy ntabwo yica mu buryo butaziguye. Ariko indwara itera iyo palsy (urugero: paralysis )`, `ALS`) ishobora kwica. Nanone, ingorane nka `aspiration pneumonia` zishobora gushyira ubuzima mu kaga iyo zitavuwe neza.

Ese hari uburyo bwo gukumira ibi?

Kubera ko hari ibintu byinshi bishobora gutera pseudobulbar palsy, nta buryo butaziguye bwo kuyirinda. Ariko, gukurikiza ingeso z'ubuzima zishobora gukumira ibintu bishobora gutera ibyago nko "kurema" bishobora gufasha mu buryo butaziguye.

Ni ryari ngomba kujya kwa muganga?

Niba ufite Pseudobulbar Palsy, ugomba guhura n'itsinda ry'abaganga buri gihe kugira ngo urebe neza ko gahunda yawe yo kuvura ikora neza.

Iyi ndwara ishobora kugira ingaruka zikomeye ku buzima bwawe bwa buri munsi, kandi ushobora kumva uremerewe cyane. Muri ibyo bihe , ntugatinye gushaka ubufasha ku bakunzi bawe, ndetse no ku mujyanama mu by'ubuzima bwo mu mutwe . Wibuke ko itsinda ry'abaganga bawe rihora riri kumwe nawe kugira ngo bagufashe kubona gahunda y'ubuvuzi ikubereye.

Ubutumwa bwo kujyana mu rugo

Sawa, reka twibuke ibi nk'incamake y'indwara ya Pseudobulbar Palsy twavuzeho uyu munsi:

• Iyi si indwara yihariye, ahubwo ni uruhurirane rw'ibimenyetso biterwa no kwangirika k'igice runaka cy'ubwonko.
• Ibimenyetso by'ingenzi ni ukugorwa no kuvuga, kugorwa no kumira, no guseka cyangwa kurira ubudatuza.
• Impamvu zirimo indwara zo mu bwonko nka paralysis, Parkinson's disease, MS, cyangwa ibikomere byo mu mutwe .
• Ubuvuzi bugamije kuvura indwara isanzwe no kugenzura ibimenyetso. Uburyo bwo kuvura indwara mu mivugire, imyitozo ngororamubiri yo kumira, n'imiti bishobora gufasha muri ibi.
• Ni ngombwa cyane kumenya ibimenyetso byihuse no gushaka inama kwa muganga.
• Urukundo rwawe, inkunga yawe, n'uburyo ubyumva ni ingenzi cyane ku muntu ubana n'iyi ndwara.

Niba wowe cyangwa umuntu wawe wa hafi ufite kimwe muri ibi bimenyetso, nyamuneka gana muganga kugira ngo akugire inama. Icyo ni cyo kintu cyiza ushobora gukora.

` Pseudobulbar palsy, indwara zo mu bwonko, ingorane zo kuvuga, ingorane zo kumira, indwara z'imitsi, kugenzura amarangamutima, PBA