Ngaba ngequbuliso unengxaki engqondweni yakho nakwi-spinal cord? Masifunde nge-ADEM (i-Acute Disseminated Encephalomyelitis)!

Ngaba wakha weva ngegama elithi `ADEM` (Acute Disseminated Encephalomyelitis)? Oku kusenokuba yinto entsha kuwe. Yimeko engaqhelekanga, oko kuthetha ukuba ichaphazela abantu abambalwa kakhulu, kodwa inokuvela ngequbuliso ize ichaphazele inkqubo yethu yemithambo-luvo . Ungakhathazeki, siza kuthetha ngayo ngokulula, ngendlela onokuyiqonda.

Yintoni i-ADEM? Masiyiqonde ngokulula.

Ngamafutshane, i-ADEM kukudumba okanye ukudumba ngequbuliso kweNkqubo yethu yeNervous eseMbindini – oko kukuthi, ingqondo kunye nomqolo. Cinga ngale ndlela, njengaxa sifumana ukwenzakala , umzimba wethu uyadumba, oku kubangela ukudumba kwezinye iindawo zengqondo kunye nomqolo.

Oku kuvutha kungonakalisa i-sheath ekhuselayo ejikeleze imicu yemithambo-luvo yethu. Le sheath ibizwa ngokuba yi-myelin sheath . Ifana neplastiki egqume ucingo lombane. Inceda imiyalezo ukuba ihambe ngemithambo-luvo ngokukhawuleza. Ngoko ke, xa le sheath ye-myelin yonakele, imiyalezo yemithambo-luvo ayihambi kakuhle. Kulapho ke kuvela khona iimpawu ezahlukeneyo. Abanye oogqirha bakwabiza le meko ngokuthi yimeko "yokususa ulwelo".

Igama elithi "acute" kwi-ADEM lithetha ukuba kwenzeka ngequbuliso . Uninzi lwexesha, kwenzeka kube kanye kuphela ebomini. Nangona kunjalo, kunokwenzeka ukuba kuphinde kwenzeke rhoqo.

Kuqheleke kangakanani oku?

I-ADEM yimeko engaqhelekanga kakhulu. Uphando lubonisa ukuba kwilizwe elifana neMelika, iyenzeka kumntu omnye kwizigidi ezibini ezinesiqingatha. Ngoko ke, esi ayisosifo sichaphazela wonke umntu.

Zithini iimpawu zale meko?

Iimpawu ze-ADEM zihlala zibonakala emva kweentsuku ezimbalwa emva kosulelo lwentsholongwane okanye lwebhaktheriya . Ezi mpawu zinokwahluka kumntu nomntu, kwaye zixhomekeke nokuba ukudumba kukuphi engqondweni okanye emgogodleni.

Ezinye iimpawu eziqhelekileyo ziquka:

• Ifiva
• Intloko ebuhlungu.
• Isicaphucaphu okanye ukuhlanza
• Ukudideka
• Ukudinwa

Ukongeza, iimpawu ezinxulumene nenkqubo ye-nervous zingabandakanya:

• Ukungaziva mnandi okanye ukurhawuzelela kwimilenze
• Ubunzima bokuginya
• Ukulahlekelwa okanye ukufiphala kombono (i-optic neuritis)
• Ubuthathaka bemisipha
• Ubunzima bokuhamba
• Ukuxhuzula

Njengoko ubona, ezi mpawu kunye nobunzima bazo zinokwahluka kakhulu kumntu nomntu . Abanye abantu banokufumana iimpawu ezibuthathaka kakhulu, ngelixa abanye banokuchaphazeleka kakhulu.

Kutheni oku kusenzeka? Zithini izizathu ze-ADEM?

Isizathu esichanekileyo se-ADEM asikaziwa okwangoku . Nangona kunjalo, uphando lubonisa ukuba xa intsholongwane okanye intsholongwane ingena emzimbeni wethu, inkqubo yethu yokuzikhusela komzimba iyayilwa nayo. Nangona kunjalo, kumntu one-ADEM, inkqubo yokuzikhusela yomzimba ihlasela ngempazamo iindawo ezithile zenkqubo yayo yemithambo-luvo ephakathi . Kufana nokuhlasela elinye lamalungu ayo, licinga ukuba lutshaba. Olu hlaselo luphosakeleyo lubangela ukudumba (ukudumba) okukhankanyiweyo ngaphambili, okubangela iimpawu.

Kufunyaniswe ukuba phakathi kwama-70% nama-80% abantu abafumana i-ADEM banosulelo okanye isifo ngaphambi kokuba kubonakale iimpawu ze-ADEM. Iimpawu ze-ADEM zihlala ziqala emva kweentsuku ezi-7 ukuya kwezi-14 emva kosulelo. Ezinye izifo eziqhelekileyo ezinokunxulunyaniswa ne-ADEM ziquka:

• Umkhuhlane okanye umkhuhlane
• I-Mascus
• Iingqukuva
• I-Rubella
• Iqhwiqhwi
• Intsholongwane kaEpstein Barr
• I-Cytomegalovirus
• Intsholongwane yeHerpes simplex (`intsholongwane yeHerpes simplex`)

Nangona iibhaktheriya ezahlukeneyo, iintsholongwane, kunye nezinye izifo ziye zanxulunyaniswa ne-ADEM, akubonakali ngathi ibangelwa yintsholongwane enye.

Kutshanje, esinye isizathu se-ADEM, ingakumbi ebantwaneni, sichongiwe njengeMyelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). Esi sikwathathwa njengemeko yokuzikhusela komzimba. Oku kuthetha ukuba inkqubo yomzimba yokuzikhusela ihlasela inkqubo yayo yemithambo-luvo. Le MOGAD inokubangela i-ADEM ngamanye amaxesha.

Ngubani osengozini enkulu yokuphuhlisa i-ADEM?

Nabani na angayifumana i-ADEM. Nangona kunjalo, ixhaphake kancinci ebantwaneni kunakwabantu abadala . Kwakhona, ukuba ukhe wanosulelo kutshanje, umngcipheko wakho wokuba ne-ADEM unokuba phezulu kancinci.

Ziziphi iingxaki ezinokubakho ze-ADEM?

I-ADEM inokubangela iingxaki ezithile, kuquka:

• Ukulahleka kwenkumbulo
• Ukucocwa kwengqondo okulibazisekileyo
• I-Coma

Kunqabile kakhulu, iimpawu ze-ADEM zinokuba yingozi ebomini ukuba ziba nzima kakhulu. Kodwa oko kunqabile kakhulu .

Abanye abantu banokuba neempawu ezithile ezihlala zikho nasemva konyango:

• Intloko ebuhlungu kakhulu.
• Ukuba ndindisholo
• Ingxaki ngokulungelelaniswa
• Umbono ofipheleyo

Ifunyaniswa njani i-ADEM?

Ukuba uneempawu ze-ADEM, ugqirha uza kuthatha imbali eneenkcukacha zemeko yakho, akubuze ngeempawu zakho, aze enze uvavanyo lwemithambo-luvo , uvavanyo lomzimba ngokubanzi, kunye nezinye iimvavanyo ezininzi ukuze abone ukuba unayo na ADEM .

Uvavanyo lwenziwa ukujonga ezinye iimeko ezifihlakeleyo, ezifana ne-MOGAD, ezinokubangela i-ADEM. Uvavanyo oluqhelekileyo lokufumanisa i-ADEM luquka uvavanyo lwegazi kunye:

• Iskeni ye-MRI
• Uvavanyo lolwelo lomqolo

Uvavanyo lwe-MRI lukhangela ntoni?

I-MRI (Magnetic Resonance Imaging) yindlela ekhethekileyo yokufota enokujonga utshintsho olungaphakathi engqondweni. Oogqirha bakhangela izilonda okanye amabala abangelwa yi-ADEM kwiindawo ezintathu eziphambili zenkqubo ye-nervous central: ingqondo, i-spinal cord, kunye ne-optic nerves.

• I-White matter : Kulapho imicu yemithambo-luvo igqunywe khona yi-myelin. Ezi zibonakala zimhlophe kwi-MRI.
• Izinto ezingwevu : Ezi ziquka imizimba yeeseli zemithambo-luvo. Zibonakala zimnyama kwi-MRI kuba azinayo i-myelin.

Kwiinyanga ezimbalwa emva kwe-MRI yokuqala, ugqirha unokuyalela enye i-MRI ukuze abone ukuba ezi ndawo zitshintsha njani ngokuhamba kwexesha.

Yintoni ekhangelwayo xa kuvavanywa ulwelo lomqolo?

Oku kukwabizwa ngokuba yi-lumbar puncture . Olu luvavanyo olubalulekileyo lokufumanisa unobangela weempawu ze-neurological. Lubandakanya ukuthatha umlinganiselo omncinci wolwelo lwakho lwe-cerebrospinal (CSF). I-CSF lulwelo olucacileyo, olungenambala olujikeleza, olukhusela, nolondla ingqondo yakho kunye nomqolo.

Kwi-ADEM, ulwelo lwe-cerebrospinal luqulathe inani elandayo leeseli ezimhlophe zegazi, ingakumbi ii-lymphocytes . Ezi seli ziyinxalenye esebenzayo yenkqubo yethu yokuzikhusela komzimba. Le sampulu ye-CSF isetyenziselwa ukubona indlela ezi seli ezisabela ngayo kwiibhaktheriya okanye iintsholongwane ekucingelwa ukuba zibangela i-ADEM, kunye nokujonga ezinye izifo ezibangelwa kukudumba kwemithambo-luvo.

Zithini iindlela zonyango ze-ADEM?

Injongo ephambili yokunyanga i-ADEM kukunciphisa ukudumba engqondweni nasemgogodleni . Olu nyango lulandelayo lungasetyenziswa:

• Amayeza e-steroidAmayeza e-steroid: Unyango lokuqala lwe-ADEM yi-intravenous (IV) steroids. Oku kunokunikwa nge-intravenous iintsuku ezininzi. Emva koko unokunikwa iipilisi ze-steroid zomlomo iintsuku ezimbalwa.
• I-Intravenous immunoglobulin (IVIG) : Olu lunyango oluqulethe ii-antibodies ezenziwe nge-plasma yegazi elinikelwayo. Olu lunikwa nakwimithambo yegazi.
• Ukutshintshiselana ngeplasma (okanye iplasmapheresis): Oku kuquka ukuthatha inxalenye yegazi lakho, ulisebenzise kumatshini osusa ezinye zezinto ezenza buthathaka inkqubo yakho yokuzikhusela komzimba, uze ulibuyisele emzimbeni wakho. Olu nyango lungathatha iiyure ezininzi kwaye lunokwenziwa amaxesha amaninzi.

Uphando luyaqhubeka nokufunda okungakumbi ngale meko kunye nokufumana unyango olutsha.

Khumbula, olu nyango lumiselwa ngugqirha wakho. Nguye oza kukhetha eyona ifanelekileyo kwimeko yakho.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga kwezi ndlela zonyango?

Njengakwezinye iindlela zonyango, ezinye iziphumo ebezingalindelekanga zinokubakho.

Iziphumo ebezingalindelekanga zonyango lwe-steroid lwexesha elifutshane zihlala zizezexeshana, kodwa zingabandakanya:

• Amanqanaba eswekile egazini anyukileyo
• Amanqanaba e-potassium anciphileyo
• Ubunzima bokulala
• Utshintsho lweemvakalelo (ukucaphuka, ukukhala, ixhala)
• Ukutyeba kwakho
• Ububomvu bezihlathi
• Ukuva incasa yesinyithi emlonyeni

Iziphumo ebezingalindelekanga kunye neengxaki zonyango lwe-'IVIG' :

• Impendulo yokunganyamezelani
• Iintsholongwane
• Ubunzima bokuphefumla
• Amahlwili egazi
• Umonakalo wezintso
• Intloko ebuhlungu.

Iingxaki zePlasmapheresis :

• Ukuphazamiseka
• Ukopha
• Iintsholongwane
• Umonakalo wezintso
• Ukunikezelwa kwegazi okwaneleyo kwilungu lomzimba (`Ischemia`)

Thetha nogqirha wakho ngezi ziphumo ebezingalindelekanga. Ixesha elininzi, zinokulawulwa.

Kuthatha ixesha elingakanani ukuchacha emva konyango?

Uninzi lwabantu abanyangwa yi-ADEM baqala ukuziva bebhetele kwiintsuku ezimbalwa emva konyango . Nangona kunjalo, ngokuxhomekeke kubukhali beempawu zakho, kungathatha ukuya kwiinyanga ezintandathu ukuba baphile ngokupheleleyo. Amaxesha amaninzi, abanye abantu basenokungaphili ngokupheleleyo. Nangona kunjalo, uninzi lwabantu luyaphila kakuhle.

Ngaba ikho indlela yokuthintela i-ADEM?

Akukho ndlela ithile yokuthintela i-ADEM. Nangona kunjalo, unganciphisa umngcipheko wakho ngokwenza imikhwa emihle yococeko ukuze uphephe usulelo lwentsholongwane kunye neentsholongwane (umzekelo, ukuhlamba izandla zakho rhoqo kunye nokuhlala kude nabantu abagulayo).

Injani ikamva le-ADEM? Ingaba iyanyangeka?

Uninzi lwabantu abane-ADEM bayachacha ngokupheleleyo okanye phantse ngokupheleleyo emva konyango.Ukuba ukudumba kukhulu kakhulu, akunakuba yingozi ebomini. Ugqirha wakho angakunika umbono ongcono ngemeko okuyo.

Iimpawu ze-ADEM zihlala zisenzeka kube kanye kuphela , kodwa zinokuphinda zibuye ngokuxhomekeke kwisizathu esiyintloko (njenge-MOGAD). I-ADEM idla ngokuphela ngonyango, kodwa iimpawu zinokuphinda zibuye. Uninzi lwabantu luphila ubomi obuqhelekileyo.

Ndifanele ndimbone nini ugqirha?

Ukuba uneempawu ezifana neze-ADEM, ingakumbi emva kokuba usulelo , qiniseka ukuba ubona ugqirha. Okukhona lubonwa kwangethuba, kokukhona unyango lunokuqala ngokukhawuleza.

Imibuzo ebalulekileyo yokubuza ugqirha wakho

Ukuba ufunyaniswe une-ADEM, ungabuza ugqirha wakho le mibuzo:

• Ndingazilungiselela njani iimvavanyo?
• Luhlobo luni lonyango olucetyiswayo?
• Zithini iziphumo ebezingalindelekanga zonyango?
• Ngaba iimpawu zam ziya kuhlala zikho emva konyango?

Kuqhelekile ukuba nexhala kwaye woyike xa ngequbuliso ufumana iimpawu ezifana nokungakwazi ukuhamba, ukulahlekelwa yimpumlo, okanye ukuba nokuxhuzula okungachazekiyo. Iqela lakho lezonyango liza kukunceda ubhekane noku. Ezinye iindlela zonyango zingathatha iintsuku ezimbalwa okanye iiyure. Ngeli xesha, funda incwadi okanye wenze into eza kukuthomalalisa. Khumbula, oku kwenzeka kube kanye kubantu abaninzi, kodwa kunokwenzeka kwakhona.

Amanqaku amafutshane ekufuneka uwakhumbule

• I-ADEM kukudumba okukhawulezileyo kwengqondo kunye nomqolo.
• Oku kunqabile kakhulu kwaye kudla ngokuvela emva kokosuleleka.
• Kukholelwa ukuba oku kwenzeka xa inkqubo yethu yokuzikhusela komzimba ihlasela ngempazamo inkqubo yemithambo-luvo.
• Iimpawu ziyahluka kwaye zinokubandakanya umkhuhlane, intloko ebuhlungu , ukuba ndindisholo, iingxaki zokubona, kunye nobunzima bokuhamba.
• Ifunyanwa ikakhulu nge-MRI kunye novavanyo lolwelo lomqolo.
• Kukho unyango olufana nee-steroids, i-IVIG, kunye nokutshintshiselana kwe-plasma.
• Uninzi lwabantu luyachacha kakuhle, kodwa ukuchacha ngokupheleleyo kungathatha iinyanga ezininzi.
• Nangona kungekho ndlela ithile yokukuthintela, kubalulekile ukuzikhusela kwiintsholongwane.

Ndiyathemba ukuba olu lwazi luza kukunceda. Ukuba unemibuzo engaphezulu, ungalibali ukuthetha nogqirha.