Ngaba elinye icala lomzimba wakho lindindisholo kwaye elinye icala lindindisholo? Ngaba mhlawumbi yiBrown-Séquard Syndrome?

Ngaba wakha weva ngemeko engaqhelekanga apho ungakwaziyo ukushukumisa icala elinye lomzimba wakho kwaye ungaziva nto kwelinye? Inokwenzeka emva kwengozi. Iyoyikisa kancinci, kodwa namhlanje siza kuthetha ngemeko enokwenzeka ngexesha elifanelekileyo, kodwa ayiqhelekanga kangako, ebizwa ngokuba yiBrown-Séquard Syndrome . Ungakhathazeki, masithethe ngayo ngokulula.

Yintoni iBrown-Séquard Syndrome, esi sifo sibizwa ngegama elingaqhelekanga?

Ngamafutshane, iBrown-Séquard syndrome (BSS) yimeko engaqhelekanga kakhulu yemithambo-luvo. Yenzeka xa kukho umonakalo kumqolo wakho, kodwa umonakalo ulinganiselwe kwicala elinye lomqolo. Cinga ngayo njengomqolo wakho, ofana nentambo ethwala imiyalezo esuka engqondweni yakho kuwo wonke umzimba wakho ize idlulisele ulwazi oluvela emzimbeni wakho lubuyele engqondweni yakho. Ngoko ke le ngxaki yenzeka kuphela xa kukho umonakalo kwicala elinye lomqolo.

Okwenzekayo kukuba kwicala elinye lomqolo owonakeleyo, kukho ubuthathaka okanye ukukhubazeka kwemisipha engaphantsi komgangatho womonakalo. Oku kuthetha ukuba awukwazi ukushukumisa elo cala. Kodwa, ngokumangalisayo, ukuziva intlungu kunye nobushushu kulahleka kwelinye icala , kodwa ngaphantsi komgangatho womonakalo. Kuvakala kuyinkimbinkimbi kancinci, akunjalo? Masichaze ngakumbi.

Intambo yakho yomqolo yisakhiwo esisilinda esiqala kwisiseko sobuchopho ukuya kuthi ga kwisiseko somqolo wakho. Ithambile kakhulu. Yenziwe ngemicu emininzi yemithambo-luvo. Yinxalenye enkulu yenkqubo yethu yemithambo-luvo.

I-Brown-Séquard syndrome ithathwa njengengozi yomqolo engaphelelanga (SCI) . Oku kuthetha ukuba kukho ukulahleka kwemvakalelo, ukusebenza kwemisipha, okanye zombini ezingaphantsi kwendawo yokwenzakala. Kwi-SCI epheleleyo, akukho mvakalelo okanye intshukumo engaphantsi kwendawo yokwenzakala.

Ithiywe ngegama lesazinzulu uCharles-Edouard Brown-Sequard, owaqala ukuchaza le meko ngo-1849.

Oku kwahluke njani kwiCentral Cord Syndrome?

Usenokuba ukhe weva ngeCentral Cord Syndrome (CCS) . Nangona zombini zizinto ezingalunganga ngokupheleleyo kwi-spinal cord, zizinto ezimbini ezahlukeneyo.

I-CCS kukulimala okungaphelelanga embindini womqolo, ngokuqhelekileyo entanyeni. Oku kubangela ubuthathaka kwiingalo ngaphezu kwemilenze.

Nangona kunjalo, kwi -BSS , umonakalo kuyo nayiphi na inxalenye yomqolo kwelinye icala ubangela ukukhubazeka kwicala elichaphazelekayo, ngelixa elinye icala lilahlekelwa yimvakalelo. Ngaba uyayiqonda umahluko?

Ngubani onokufumana le meko? Ixhaphake kangakanani?

I-Brown-Séquard syndrome inokuchaphazela nabani na. Nangona kunjalo, yimeko engaqhelekanga kakhulu.Oku kunokwenzeka nokuba umntu ungumntu wesini na.

E-United States kuphela, kukho malunga ne-12,000 yamatyala amatsha okwenzakala komgogodla axelwayo minyaka le. Kula matyala, i-BSS ibandakanya kuphela i-2% ukuya kwi-4%. Oku kuthetha ukuba eSri Lanka, izinga lisenokuba liphantsi nangakumbi.

Zithini iimpawu zeBrown-Séquard syndrome (BSS)?

Iimpawu ze-BSS zihlala ziqala emva kokuba icala lomqolo lonakele.

Iimpawu zokuqala ezibonakala zezi:

• Ukungakwazi ukuhambisa ilungu elingaphantsi kwenxeba (ukulahlekelwa kukunyakaza kwemisipha) kwicala elinye lenxeba lomqolo. Oku kunokuqala njengobuthathaka kwaye kuqhubekele ekubeni kukukhubazeka.
• Kwelinye icala, kukho ukulahleka kwentlungu kunye nobushushu obungaphantsi komgangatho wokwenzakala.

Cinga ngale ndlela. Ukuba umntu une-BSS, oku kukulimala komqolo kwicala lasekunene lomqolo wakhe, akayi kukwazi ukuhambisa icala lakhe lasekunene, oko kukuthi, ukusuka embindini womqolo wakhe ukuya ezantsi - isinqe sakhe sasekunene, umlenze, nonyawo. Nangona kunjalo, kwicala lasekhohlo, ukusuka embindini womqolo wakhe ukuya ezantsi, uya kulahlekelwa yintlungu aze azive ubushushu/ukubanda, kodwa uya kukwazi ukuhambisa icala lakhe lasekhohlo. Intloko, intamo, amahlombe, kunye neengalo ziya kusebenza ngendlela eqhelekileyo, zingachaphazeleki yile ngozi.

Ukongeza, i-BSS inokubangela iimpawu ezifana nezi:

• Ukungakwazi ukulawula umchamo kunye nendle (ukungakwazi ukuzibamba komchamo kunye nendle).
• Ubuthathaka bemisipha kunye nokuphelelwa ngamandla (ukuwohloka kwemisipha) kwindawo echaphazelekayo.

Iimpawu ze-BSS zinokuba buthathaka kakhulu kwabanye abantu, kwaye zibe nzima kakhulu kwabanye. Nangona kunjalo, ngonyango olufanelekileyo, ezi mpawu ziyaphucuka kancinci kancinci .

Ngaba oku kuyabuhlungu?

Ukuba unobangela we-BSS sisiganeko esibuhlungu njengenxeba lokudutyulwa okanye ingozi yemoto, ingozi ngokuqinisekileyo iya kubangela iintlungu. Nangona kunjalo, ngenxa yesifo ngokwaso, oko kukuthi, umonakalo kumqolo, kusenokungabikho ntlungu.

Nangona kunjalo, abanye abantu abane-BSS banokufumana iimvakalelo ezingaqhelekanga (i-dysesthesia) ngenxa yomonakalo womthambo womqolo, onokuba kukutsha, ukurhawuzelelwa, okanye ukurhawuzelelwa.

Ziziphi izizathu eziphambili zeBrown-Séquard syndrome (BSS)?

Ezona zinto zixhaphakileyo ze-BSS kukwenzakala komqolo:

• Iimbumbulu.
• Ukuhlaba.
• Iingozi zeemoto.
• Ukonzakala okungaqondakaliyo.
• Ukwaphuka komqolo ngenxa yengozi efana nokuwa.

Ukuba unengozi efana nale, kubaluleke kakhulu ukuya esibhedlele esikufutshane ngokukhawuleza kwaye ufumane unyango ngokukhawuleza.

Ukongeza koku, i-BSS inokwenzeka ngenxa yezizathu ezingezizo ezengozi, kodwa azixhaphakanga kangako:

• I-Spondylosis yomlomo wesibeleko.
• Isifo sokudakumba sisifo esenzeka emva kokuba umntu ebekwe phantsi koxinzelelo olugqithisileyo phantsi kwamanzi.
• Idiski etyibilikileyo emgogodleni (idiski ene-herniated).
• Izifo ezifana ne-meningitis.
• Isifo se-Multiple Sclerosis (MS).
• Ukuvezwa yimitha.
• Ukuvaleka komthambo wegazi ohambisa umqolo (i-spinal ischemia).
• Iithumba zomqolo.
• I-myelitis eguqukayo.
• Isifo sephepha.

Oogqirha bayixilonga njani le nto? (Ukuxilongwa)

Ukuba ugqirha wakho ukrokrela ukuba une-BSS, uza kwenza oku kulandelayo:

• Wenza uvavanyo olupheleleyo lomzimba .
• Uvavanyo lwemithambo-luvo lwenziwa oluhlola intshukumo kunye neemvakalelo ngokweenkcukacha.
• Baza kukubuza ngembali yakho yezonyango, iingxaki zemithambo-luvo, kunye nazo naziphi na iingozi oye wazifumana.

Emva koko, baya kuyalela iimvavanyo ezininzi, ezifana ne -MRI scan , ukuqinisekisa ukuxilongwa kunye nokujonga ezinye izizathu.

Zeziphi iimvavanyo ezenziwayo koku?

Ukuba kurhanelwa ukuba une-BSS, ugqirha wakho unokuyalela iimvavanyo ezifana nezi:

• I-MRI scan (Magnetic Resonance Imaging): Olu luvavanyo olungenabuhlungu. Lusebenzisa imagnethi enkulu, amaza erediyo, kunye nekhompyutha ukwenza imifanekiso ecacileyo yamalungu kunye nezakhiwo ngaphakathi emzimbeni. I-MRI iluncedo kakhulu kwi-BSS kuba inokunceda ekuchongeni umonakalo wolwakhiwo lomqolo kwaye incede ekufumaneni unobangela we-BSS eyenzeka ngaphandle kwengozi.
• I-Myelogram kunye ne-CT scan (i-Computed Tomography): Ukuba awukwazi ukwenza i-MRI, ugqirha wakho unokuyalela i-myelogram aze emva koko acele i-CT scan yomqolo wakho. Olu vavanyo lunokujonga umonakalo kwizicubu zemithambo-luvo kwelinye icala lomqolo wakho. I-myelogram luvavanyo lomfanekiso oluhlola unxibelelwano phakathi komqolo wakho, iidiski, umqolo, imithambo-luvo kunye neengcambu zemithambo-luvo. I-CT scan isebenzisa ii-X-ray kunye neekhompyutha ukwenza imifanekiso eneenkcukacha zangaphakathi lomzimba wakho.
• Uvavanyo lwegazi: Ukuba unobangela we-BSS awucaci, ugqirha wakho unokuyalela uvavanyo lwegazi oluninzi ukujonga usulelo olunokubangela le meko.
• Ukubhobozwa kweLumbar / Ukucofa umqolo: Ukuba kukho i-multiple sclerosis (MS) , i-transverse myelitis, okanye isifo sephepha kurhanelwa ukuba yimbangela ye-BSS, ugqirha wakho unokwenza ukubhobozwa kweLumbar ukuze athathe isampuli yolwelo lwe-cerebrospinal (CSF) . I-CSF lulwelo olucacileyo olujikeleze umqolo wakho kunye nobuchopho.

Ziziphi iindlela zonyango lwe-Brown-Séquard syndrome (BSS)?

Unyango lwe-BSS luxhomekeke kwisizathu esibangela umonakalo womqolo.

Ngokubanzi, iinjongo zonyango lwe-BSS zezi:

• Ukugcina okanye ukuphucula ukusebenza kwe-motor kunye ne-sensory.
• Ukuthintela umonakalo wesibini.
• Ukunciphisa iingxaki.

Umntu one-BSS ngenxa yokwenzakala okubukhali kwisixhobo, njengenxeba lokuhlatywa ngemela, kuya kufuneka anyangwe ngenxa yokopha kunye nomonakalo wezicubu. Ukongeza, abantu abanezinye iingozi ezivela kwingozi ebangele i-BSS baya kufuna unyango olongezelelweyo ngenxa yezo zingozi.

Kukho amanqanaba amabini aphambili onyango lwe-BSS: unyango lokuqala kunye nokuvuselelwa .

Unyango Lokuqala

Unyango lokuqala lwe-BSS lungabandakanya:

• Utyando: Kwimeko apho i-BSS yenzeka ngaphandle kwengozi, idla ngokuba ngenxa yokucinezelwa okanye ukuqhekeka komqolo. Utyando luyafuneka ukuze kuncitshiswe olu xinzelelo.
• Amayeza okuthintela ukuqhekeka kwegazi: Abantu abenzakeleyo kwi-spinal cord basengozini enkulu yokuba namahlwili egazi kwimithambo yegazi (i-Venous Thromboembolism - VTE) . Oku kuquka izinto ezifana ne -deep vein thrombosis (DVT) kunye ne-pulmonary embolism . Ugqirha wakho angakunika amayeza abizwa ngokuba yi-anticoagulants , njenge-heparin okanye i-warfarin, ukuthintela amahlwili egazi.
• Ukukhusela ulusu (ukuthintela izilonda zebhedi): Ukuthintela ukwenzakala koxinzelelo/izilonda zebhedi, iqela lakho lezonyango liza kukunceda ujike kwaye utshintshe indawo ubuncinci rhoqo emva kweeyure ezimbini. Baza kukunceda ugcine ulusu lwakho lucocekile kwaye lomile, kwaye bafake i-moisturizer kulusu olomileyo.
• Ityhubhu yeGastrostomy (ityhubhu yeG): Ukuze kuncitshiswe umngcipheko wokudumba kwesisu ngenxa ye -paralytic ileus, ugqirha wakho unokubeka ityhubhu yeG esiswini sakho. Ityhubhu yeG yityhubhu ehambisa isondlo ngqo ukusuka esiswini ukuya esiswini. I-Paralytic ileus kukulahlekelwa okwethutyana kokucutheka kwemisipha okuhambisa ukutya emathunjini. Oku kuqhelekile kwizilonda zomqolo.
• Inkxaso yokuphefumla: Ukuba unengxaki yokuphefumla ngenxa yokwenzakala komqolo wakho, kunokufuneka uqhagamshelwe kwi- ventilator . Lo ngumatshini okuncedayo ukuphefumla, okanye ophefumlela wena.
• Ulawulo lwe-neurogenic bladder: Abantu abenzakeleyo emgogodleni, kuquka ne-BSS, banokulahlekelwa lulawulo lwe-bladder. Ukuba oku kuyenzeka, kufuneka i-catheter yomchamo kunye nolunye unyango olunxulumene nenkqubo yomchamo.
• Unyango lwe-Autonomic dysreflexia: Abantu abenzakeleyo kwi-spinal cord banokufumana utshintsho olukhulu kuxinzelelo lwegazi kunye nezinye iimpawu. Oku kufuneka kuphathwe ngononophelo ngamayeza alawula uxinzelelo lwegazi kunye nesantya sentliziyo.
• Iingubo ezilawula ubushushu: Abantu abane-BSS badla ngokuba nobunzima ekulawuleni ubushushu bomzimba wabo. Iqela lezonyango linokubanika iingubo ezilawula ubushushu ukunceda koku.

Ukuvuselelwa

Emva konyango lokuqala lwe-BSS, ukuvuselelwa, okufana nonyango lomzimba kunye nonyango lomsebenzi , kufuneka kuqalwe ngokukhawuleza ukuze kuphuculwe kwaye/okanye kubuyiselwe ukuhamba.

Iinjongo zonyango lomzimba:

• Ukugcina amandla emisipha kunye nokusebenza kakuhle kwemithambo-luvo.
• Ukugcina umgama wokuhamba kwamalungu.
• Nqanda ukuqhekeka kolusu ngokuma ngendlela efanelekileyo kunye nokutshintsha ubunzima.
• Ukuphucula ukuhambahamba .

Unyango lomzimba lubandakanya imithambo kunye nonyango olukunceda ukunciphisa iintlungu kwaye lukubuyisele ekusebenzeni okuqhelekileyo kunye nokuhambahamba. Ingcali yakho yonyango lomzimba iya kusebenza nawe ukuphucula ukuhambahamba kwakho. Banokukunika izixhobo zokukunceda wenze imisebenzi yemihla ngemihla, efana neebraces, ii-hand splints, izixhasi zamalungu, okanye isitulo esinamavili.

Unyango lomsebenzi lubandakanya unyango kunye nokuzilolonga okukunceda ukuba uphinde uzimele kuzo zonke iinkalo zobomi bakho emva kwengxaki yomzimba okanye yemithambo-luvo. Xa ufumana unyango lomsebenzi we-BSS, uza kufunda iindlela ezintsha zokwenza imisebenzi yemihla ngemihla, efana nokuzicoca, ukutya, kunye nokunxiba, usebenzisa okanye ngaphandle kwezixhobo zokuncedisa.

Ngaba oku kungathintelwa ukuba kwenzeke?

Eyona ndlela yokuthintela isifo seBrown-Séquard kukulandela amanyathelo okhuseleko aqhelekileyo ukuze ungonakalisi umqolo wakho. Umzekelo, lumka xa uqhuba kwaye uhamba endleleni.

Zithini amathuba okuchacha kule meko? (Ingqikelelo)

Ithemba lokuchacha kwi-BSS lixhomekeke kwizinto ezahlukeneyo, kuquka unobangela womonakalo womqolo kunye nobungakanani bomonakalo.

Nangona kunjalo, ngokubanzi, izinga lokuchacha kwi-BSS lihle ngokubanzi . Abantu abane-BSS banethuba elihle lokuphinda basebenze, kuquka nokuhamba. Nangona kunjalo, ukuchacha yinkqubo ecothayo . Ukuchacha kuhamba kancinci, kuthatha iinyanga ezintathu ukuya kwezintandathu ukususela ekuqaleni kwesifo, kwaye kungathatha ukuya kwiminyaka emibini ukuba imithambo-luvo iphile ngokupheleleyo.

Zeziphi iingxaki ezinokwenzeka ukuba azinyangwa?

Ukuba i-Brown-Séquard syndrome ayinyangwa, iingxaki ezifana nezi:

• Ukuvuvukala kwesisu.
• Uxinzelelo.
• Uxinzelelo lwegazi oluphantsi (iHypotension).
• Ukuxhuzula kwemithambo yegazi.
• Iintsholongwane – ikakhulu emiphungeni nasemchameni.
• Ukukhubazeka okungapheliyo.

Ngawaphi amaxesha afanelekileyo okubonana nogqirha?

Ukuba ngequbuliso ufumana ubuthathaka bemisipha okanye ukukhubazeka komzimba kunye/okanye ulahlekelwa yimvakalelo kwelinye icala lomzimba wakho, yiya kwigumbi likaxakeka elikufutshane ngokukhawuleza .

Ukuba ufunyaniswe uneBrown-Séquard syndrome, kufuneka uye kwiqela lakho lezonyango rhoqo ukuqinisekisa ukuba ukwenzakala komgogodla wakho kuyaphola ngokufanelekileyo. Qiniseka ukuba ugcina amadinga akho onyango lomzimba kunye nonyango lomsebenzi ukuze akuncede uphile kakuhle nangokukhawuleza.

Eyona nto ibalulekileyo ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

I-Brown-Séquard syndrome inokuba yinto eyoyikisayo ukuyiva. Kodwa iindaba ezimnandi zezokuba abantu abaninzi abanale meko baphinda bafumane okanye baphucule ubuchule babo bokusebenza kunye neemvakalelo emva kweenyanga ezimbalwa bephilile. Khumbula, iqela lakho lezonyango liya kuhlala likhona ukukunceda ubuyele endleleni. Ngoko ke hlala uqinile kwaye ulandele icebiso elinikiweyo.

Isifo sikaBrown -Séquard, umqolo, umqolo, imithambo-luvo, ukukhubazeka, ukulahlekelwa zimvakalelo, umonakalo womqolo