Ngaba umntu omthandayo unazo ezi mpawu zingaqhelekanga? Ngaba kunzima ukuthetha okanye ukuginya? Masifunde nge (Pseudobulbar Palsy)!

Ngaba wakha waphawula ukuba ngamanye amaxesha abantu esibathandayo baqala ukuhleka ngaphandle kwesizathu, okanye baqale ukukhala ngaphandle kokuva lusizi? Okanye ngaba bayawathetha amazwi ahlabayo xa bethetha, okanye banengxaki yokuginya ukutya? Ukuba unenye okanye ngaphezulu kwezi zinto, isenokuba ibangelwa yimeko ebizwa ngokuba yi-'Pseudobulbar Palsy' esiza kuthetha ngayo namhlanje. Esi asisosifo esahlukileyo, kodwa yingqokelela yeempawu ezibangelwa zizifo ezithile zemithambo-luvo. Ngoko ke, masithethe ngale nto ngokweenkcukacha?

Yintoni iPseudobulbar Palsy?

Ngamafutshane, iPseudobulbar Palsy yingqokelela yeempawu zemithambo-luvo ezibangelwa kukonakala kwenxalenye ethile yobuchopho bethu ebizwa ngokuba yi-corticobulbar tract. Le nxalenye ye-corticobulbar tract inceda ukulawula izihlunu entlokweni nasebusweni bethu. Xa oku konakele, kuvela iingxaki ezintathu eziphambili:

• Ubunzima bokuthetha, ngokwezonyango sibiza oku ngokuthi 'yi-dysarthria' .
• Ubunzima bokuginya ukutya okanye ulwelo kuthiwa yi -dysphagia .
• Ukungakwazi ukulawula iimvakalelo zakho, njengokuhleka okanye ukukhala ngequbuliso, kubizwa ngokuba yi-"pseudobulbar affect."

Into ebalulekileyo kukuba esi ayisosifo sithile, kodwa yingxaki ebangelwa zezinye izifo zemithambo-luvo okanye iimeko zemithambo-luvo. Ngamanye amaxesha oogqirha babiza oku ngokuthi 'yi-supranuclear bulbar palsy'.

Zithini iimpawu zale meko?

Njengoko bekutshiwo ngaphambili, iimpawu ezintathu eziphambili kukuthetha nzima, ukuginya nzima, kunye nokungakwazi ukulawula iimvakalelo. Nangona kunjalo, ezinye iimpawu zinokubonakala, ezinje:

• Ukuvuza amathe okanye ukuvuza amathe kakhulu: Ngamanye amaxesha amathe anokuphuma emlonyeni ungaqondanga.
• Utshintsho kwindlela yokuthetha kunye nethoni: Intetho isenokungacaci. Isenokuvakala ngathi uthetha ngempumlo yakho (ithoni yempumlo egqithisileyo).
• Ubuthathaka bolwimi okanye ukukhubazeka: Oku kubizwa ngokuba yi-'glossoplegia'. Oku kunokwenza kube nzima ukuthetha nokuhlafuna ukutya.
• Ubuthathaka bemisipha yobuso: Icala elinye okanye omabini obuso asenokungabi nabomi.
• Ubunzima bokuhlafuna ukutya: Ekubeni ungakwazi ukuhlafuna ukutya kakuhle, kuba nzima ukukuginya.
• Ukuhleka okanye ukukhala okungalawulekiyo okanye okungafanelekanga: Khawuthelekelele ukukhala ngequbuliso ngaphandle kwesizathu esicacileyo, okanye ukuhlekela phezulu into encinci, kwaye ungakwazi ukuyilawula. Oku kubizwa ngokuba yi-"pseudobulbar affect."
• Ukuqina okanye ukuqina kwemisipha yomhlathi: Oku kukwabizwa ngokuba yi-'trismus'. Kunokuba nzima ukuvula nokuvala umlomo wakho.
• Ukwanda kokusabela kobuso: Umzekelo, ukuxhuzula kwemihlathi kunokwenzeka.

Kukwaxelwa ukuba malunga ne-85% yabantwana abane-Pseudobulbar Palsy banokuba neemeko ezifana nokukhubazeka kwengqondo kunye nokuxhuzula .

Kunye nezi mpawu, ezinye iimpawu zinokuvela ngokuxhomekeke kwisifo esibangela i-pseudobulbar palsy.

Kutheni oku kusenzeka? Zithini izizathu?

Eyona nto ibangela iPseudobulbar Palsy kukonakala kwamacala omabini e-corticobulbar tract engqondweni yethu. Umsebenzi wale ndlela kukulawula izihlunu entlokweni nasebusweni. Le nxalenye ikwabonelela ngegalelo kwimithambo-luvo yentloko enika imiyalezo efunekayo kwezi zihlunu.

Ngoko ke, kukho iimeko ezahlukeneyo ezinokonakalisa le "corticobulbar tract." Nazi:

• Ukulimala okunzulu entloko (ukulimala kwengqondo okubuhlungu).
• Iithumba ze-Brainstem .
• Ukudumba kunye nosulelo oluchaphazela ingqondo.
• Iimeko ze-neurological ezingapheliyo .
• Izifo ezinxulumene nemithambo yegazi yobuchopho, umzekelo "ukubetheka" kunye "nokukhubazeka kwemithambo yegazi".

Ezinye zeemeko ze-neurological eziqhelekileyo, ezihlala ixesha elide ezibangela i-pseudobulbar palsy ziquka:

• I-Amyotrophic lateral sclerosis (ALS).
• Isifo sikaParkinson .
• I-progressive supranuclear palsy. ( I-Palsy ye-Supranuclear eqhubekayo).
• I-Multiple sclerosis (`I-Multiple sclerosis - MS`).

Uyibona njani le nto?

Oogqirha badla ngokuxilonga iPseudobulbar Palsy ngokweempawu zakho. Eyona nto ibalulekileyo apha kukufumanisa ukuba yintoni imeko ebangela esi sifo. Usenokuba sele uyayazi, okanye kusenokufuneka ufumane into entsha.

Ugqirha uza kukubuza ngeempawu zakho, ukuba zaqala nini, kunye nembali yakho epheleleyo yezonyango, njengokuthi ngaba ukhe wanayo na imeko yangaphambili efana nestroke. Emva koko baza kwenza uvavanyo lomzimba kunye novavanyo lwemithambo-luvo .

Ekubeni kukho iimeko ezininzi ezinokubangela i-pseudobulbar palsy, ugqirha wakho unokucebisa iimvavanyo ezahlukeneyo. Ezinye zezi ziquka:

• Uvavanyo lwegazi .
• Umpompo womqolo wolwelo lwe-cerebrospinal (uhlalutyo lwe-CSF).
• Uvavanyo lwemifanekiso, njenge-MRI scan yobuchopho .
• Uvavanyo lwe-`EEG` (`EEG - electroencephalogram`), olulinganisa umsebenzi wombane wengqondo.
• Uvavanyo lwe-'Evoked Potential'(`Uvavanyo olunokwenzeka oluvusiweyo`).
• Uvavanyo lwentetho kunye nolwengqondo .

Ezi mvavanyo ziza kusinceda sifumanise ukuba yintoni kanye kanye imbangela.

Iphathwa njani?

Akukho nyango luthe ngqo lwePseudobulbar Palsy. Endaweni yoko, iqela lakho lezonyango liza kucebisa iindlela ezahlukeneyo zonyango ukulawula iimpawu zesifo. Ukongeza, imeko esisiseko inokufuna unyango.

Ukuze wenze oku, uza kufuna uncedo lweqela loogqirha eliquka iingcali ezahlukeneyo. Phakathi kwazo kukho:

• Ugqirha wakho wosapho (`ugqirha wezonyango oluphambili`).
• Iingcali ze-neurological.
• Iingcali zezifo zolwimi lokuthetha.
• Iingcali zonyango lokuphefumla.
• Iingcali zengqondo okanye iingcali zengqondo.
• Abasebenzi bezentlalo.
• Iingcali zekhemesti.

Unyango lobunzima bokuginya (i-Dysphagia)

Kukho iindlela ezahlukeneyo zonyango ezifumanekayo ngokuxhomekeke kubunzima bokuginya. Ezinye zazo ziquka:

• Ukutshintsha iindawo zokutya, ukutshintsha izixhobo zokutya, kunye nokutshintsha indlela ukutya okuhlala ngayo. Umzekelo, ungakucola ukutya kakuhle kwaye ukuwenze kube manzi ngakumbi ukuze kube lula ukuginya.
• Ukuzilolonga ukuqinisa izihlunu ezinceda ekuginyeni (`Uqeqesho lwezihlunu lokuginya`).
• Unyango lwe-physiotherapy, njengokukhuthaza umbane, i-magnetic okanye i-thermal.
• Amayeza, umzekelo, amayeza anjenge-`nifedipine` kunye ne-`metoclopramide`.

Khumbula, ukuba awukwazi ukutya okanye ukusela ngokufanelekileyo, okanye ukuba usemngciphekweni wokukrwitshwa, ugqirha wakho unokucebisa ukuba ukondle ngetyhubhu ('ityhubhu yokondla') efakwa ngqo empumlweni okanye esiswini sakho .

Unyango lweengxaki zokuthetha

Ukuba unengxaki yokuthetha, unyango lokuthetha lunokuba luncedo kakhulu. Ingcali yokuthetha ayifundisi wena wedwa, kodwa ifundisa nosapho lwakho indlela yokunxibelelana ngcono nawe.

Ngexesha leeseshoni zonyango lokuthetha, ungafunda izinto ezinje:

• Ukuzilolonga okuqinisa ulwimi, imilebe, kunye nemisipha yomhlathi (ukuba kunokwenzeka).
• Amaqhinga okuthetha ngokucacileyo, njengokucothisa isantya sakho sokuthetha nokusebenzisa ngabom izihlunu ezithile ukubiza izandi namagama.
• Iindlela zokuveza izimvo ngaphandle kwamagama, njengolwimi lwezandla okanye ukubhala.

Unyango lokubonakaliswa kweemvakalelo okungalawulekiyo (`Pseudobulbar Affect - PBA`)

Amayeza okulawula i-"Pseudobulbar Affect (PBA)", imeko apho uhleka kwaye ulila ngokungalawulekiyoInganceda. Ugqirha wakho angakunika amayeza afana nala:

• I-Dextromethorphan/quinidine sulfate (Nuedexta®): I-U.S. Food and Drug Administration (FDA) ivumile eli yeza njengeyeza lokuqala elenzelwe ngokukodwa ukunyanga i-PBA. Liqulethe iyeza lokukhwehlela kunye nedosi ephantsi yeyeza elalisetyenziswa ngaphambili ukunyanga iingxaki zesingqisho sentliziyo.
• Amayeza okudakumba : Amayeza afana ne-tricyclic antidepressants, ii-SSRI (i-Selective serotonin reuptake inhibitors), kunye ne-SNRIs (i-Serotonin kunye ne-norepinephrine reuptake inhibitors) anokunceda ukulawula iimpawu ze-PBA.

Iza kuba njani le meko? Ngaba inganyangeka?

Uqikelelo lomntu one-pseudobulbar palsy luxhomekeke kakhulu kwisifo esibangela loo nto.

Khawucinge nje, ukuba ubunale meko ngenxa ye-"stroke" okanye "ukulimala kwengqondo okubuhlungu", kukho ithuba lokuba ukusebenza kwemithambo-luvo kubuyele esiqhelweni kancinci kancinci. Oko kukuthi, iimpawu ze-pseudobulbar palsy zinokuncipha kancinci kancinci.

Nangona kunjalo, ukuba le meko ibangelwa zizifo ezingapheliyo eziwohlokayo ezifana ne-multiple sclerosis (MS), isifo sikaParkinson, kunye ne-ALS, kudla ngokuba nzima ukulindela unyango.

Iqela lakho lezonyango liya kukwazi ukukunika umbono ocacileyo wento eza kwenzeka kwixesha elizayo kwimeko yakho ethile.

Zeziphi ezinye iingxaki ezinokubangela oku?

I-Pseudobulbar palsy inokubangela iingxaki ezifana nezi:

• I-Aspiration pneumonia: Ngenxa yokuba izihlunu zolwimi nomlomo kunzima ukuzilawula, ukutya okuncinci okanye isiselo kunokungena emiphungeni, oku kubangele imeko ebizwa ngokuba yi-aspiration pneumonia. Oku kunokuba yingozi.
• Ukungondleki kakuhle kunye nokuphelelwa ngamanzi emzimbeni: Ukuba i-dysphagia imbi kakhulu, ukungondleki kakuhle kunye nokuphelelwa ngamanzi emzimbeni kunokwenzeka ngenxa yokungakwazi ukutya nokusela ngokufanelekileyo. Kwiimeko ezinzima, kunokufuneka ityhubhu yokondla.
• Iimeko zempilo yengqondo: I-Pseudobulbar palsy inokuba nefuthe elikhulu kubomi bakho bemihla ngemihla. Usenokuba ngumntu ozikhethayo ebantwini ngenxa yezinto ezifana nobunzima bokuthetha kunye nokuqhuma kweemvakalelo okungalawulekiyo. Oku kunokukhokelela kwiingxaki zempilo yengqondo ezifana nokudakumba kunye noxinzelelo .

Ngaba iPseudobulbar Palsy iyabulala?

I-Pseudobulbar palsy ayibulali ngokuthe ngqo. Nangona kunjalo, isifo esibangela oku (umz., ukukhubazeka )`, `ALS`) ingabulala. Kwakhona, iingxaki ezifana ne-`aspiration pneumonia` zinokuba yingozi ebomini ukuba azinyangwa ngokufanelekileyo.

Ngaba ikho indlela yokuthintela oku?

Ekubeni zininzi izinto ezinokubangela i-pseudobulbar palsy, akukho ndlela ingqalileyo yokuyithintela. Nangona kunjalo, ukulandela imikhwa yempilo enokuthintela izinto ezinobungozi ezifana "nokukhubazeka" kunokuba luncedo ngokungangqalanga.

Ndifanele ndimbone nini ugqirha?

Ukuba unePseudobulbar Palsy, kufuneka udibane neqela lakho lezonyango rhoqo ukuqinisekisa ukuba isicwangciso sakho sonyango sisebenza kakuhle.

Le meko inokuba nefuthe elikhulu kubomi bakho bemihla ngemihla, kwaye ungaziva uxinezelekile. Ngamaxesha anjalo , ungathandabuzi ukufuna uncedo kubantu obathandayo, kunye nomcebisi wezempilo yengqondo . Khumbula, iqela lakho lezonyango lihlala linawe ukuze lifumane isicwangciso sonyango esikufaneleyo.

Umyalezo Wokuya Ekhaya

Kulungile, masikhumbule oku njengesishwankathelo sePseudobulbar Palsy esithethe ngayo namhlanje:

• Esi asisosifo esahlukileyo, kodwa yingqokelela yeempawu ezibangelwa kukonakala kwenxalenye ethile yengqondo.
• Iimpawu eziphambili kukuthetha nzima, ukuginya nzima, kunye nokuhleka okanye ukukhala ngendlela engalawulekiyo.
• Izizathu ziquka izifo zemithambo-luvo ezifana nokukhubazeka, isifo sikaParkinson, i-MS, okanye ukwenzakala entloko .
• Unyango lujoliswe ekunyangeni imeko engundoqo kunye nokulawula iimpawu. Unyango lokuthetha, ukuzilolonga ngokuginya, kunye namayeza anokunceda koku.
• Kubaluleke kakhulu ukuqaphela iimpawu ngokukhawuleza nokufuna iingcebiso zonyango.
• Uthando lwakho, inkxaso yakho, kunye nokuqonda kwakho kubaluleke kakhulu kumntu ophila nale meko.

Ukuba wena okanye umntu osondeleyo kuwe unenye yezi mpawu, nceda ubone ugqirha ukuze akunike icebiso. Leyo yeyona nto ingcono onokuyenza.

I- Pseudobulbar palsy, iingxaki zobuchopho, ubunzima bokuthetha, ubunzima bokuginya, izifo zemithambo-luvo, ulawulo lweemvakalelo, i-PBA