Ingabe ngokuzumayo uhlangabezana nezinkinga ngobuchopho bakho kanye nomgogodla? Ake sifunde nge-ADEM (i-Acute Disseminated Encephalomyelitis)!

Wake wezwa ngegama elithi `ADEM` (Acute Disseminated Encephalomyelitis)? Lokhu kungase kube yinto entsha kuwe. Kuyisimo esingavamile, okusho ukuthi sithinta abantu abambalwa kakhulu, kodwa singavela ngokuzumayo futhi sithinte isimiso sethu sezinzwa . Ungakhathazeki, sizokhuluma ngakho kalula, ngendlela ongayiqonda.

Kuyini i-ADEM? Ake sikuqonde kalula.

Kalula nje, i-ADEM ukuvuvukala okungazelelwe noma ukuvuvukala kweSistimu Yethu Yezinzwa Ephakathi - okungukuthi, ubuchopho nomgogodla. Cabanga ngale ndlela, njengoba nje lapho sithola ukulimala , umzimba wethu uyavuvukala, lokhu kubangela ukuvuvukala kwezinye izindawo zobuchopho nomgogodla.

Lokhu kuvuvukala kungalimaza igobolondo elivikelayo elizungeze imicu yezinzwa zethu. Le gobolondo libizwa ngokuthi igobolondo le-myelin . Lifana nepulasitiki elimboze ucingo lukagesi. Lisiza imiyalezo ukuthi ihambe ngokushesha ngemithambo. Ngakho-ke, lapho le gobolondo le-myelin lonakele, imiyalezo yezinzwa ayihambi kahle. Yilapho kuvela khona izimpawu ezahlukahlukene. Abanye odokotela babiza lesi simo ngokuthi isimo "sokususa ulwelwesi".

Igama elithi "acute" ku-ADEM lisho ukuthi kwenzeka ngokuzumayo . Esikhathini esiningi, kwenzeka kanye kuphela empilweni. Kodwa-ke, kungenzeka ukuthi kuphinde kwenzeke kaningi.

Kuvamile kangakanani lokhu?

Empeleni i-ADEM iyisimo esingavamile kakhulu. Ucwaningo lubonisa ukuthi ezweni elifana neMelika, kwenzeka cishe kubantu abayisigidi ezimbili nesigamu. Ngakho-ke, lesi akusona isifo esithinta wonke umuntu.

Ziyini izimpawu zalesi simo?

Izimpawu ze-ADEM zivame ukuvela ezinsukwini ezimbalwa ngemva kokutheleleka ngegciwane noma ngebhaktheriya . Lezi zimpawu zingahluka kumuntu nomuntu, futhi zincike ekutheni ukuvuvukala kukuphi ebuchosheni noma emgogodleni.

Ezinye izimpawu ezivamile zifaka:

• Imfiva
• Ikhanda elibuhlungu.
• Isicanucanu noma ukuhlanza
• Ukudideka
• Ukukhathala

Ngaphezu kwalokho, izimpawu ezihlobene nesimiso sezinzwa zingafaka:

• Ukungazweli noma ukuzwa ukuthuthumela emilenzeni
• Ubunzima bokugwinya
• Ukulahlekelwa noma ukufiphala kombono (i-optic neuritis)
• Ubuthakathaka bemisipha
• Ubunzima bokuhamba
• Ukuquleka

Njengoba ubona, lezi zimpawu kanye nobunzima bazo kungahluka kakhulu kumuntu nomuntu . Abanye abantu bangase babe nezimpawu ezincane kakhulu, kanti abanye bangase bathinteke kakhulu.

Kungani lokhu kwenzeka? Ziyini izimbangela ze-ADEM?

Imbangela eqondile ye-ADEM ayaziwa okwamanje . Kodwa-ke, ucwaningo lubonisa ukuthi lapho igciwane noma igciwane lingena emzimbeni wethu, amasosha omzimba ethu ayalwa nalo. Kodwa-ke, kumuntu one-ADEM, amasosha omzimba ahlasela ngephutha izingxenye zesimiso sawo sezinzwa esiyinhloko . Kufana nokuhlasela elinye lamalungu alo, licabanga ukuthi liyisitha. Lokhu kuhlasela okungalungile kubangela ukuvuvukala (ukuvuvukala) okukhulunywe ngakho ekuqaleni, okube sekudala izimpawu.

Kutholakale ukuthi phakathi kuka-70% no-80% wabantu abathola i-ADEM banesifo noma ukugula ngaphambi kokuba kuvele izimpawu ze-ADEM. Izimpawu ze-ADEM zivame ukuqala ezinsukwini eziyi-7 kuya kweziyi-14 ngemva kokutheleleka. Ezinye izifo ezivamile ezingase zihlotshaniswe ne-ADEM zifaka:

• Umkhuhlane noma Umkhuhlane
• Isimungumungwane
• Ama-mumps
• I-Rubella
• Inqubulunjwana
• Igciwane le-Epstein Barr
• I-Cytomegalovirus
• Igciwane le-Herpes simplex (`igciwane le-Herpes simplex`)

Nakuba amagciwane ahlukahlukene, amagciwane, kanye nezinye izifo kuye kwaxhunyaniswa ne-ADEM, akubonakali sengathi ibangelwa yi-ejenti eyodwa ethelelanayo.

Muva nje, esinye isizathu se-ADEM, ikakhulukazi ezinganeni, sitholakale njenge- Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). Lokhu kubhekwa futhi njengesimo sokuzivikela komzimba. Lokhu kusho ukuthi isimiso somzimba sokuzivikela sihlasela isimiso saso sezinzwa. Le MOGAD ingabangela ne-ADEM ngezinye izikhathi.

Ubani osengozini enkulu yokuthola i-ADEM?

Noma ubani angathola i-ADEM. Kodwa-ke, ivame kakhulu ezinganeni kunakubantu abadala . Futhi, uma uke waba nokutheleleka muva nje, ingozi yakho yokuthola i-ADEM ingase ibe phezulu kancane.

Yiziphi izinkinga ezingaba khona ze-ADEM?

I-ADEM ingabangela ezinye izinkinga, okuhlanganisa:

• Ukulahlekelwa yinkumbulo
• Ukucubungula kwengqondo okubambezelekile
• I-Coma

Akuvamile kakhulu, izimpawu ze-ADEM zingaba yingozi empilweni uma ziba zimbi kakhulu. Kodwa lokho akuvamile kakhulu .

Abanye abantu bangase babe nezimpawu ezithile eziqhubekayo ngisho nangemva kokwelashwa:

• Ikhanda elibuhlungu kakhulu.
• Ukuba ndikindiki
• Inkinga ngokuxhumana
• Umbono ofiphele

I-ADEM ihlolwa kanjani?

Uma unezimpawu ze-ADEM, udokotela uzothatha umlando oningiliziwe wesimo sakho, abuze ngezimpawu zakho, futhi enze ukuhlolwa kwezinzwa , ukuhlolwa ngokomzimba okuvamile, kanye nezinye izivivinyo eziningana ukuze anqume ukuthi unayo yini ADEM .

Ukuhlolwa kwenziwa futhi ukuhlola ezinye izimo eziyisisekelo, njenge-MOGAD, ezingase zibangele i-ADEM. Ukuhlolwa okuvamile kokuxilonga i-ADEM kufaka phakathi ukuhlolwa kwegazi kanye:

• Ukuskena kwe-MRI
• Ukuhlolwa koketshezi lomgogodla

Yini ebhekwa yi-MRI test?

I-MRI (Magnetic Resonance Imaging) iyindlela ekhethekile yokuthwebula izithombe engabheka izinguquko ezijulile ebuchosheni. Odokotela bafuna izilonda noma amabala abangelwa yi-ADEM ezindaweni ezintathu eziyinhloko zesimiso sezinzwa esiyinhloko: ubuchopho, intambo yomgogodla, kanye nezinzwa ze-optic.

• Okumhlophe : Yilapho imicu yezinzwa imbozwe khona yi-myelin. Lokhu kubonakala kumhlophe ku-MRI.
• Okumpunga : Lokhu kuqukethe imizimba yamangqamuzana ezinzwa. Abonakala emnyama ku-MRI ngoba awanawo ama-myelin.

Ezinyangeni ezimbalwa ngemva kwe-MRI yokuqala, udokotela angase acele enye i-MRI ukuze abone ukuthi lezi zindawo zishintsha kanjani ngokuhamba kwesikhathi.

Yini efunwayo ekuhlolweni koketshezi lomgogodla?

Lokhu kubizwa nangokuthi ukubhoboza kwe-lumbar . Lokhu ukuhlolwa okubalulekile ukuthola imbangela yezimpawu zezinzwa. Kuhilela ukuthatha inani elincane loketshezi lwakho lwe-cerebrospinal (CSF). I-CSF iwuketshezi olucacile, olungenambala oluzungeza, luvikele, futhi londle ubuchopho bakho kanye nomgogodla.

Ku-ADEM, uketshezi lwe-cerebrospinal luqukethe inani elikhulayo lamaseli amhlophe egazi, ikakhulukazi ama-lymphocyte . Lawa maseli ayizingxenye ezisebenzayo zesimiso sethu somzimba sokuzivikela. Lesi sampula se-CSF sisetshenziselwa ukubona ukuthi lawa maseli asabela kanjani kumagciwane noma amagciwane okucatshangwa ukuthi abangela i-ADEM, kanye nokuhlola ezinye izifo zokuvuvukala kwemizwa.

Yiziphi izindlela zokwelapha i-ADEM?

Umgomo oyinhloko wokwelapha i-ADEM ukunciphisa ukuvuvukala ebuchosheni nasemgogodleni . Izindlela zokwelapha ezilandelayo zingasetshenziswa:

• Imithi ye-steroidImithi ye-steroid: Umugqa wokuqala wokwelashwa kwe-ADEM ama-steroid e-intravenous (IV). Lokhu kunganikezwa ngemithambo izinsuku eziningana. Ungabe usunikwa amaphilisi e-steroid omlomo izinsuku ezimbalwa.
• I-Intravenous immunoglobulin (IVIG) : Lokhu ukwelashwa okuqukethe ama-antibodies enziwe nge-plasma yegazi elinikelayo. Lokhu kunikezwa futhi emthanjeni.
• Ukushintshaniswa kwe-plasma (noma i-plasmapheresis): Lokhu kuhilela ukuthatha ingxenye yegazi lakho, ulidlulise emshinini osusa ezinye zezingxenye ezenza buthaka isimiso sakho somzimba, bese ulibuyisela emzimbeni wakho. Lokhu kwelashwa kungathatha amahora amaningana futhi kungenziwa izikhathi eziningana.

Ucwaningo luyaqhubeka nokufunda kabanzi ngalesi simo nokuthola izindlela ezintsha zokwelapha.

Khumbula, lezi zindlela zokwelapha zinqunywa udokotela wakho. Uzokhetha ukuthi yikuphi okulungele isimo sakho.

Ingabe ikhona imiphumela emibi kulezi zindlela zokwelapha?

Njenganoma yikuphi ukwelashwa, kungase kube nemiphumela emibi.

Imiphumela emibi yokwelashwa kwe-steroid yesikhashana ivame ukuba yesikhashana, kodwa ingafaka:

• Amazinga kashukela egazini akhuphukile
• Amazinga e-potassium anciphile
• Ubunzima bokulala
• Ukushintsha kwesimo sengqondo (ukucasuka, ukukhala, ukukhathazeka)
• Ukwanda kwesisindo
• Ukubomvu kwezihlathi
• Ukuzwa ukunambitheka kwensimbi emlonyeni

Imiphumela emibi kanye nezinkinga zokwelashwa kwe-'IVIG' :

• Ukusabela kokungezwani komzimba
• Izifo
• Ubunzima bokuphefumula
• Amahlule egazi
• Ukulimala kwezinso
• Ikhanda elibuhlungu.

Izinkinga ze -Plasmapheresis :

• Ukuphazamiseka
• Ukopha
• Izifo
• Ukulimala kwezinso
• Ukunikezwa kwegazi okunganele engxenyeni yomzimba (`Ischemia`)

Khuluma nodokotela wakho ngale miphumela emibi. Isikhathi esiningi, ingalawulwa.

Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa?

Iningi labantu abelashwa i-ADEM liqala ukuzizwa lingcono ezinsukwini ezimbalwa zokwelashwa . Kodwa-ke, kuye ngokuthi izimpawu zakho zibucayi kangakanani, kungathatha izinyanga eziyisithupha ukululama ngokuphelele. Akuvamile kakhulu, abanye abantu bangase bangalulami ngokugcwele. Kodwa-ke, iningi labantu lilulama kahle.

Ingabe ikhona indlela yokuvimbela i-ADEM?

Ayikho indlela eqondile yokuvimbela i-ADEM. Kodwa-ke, unganciphisa ingozi yakho ngokwenza imikhuba emihle yokuhlanzeka ukuze ugweme ukutheleleka ngamagciwane namagciwane (isibonelo, ukugeza izandla zakho njalo nokugwema abantu abagulayo).

Iyini inhloso ye-ADEM? Ingabe iyelapheka?

Iningi labantu abane-ADEM lilulama ngokuphelele noma cishe ngokuphelele ngemva kokwelashwa.Uma ukuvuvukala kukhulu kakhulu, akuvamile ukuba yingozi empilweni. Udokotela wakho angakunikeza umbono ongcono kakhulu ngesimo sakho.

Izimpawu ze-ADEM zivame ukwenzeka kanye kuphela , kodwa zingaphinde zivele kuye ngokuthi imbangela iyini (njenge-MOGAD). I-ADEM ivame ukuphela ngokwelashwa, kodwa izimpawu zingaphinde zivele. Iningi labantu liphila impilo evamile.

Kufanele ngimbone nini udokotela?

Uma unezimpawu ezifana neze-ADEM, ikakhulukazi ngemva kokutheleleka , qiniseka ukuthi ubona udokotela. Uma kutholakala kusenesikhathi, ukwelashwa kungasheshe kuqale.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Uma kutholakale ukuthi une-ADEM, ungase ufune ukubuza udokotela wakho le mibuzo:

• Kufanele ngizilungiselele kanjani izivivinyo?
• Hlobo luni lokwelashwa olunconywayo?
• Iyini imiphumela emibi yokwelashwa?
• Ingabe izimpawu zami ziyaqhubeka ngemva kokwelashwa?

Kuvamile ukuzizwa ukhathazekile futhi wesaba lapho uhlangabezana nezimpawu ezinjengokungakwazi ukuhamba, ukulahlekelwa ukubona, noma ukuba nezimpawu ezingachazeki. Ithimba lakho lezokwelapha lizokusiza ukuthi ubhekane nalokhu. Ezinye izindlela zokwelapha zingathatha izinsuku ezimbalwa noma ngisho namahora. Phakathi nalesi sikhathi, funda incwadi noma wenze okuthile okuzola. Khumbula, lokhu kuyinto eyenzeka kanye kubantu abaningi, kodwa kungenzeka futhi.

Amaphuzu amafushane okufanele uwakhumbule

• I-ADEM ukuvuvukala okungazelelwe kobuchopho nomgogodla.
• Lokhu akuvamile kakhulu futhi kuvame ukwenzeka ngemva kokutheleleka.
• Kucatshangwa ukuthi lokhu kwenzeka lapho amasosha ethu omzimba ehlasela ngephutha isimiso sezinzwa.
• Izimpawu ziyahlukahluka futhi zingafaka phakathi umkhuhlane, ikhanda elibuhlungu , ukuba ndikindiki, izinkinga zokubona, kanye nobunzima bokuhamba.
• Itholakala kakhulu nge-MRI kanye nokuhlolwa koketshezi lomgogodla.
• Kunezindlela zokwelapha ezifana nama-steroids, i-IVIG, kanye nokushintshaniswa kwe-plasma.
• Iningi labantu liyalulama kahle, kodwa ukululama okuphelele kungathatha izinyanga eziningana.
• Nakuba kungekho ndlela eqondile yokukuvimbela, kubalulekile ukuzivikela ezifweni.

Ngithemba ukuthi lolu lwazi luzokusiza. Uma uneminye imibuzo, ungakhohlwa ukukhuluma nodokotela.