Cabanga ukuthi wena noma ingane yakho ninomkhuhlane noma umkhuhlane ovamile futhi nibe ngcono ezinsukwini ezimbalwa. Ngesikhathi wonke umuntu ejabule, ngemva kokuba lokho kugula sekuphelile, ukugula okusha kuqala ngokuzumayo cishe ngesonto elilodwa noma amabili. Ngokuzumayo, ulahlekelwa amandla akho, umbono wakho uyancipha, uba nobunzima bokukhuluma, uphathwa yikhanda elibuhlungu futhi uqala ukuhlanza. Besingasaba kangakanani uma kwenzeka into efana nale? Namuhla, sikhuluma ngesifo esibi esingasolwa ngaleso sikhathi, nakuba singavamile, sidinga ukwelashwa ngokushesha. Lesi sifo sibizwa ngokuthi i-ADEM (Acute Disseminated Encephalomyelitis) .
Kuyini i-ADEM (i-Acute Disseminated Encephalomyelitis)?
Kalula nje, i-ADEM ukuvuvukala okungazelelwe noma ukuvuvukala kwesimiso sethu sezinzwa esiyinhloko , okungukuthi, ubuchopho kanye nomgogodla. Kufana nomkhuhlane wobuchopho.
Ake sikuqonde lokhu kalula. Imicu yezinzwa emzimbeni wethu ifana nezintambo zikagesi. Kukhona isembozo sepulasitiki esizungeze izintambo zikagesi, akunjalo? Yilokho okuvumela ugesi ukuthi uhambe ngokunembile nangokushesha futhi uvikele intambo. Ngokufanayo, kukhona isembozo esivikelayo, isembozo esibizwa ngokuthi "i-myelin" esizungeze imicu yezinzwa zethu. Lesi sembozo se-myelin yiso esivumela imiyalezo (amasignali) ukuthi ihambe ngokushesha nangokunembile ngemithambo yegazi isuka kwenye ingxenye yomzimba iye kwenye.
Ku-ADEM, amasosha ethu omzimba ahlasela ngephutha lesi sigxobo se-myelin. Bese siqala ukubhujiswa nokonakala. Njengoba nje ipulasitiki esentanjeni kagesi iphumile. Bese imiyalezo yezinzwa ingahambi kahle. Yingakho kuvela izimpawu ezifana nokungazweli ezithweni, ukubona okufiphele, kanye nobunzima bokukhuluma.
Lesi sifo sibizwa ngokuthi 'i-acute' ngoba izimpawu zivela ngokuzumayo, zingakapheli izinsuku ezimbalwa. Sivame ukwenzeka kanye kuphela empilweni. Kodwa-ke, asivamile ukuphinda sibuye.
I-ADEM iyisifo esingavamile. Ngokusho kocwaningo, cishe umuntu oyedwa kwabangu-150,000 ezweni elinjenge-United States uthola lesi sifo. Ngakho-ke asikho isidingo sokwesaba kakhulu lokhu, kodwa kubaluleke kakhulu ukuqaphela.
Ziyini izimpawu ze-ADEM?
Izimpawu ze-ADEM zingahluka kakhulu, kuye ngokuthi iyiphi ingxenye yesimiso sezinzwa ethintekile. Kodwa-ke, zivame ukuvela cishe isonto noma amabili ngemva kokuphela kokutheleleka ngegciwane noma kwebhaktheriya (njengomkhuhlane, isimungumungwane, noma i-chickenpox).
Ukuze kube lula ukuqonda, ake sihlukanise lezi zici zibe izingxenye ezimbili.
| Uhlobo lwesibonakaliso | Izimpawu ezingaba khona |
|---|---|
| Izici ezijwayelekile |
|
| Izici ezihlobene nesimiso sezinzwa |
|
Ubukhali balezi zimpawu bungahluka kuye ngomuntu nomuntu. Kwabanye, zingase zibe mnene futhi ziphele zodwa, kanti kwabanye, zingase zibe zimbi ngokwanele ukuthi zidinge ukulaliswa esibhedlela.
Kungani kwenzeka into efana nale?
Imbangela eqondile ye-ADEM ayaziwa ngokuphelele, kodwa odokotela nososayensi bakholelwa ukuthi ibangelwa ukungasebenzi kahle kwesimiso sethu somzimba sokuzivikela .
Masiqonde lokhu ngale ndlela. Amasosha ethu omzimba afana nebutho lezwe lethu. Umsebenzi waleli butho ukubona nokuhlasela izitha ezifana namagciwane namagciwane avela ngaphandle, nokusivikela ezifweni. Kodwa okwenzekayo ku-ADEM ukuthi leli butho lenza iphutha elincane. Ngemva kokuqeda ukulwa nesitha esingene ezweni (isibonelo, igciwane lomkhuhlane), liqala ukuhlasela i-myelin sheath ohlelweni lwethu lwezinzwa, licabanga ukuthi yisitha. Kufana nokuhlasela isisekelo sezempi ezweni lakini, ucabanga ukuthi yibutho lesitha. Lokhu kubizwa ngokuthi 'ukusabela okuzenzakalelayo' . Lokhu kuhlasela kubangela ukuvuvukala nokuvuvukala ohlelweni lwezinzwa.
Phakathi kuka-70% no-80% weziguli ze-ADEM zinesifo ngaphambi kokuba kuvele izimpawu. Izifo ezivame kakhulu ezandulela i-ADEM yilezi:
- Umkhuhlane (Umkhuhlane)
- Isimungumungwane
- Ama-mumps
- I-Rubella
- Inqubulunjwana
- Igciwane le-Epstein-Barr
Okunye okutholakele muva nje ukuthi ezinye izingane zingase zibe ne-ADEM.Kungenzeka futhi ukuthi isimo esibizwa ngokuthi i-MOGAD (i-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease) singaba yimbangela. Lesi esinye isimo esithile esihlobene nesistimu yomzimba.
I-ADEM ihlolwa kanjani?
Udokotela wakho uzoqala ngokukubuza umbuzo onemininingwane mayelana nezimpawu zakho bese enza ukuhlolwa kwezinzwa. Ngemuva kwalokho uzokwenza izivivinyo eziningana ukuqinisekisa ukutholakala kwe-ADEM futhi akhiphe ezinye izimo ezingase zibangele izimpawu ezifanayo.
Ukuhlolwa okuyinhloko okwenziwe yile:
1. Ukuskena kwe-MRI (Ukufanekisa Ukuzwakala Kwe-Magnetic)
I-MRI ukuhlolwa okusebenzisa amandla kazibuthe anamandla kanye namagagasi omsakazo ukuthatha izithombe ezinemininingwane eminingi zobuchopho bethu kanye nomgogodla. Ayisebenzisi ama-X-ray. Esikeni se-MRI somuntu one-ADEM, izindawo zomonakalo ku-myelin sheath (izilonda) zingabonakala ngokucacile njengamabala amhlophe. Udokotela uzobheka indawo kanye nohlobo lwala mabala ukuze anqume ukuthi ngabe yi-ADEM.
2. Ukubhoboza Umgogodla / Ukubhoboza I-Lumbar
Leli gama lingase lesabise abanye abantu, kodwa luwukuhlolwa okucophelela kakhulu okuzokwenziwa udokotela wakho. Kuhilela ukukujika ngohlangothi bese ufaka inalithi encane emhlane wakho ongezansi ukuze uthathe isampula encane yoketshezi oluzungeze ubuchopho bakho nomgogodla , olubizwa ngokuthi uketshezi lwe-cerebrospinal (CSF) . Abantu abane-ADEM banenani elikhulu lamaseli omzimba, ikakhulukazi amaseli amhlophe egazi. Lokhu kungaba usizo kakhulu ekuqinisekiseni lesi sifo.
Ngaphezu kwalokho, kwenziwa nokuhlolwa kwegazi.
Yiziphi izindlela zokwelapha i-ADEM?
Umgomo oyinhloko wokwelapha i-ADEM ukunciphisa ngokushesha ukuvuvukala ebuchosheni nasemgogodleni nokuvimba amasosha omzimba ukuba angasebenzi kahle. Udokotela wakho angase asebenzise izindlela zokwelapha eziningana ukuze afeze lokhu.
| Indlela yokwelapha | Incazelo elula |
|---|---|
| Imithi ye-steroid | Lokhu ukwelashwa okuyinhloko okunikezwa kuqala. Imithamo ephezulu yemithi ye-steroid inikezwa ngemithambo izinsuku eziningana. Lokhu kucindezela amasosha omzimba futhi kunciphisa ukuvuvukala ngokushesha. Ngemva kokumiswa kokwelashwa ngemithambo, ungase ucelwe ukuthi uthathe amaphilisi omlomo isikhashana. |
| I-IVIG (I-Intravenous Immune Globulin) | Lokhu kwelashwa kunikezwa abantu abangasabeli kahle kuma-steroid. Kuhilela ukunikeza umzimba ama-antibodies athathwe egazini lezinkulungwane zabantu abaphilile ngomthambo. Lokhu kusiza futhi ukulawula amasosha ethu omzimba, angasebenzi kahle. |
| Ukushintshaniswa kwePlasma / iPlasmapheresis | Lokhu ukwelashwa okuyinkimbinkimbi kancane. Kwenzelwa abantu abanezimpawu ezinzima kuphela. Lapha, igazi lesiguli lidluliswa ngomshini, bese i-plasma yegazi (ingxenye ewuketshezi) ihlukaniswa futhi isuswe. Ngoba ama-antibodies angalungile akule plasma. Ngemuva kwalokho amaseli egazi aphinde afakwe emzimbeni nge-plasma ehlanzekile. Lokhu kungavimba amasosha omzimba ekuhlaseleni. |
Kuzothatha isikhathi esingakanani ukululama? Uyini umbono?
Lona ngumbuzo omkhulu engqondweni yawo wonke umuntu. Izindaba ezinhle kakhulu nge-ADEM ukuthi iningi labantu abatholakale benalesi sifo bayalulama ngokuphelele noma cishe ngokuphelele .
Iningi labantu liqala ukuzizwa lingcono ezinsukwini ezimbalwa zokuqala ukwelashwa. Kodwa-ke, kuye ngokuthi izimpawu zinzima kangakanani, kungathatha izinyanga eziningana, ngezinye izikhathi kuze kube yizinyanga eziyisithupha, ukuze kuphole ngokuphelele. Akuvamile kakhulu, abanye abantu bangase baqhubeke nokuba nezinkinga ezincane zokubona noma ukuba ndikindiki.
Akuvamile kakhulu, futhi kuphela uma ukuvuvukala kukhulu kakhulu, lapho kusongela khona impilo. Ngakho-ke, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha nje lapho kuvela izimpawu.
Kufanele ubonane nini nodokotela?
Uma wena noma othile emndenini wakho, ikakhulukazi ingane, eba nezimpawu esixoxe ngazo ngemva kokululama ekuthelelekeni okufana nomkhuhlane noma umkhuhlane, xhumana nodokotela ngokushesha ngaphandle kokulibala.
- Ukulahlekelwa ingqondo ngokuzumayo
- Ukungakwazi ukuhamba noma ukukhubeka
- Ukufiphala noma ukulahlekelwa umbono
- Ubunzima bokukhuluma
- Ukuquleka ngaphandle kwesizathu
Uma unalezi zimpawu, ungahlali nje ekhaya ucabange ukuthi kuyinto evamile. Into engcono kakhulu ongayenza ukuya esibhedlela, ikakhulukazi i-Emergency Treatment Unit (ETU), ngokushesha okukhulu. Ngoba kulezi zinhlobo zezifo, uma ukwelashwa kuqalwa ngokushesha, amathuba okululama ayanda.
Umlayezo Wokuya Nawe Ekhaya
- I-ADEM ukuvuvukala okungazelelwe kwesimiso sezinzwa okuvame ukwenzeka ngemva kokutheleleka ngegciwane noma ngebhaktheriya.
- Lokhu kubangelwa ukuthi amasosha ethu omzimba ahlasela ngephutha i-myelin sheath evikelayo yezinzwa.
- Lokhu kubonakala kakhulu ezinganeni nakubantu abasha.
- Uma uhlangabezana nezimpawu ezifana nokulahlekelwa yingqondo ngokuzumayo, ukulahlekelwa umbono, noma ubunzima bokuhamba, ungazinaki. Bonana nodokotela ngokushesha.
- Lesi sifo singahlolwa ngokunembile nge-MRI kanye nokuhlolwa koketshezi lomgogodla.
- Uma ukwelashwa (njenge-steroids) kuqalwa kusenesikhathi, abantu abaningi abathola i-ADEM bazolulama cishe ngokuphelele.
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