Ingabe uhlangothi olulodwa lomzimba wakho luyindilinga kanti olunye uhlangothi luyindilinga? Ingabe kungaba yi-Brown-Séquard Syndrome?

Wake wezwa ngesimo esingajwayelekile lapho ungakwazi ukuhambisa uhlangothi olulodwa lomzimba wakho futhi ungezwa lutho kolunye? Kungenzeka ngemva kwengozi. Kuyesabeka kancane, kodwa namuhla sizokhuluma ngesimo esingase senzeke ngesikhathi esifanele, kodwa esingavamile kakhulu, esibizwa ngokuthi i-Brown-Séquard Syndrome . Ungakhathazeki, ake sixoxe ngaso kalula.

Iyini i-Brown-Séquard Syndrome, lesi sifo esibizwa ngegama elingavamile?

Kalula nje, i-Brown-Séquard syndrome (BSS) iyisimo semizwa esingavamile kakhulu. Senzeka uma kukhona umonakalo emgogodleni wakho, kodwa umonakalo ukhawulelwe ohlangothini olulodwa lomgogodla. Cabanga ngakho njengomgogodla wakho, ofana nekhebula elithwala imiyalezo evela ebuchosheni bakho kuwo wonke umzimba wakho bese lidlulisela ulwazi oluvela emzimbeni wakho lubuyela ebuchosheni bakho. Ngakho-ke le nkinga yenzeka kuphela uma kukhona umonakalo ohlangothini olulodwa lwale khebula.

Okwenzekayo ukuthi ohlangothini olufanayo lomgogodla owonakele, kukhona ubuthakathaka noma ukukhubazeka kwemisipha engaphansi kwezinga lomonakalo. Lokhu kusho ukuthi awukwazi ukuhambisa lolo hlangothi. Kodwa, ngokumangazayo, umuzwa wobuhlungu kanye nokushisa ulahlekile kolunye uhlangothi , kodwa ngaphansi kwezinga lomonakalo. Kuzwakala kuyinkimbinkimbi kancane, akunjalo? Ake sichaze kabanzi.

Intambo yakho yomgogodla iyisakhiwo esiyisilinda esiqala kusukela esiqwini sobuchopho kuze kufike phansi komgogodla wakho. Ithambile kakhulu. Yakhiwe ngemicu eminingi yemizwa. Iyingxenye enkulu yesimiso sethu sezinzwa.

I-Brown-Séquard syndrome ibhekwa njengokulimala komgogodla okungaphelele (SCI) . Lokhu kusho ukuthi kukhona ukulahlekelwa okuthile kokuzwa, ukusebenza kwemisipha, noma kokubili ngaphansi kwendawo yokulimala. Ku-SCI ephelele, akukho ukuzwa noma ukunyakaza ngaphansi kwendawo yokulimala.

Iqanjwe ngegama lososayensi uCharles-Edouard Brown-Sequard, owaqala ukuchaza lesi simo ngo-1849.

Lokhu kuhluke kanjani ku-Central Cord Syndrome?

Kungenzeka ukuthi uke wezwa nge- Central Cord Syndrome (CCS) . Nakuba kokubili kungamanxeba angaphelele omgogodla, kuyizifo ezimbili ezihlukene.

I-CCS iwukulimala okungaphelele phakathi komgogodla, ngokuvamile entanyeni. Lokhu kubangela ubuthakathaka ezingalweni ngaphezu kwemilenze.

Kodwa-ke, ku- BSS , ukulimala kwanoma iyiphi ingxenye yomgogodla ohlangothini olulodwa kubangela ukukhubazeka ohlangothini oluthintekile, kanti olunye uhlangothi lulahlekelwa umuzwa. Uyawuqonda umehluko?

Ubani ongaba nalesi simo? Sivame kangakanani?

I-Brown-Séquard syndrome ingathinta noma ubani. Kodwa-ke, iyisimo esingavamile kakhulu.Lokhu kungenzeka kungakhathaliseki ubulili.

E-United States kuphela, kubikwa amacala amasha angaba ngu-12,000 okulimala komgogodla minyaka yonke. Kulawa, i-BSS ibalwa kuphela phakathi kuka-2% no-4%. Lokhu kusho ukuthi eSri Lanka, izinga lingase libe phansi nakakhulu.

Ziyini izimpawu ze-Brown-Séquard syndrome (BSS)?

Izimpawu ze-BSS zivame ukuqala ngemva kokulimala kolunye uhlangothi lomgogodla.

Izimpawu zokuqala ezibonakala yilezi:

• Ukungakwazi ukuhambisa isitho esingaphansi kokulimala (ukulahlekelwa ukunyakaza kwemisipha) ohlangothini olufanayo lokulimala komgogodla. Lokhu kungaqala njengobuthakathaka bese kuqhubekela ekukhubazekeni.
• Ngakolunye uhlangothi, kukhona ukulahlekelwa ubuhlungu kanye nomuzwa wokushisa ngaphansi kwezinga lokulimala.

Cabanga ngale ndlela. Uma umuntu ene-BSS, okuwukulimala komgogodla ohlangothini lwesokudla lomgogodla wakhe, ngeke akwazi ukuhambisa uhlangothi lwakhe lwesokudla, okungukuthi, kusukela maphakathi nomgogodla wakhe phansi - isinqe sakhe sokunene, umlenze, nonyawo. Kodwa-ke, ohlangothini lwesobunxele, kusukela maphakathi nomgogodla wakhe phansi, uzolahlekelwa ubuhlungu futhi azizwe ukushisa/ukubanda, kodwa uzokwazi ukuhambisa uhlangothi lwakhe lwesobunxele. Ikhanda, intamo, amahlombe, nezingalo kuzosebenza ngendlela evamile, kungathinteki lokhu kulimala.

Ngaphezu kwalokho, i-BSS ingabangela izimpawu ezifana nalezi:

• Ukungakwazi ukulawula umchamo kanye nendle (ukungakwazi ukuzibamba ngenxa yokuchama kanye nendle).
• Ubuthakathaka bemisipha kanye nokuphelelwa amandla (ukuwohloka kwemisipha) endaweni ethintekile.

Izimpawu ze-BSS zingaba mnene kakhulu kwabanye abantu, futhi zibe nzima kakhulu kwabanye. Kodwa-ke, ngokwelashwa okufanele, lezi zimpawu ziyathuthuka kancane kancane .

Ingabe lokhu kuyalimaza?

Uma imbangela ye-BSS kuyisenzakalo esibuhlungu njengenxeba lokudutshulwa noma ingozi yemoto, khona-ke ingozi izobangela ubuhlungu nakanjani. Kodwa-ke, ngenxa yesifo ngokwaso, okungukuthi, umonakalo emgogodleni, kungase kungabi khona ubuhlungu.

Kodwa-ke, abanye abantu abane-BSS bangase babe nemizwa engavamile (i-dysesthesia) ngenxa yokulimala komgogodla, okungaba umuzwa wokusha, wokuhlaba, noma wokuhlaba.

Yiziphi izimbangela eziyinhloko ze-Brown-Séquard syndrome (BSS)?

Izimbangela ezivame kakhulu ze-BSS ukulimala komgogodla:

• Ukudubula ngezibhamu.
• Ukugwaza.
• Izingozi zezimoto.
• Ukulimala okungaqondakali.
• Ukuphuka komgogodla ngenxa yengozi efana nokuwa.

Uma unengozi efana nale, kubaluleke kakhulu ukuya esibhedlela esiseduze ngokushesha ngangokunokwenzeka futhi uthole usizo lwezokwelapha ngokushesha.

Ngaphezu kwalokhu, i-BSS ingenzeka futhi ngenxa yezimbangela ezingezona ezengozi, kodwa azivamile kangako:

• I-spondylosis yomlomo wesibeletho.
• Isifo sokucindezeleka yisimo esenzeka ngemva kokuchayeka ekucindezelekeni okukhulu ngaphansi kwamanzi.
• Idiski eshelele emgogodleni (idiski ene-herniated).
• Izifo ezifana ne-meningitis.
• I-Multiple Sclerosis (MS).
• Ukuchayeka emisebeni.
• Ukuvaleka komthambo wegazi ohlinzeka ngomgogodla (i-spinal ischemia).
• Izimila zomgogodla.
• I-myelitis eguquguqukayo.
• Isifo sofuba.

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Uma udokotela wakho esola ukuthi une-BSS, uzokwenza okulandelayo:

• Uhlola umzimba ngokuphelele.
• Kwenziwa ukuhlolwa kwezinzwa okuhlolisisa ukunyakaza kanye nokuzwa ngokuningiliziwe.
• Bazokubuza ngomlando wakho wezokwelapha, izinkinga zezinzwa, kanye nanoma yiziphi izingozi oke waba nazo.

Ngemuva kwalokho, bazo-oda izivivinyo eziningana, njenge- MRI scan , ukuqinisekisa ukuxilongwa kanye nokuhlola ezinye izimbangela.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Uma kusolwa ukuthi i-BSS ibangelwa yi-BSS, udokotela wakho angase acele ukuhlolwa okufana nalokhu:

• I-MRI scan (Magnetic Resonance Imaging): Lokhu kuhlolwa okungenabuhlungu. Kusebenzisa i-magnet enkulu, amaza omsakazo, kanye nekhompyutha ukwenza izithombe ezicacile zezitho nezakhiwo ngaphakathi komzimba. I-MRI iwusizo kakhulu kwi-BSS ngoba ingasiza ekuboneni umonakalo wesakhiwo emgogodleni futhi isize ekutholeni imbangela ye-BSS eyenzeka ngaphandle kwengozi.
• I-Myelogram kanye ne-CT scan (i-Computed Tomography): Uma ungakwazi ukwenza i-MRI, udokotela wakho angase akucele i-myelogram bese kuba yi-CT scan yomgogodla wakho. Lokhu kuhlolwa kungabheka umonakalo ezicutshini zezinzwa ohlangothini olulodwa lomgogodla wakho. I-myelogram ukuhlolwa kwesithombe okuhlola ukuxhumana phakathi komgogodla wakho, ama-disc, umgogodla, imizwa kanye nezimpande zezinzwa. I-CT scan isebenzisa ama-X-ray namakhompyutha ukwenza izithombe ezinemininingwane zangaphakathi lomzimba wakho.
• Ukuhlolwa kwegazi: Uma imbangela ye-BSS ingacaci, udokotela wakho angase acele ukuhlolwa kwegazi okuningana ukuze ahlole izifo ezingase zibangele lesi simo.
• Ukubhoboza i-Lumbar / Ukumpompa komgogodla: Uma kusolwa ukuthi i-multiple sclerosis (MS) , i-transverse myelitis, noma isifo sofuba kuyimbangela ye-BSS, udokotela wakho angase enze ukubhoboza i-lumbar ukuze athathe isampula yoketshezi lwe-cerebrospinal (CSF) . I-CSF uketshezi olucacile oluzungeze umgogodla wakho kanye nobuchopho.

Yiziphi izindlela zokwelapha i-Brown-Séquard syndrome (BSS)?

Ukwelashwa kwe-BSS kuncike embangela eyinhloko yokulimala komgogodla.

Ngokuvamile, imigomo yokwelashwa kwe-BSS yile:

• Ukulondoloza noma ukuthuthukisa ukusebenza kwemisipha kanye nezinzwa.
• Ukuvimbela umonakalo wesibili.
• Ukunciphisa izinkinga.

Umuntu one-BSS ngenxa yokulimala kwesibhamu esibukhali, njengenxeba lokugwazwa ngommese, kuzodingeka elashwe ngenxa yokopha kanye nokulimala kwezicubu. Ngaphezu kwalokho, abantu abanezinye izingozi ngenxa yengozi ebangele i-BSS bazodinga ukwelashwa okwengeziwe nangalezo zingozi.

Kunezigaba ezimbili eziyinhloko zokwelashwa kwe-BSS: ukwelashwa kokuqala kanye nokuvuselelwa .

Ukwelashwa Kokuqala

Ukwelashwa kokuqala kwe-BSS kungafaka:

• Ukuhlinzwa: Ezimweni lapho i-BSS yenzeka ngaphandle kwengozi, ngokuvamile kubangwa ukucindezelwa komshini noma ukuqhekeka komgogodla. Ukuhlinzwa kuyadingeka ukuze kuncishiswe lokhu kucindezelwa.
• Imithi yokuvimbela ukujiya kwegazi: Abantu abanokulimala komgogodla basengozini enkulu yokuthola amahlule egazi emithanjeni (i-Venous Thromboembolism - VTE) . Lokhu kufaka phakathi izinto ezifana ne -deep vein thrombosis (DVT) kanye ne-pulmonary embolism . Udokotela wakho angakunika imithi ebizwa ngokuthi ama-anticoagulants , njenge-heparin noma i-warfarin, ukuvimbela amahlule egazi.
• Ukuvikela isikhumba (ukuvimbela izilonda zokulala embhedeni): Ukuze uvimbele ukulimala kwengcindezi/izilonda zokulala embhedeni, ithimba lakho lezokwelapha lizokusiza ukuthi ujike futhi ushintshe izikhundla okungenani njalo emahoreni amabili. Bazokusiza ukugcina isikhumba sakho sihlanzekile futhi somile, futhi bafake i-moisturizer esikhumbeni esomile.
• I-Gastrostomy tube (i-G-tube): Ukuze unciphise ingozi yokuvuvuka kwesisu ngenxa ye -paralytic ileus, udokotela wakho angase afake i-G-tube esiswini sakho. I-G-tube iyipayipi elihambisa ukudla okunomsoco ngqo kusuka esiswini kuya esiswini. I-Paralytic ileus ukulahlekelwa okwesikhashana kokufinyela kwemisipha okuhambisa ukudla emathunjini. Lokhu kuvamile ekulimaleni komgogodla.
• Ukusekelwa kokuphefumula: Uma unenkinga yokuphefumula ngenxa yokulimala komgogodla wakho, kungadingeka ukuthi uxhunywe kumshini wokuphefumula . Lona umshini okusiza ukuphefumula, noma ophefumula wena.
• Ukuphathwa kwesinye okubangelwa yizinzwa: Abantu abanokulimala komgogodla, okuhlanganisa ne-BSS, bangase balahlekelwe ukulawula isinye. Uma lokhu kwenzeka, kungadingeka i-catheter yomchamo kanye nezinye izindlela zokwelapha ezihlobene nesistimu yomchamo.
• Ukwelashwa kwe-Autonomic dysreflexia: Abantu abalimele emgogodleni bangase babe nezinguquko ezinkulu ekucindezelweni kwegazi nakwezinye izimpawu. Lokhu kufanele kwelashwa ngokucophelela ngemithi elawula ukucindezeleka kwegazi kanye nokushaya kwenhliziyo.
• Izingubo zokugqoka ezilawula izinga lokushisa: Abantu abane-BSS bavame ukuba nobunzima bokulawula izinga lokushisa lomzimba wabo. Ithimba lezokwelapha linganikeza izingubo zokugqoka ezilawula izinga lokushisa ukuze lisize ngalokhu.

Ukuvuselelwa

Ngemva kokwelashwa kokuqala kwe-BSS, ukuvuselelwa, njengokwelashwa ngokomzimba kanye nokwelashwa ngokomsebenzi , kufanele kuqale ngokushesha ngangokunokwenzeka ukuze kuthuthukiswe futhi/noma kubuyiselwe ukunyakaza.

Imigomo yokwelapha ngokomzimba:

• Ukugcina amandla emisipha nokusebenza kahle kwemizwa.
• Ukugcina ububanzi bokunyakaza emalungeni.
• Vimbela ukuwohloka kwesikhumba ngokuma kahle kanye nokushintsha isisindo.
• Ukuthuthukisa ukuhamba .

Ukwelashwa ngokomzimba kuhilela ukuzivocavoca kanye nokwelashwa okukusiza ukunciphisa ubuhlungu futhi kukubuyisele ekusebenzeni okuvamile kanye nokuhamba. Udokotela wakho wezokwelapha ngokomzimba uzosebenza nawe ukuthuthukisa ukuhamba kwakho. Bangase bakunikeze amadivayisi okukusiza ukwenza imisebenzi yansuku zonke, njengezinsimbi zokubopha, izinti zezandla, izisekeli zemilenze, noma isihlalo sabakhubazekile.

Ukwelashwa ngokomsebenzi kuhilela ukwelashwa nokuzivocavoca okukusiza ukuthi uthole ukuzimela kuzo zonke izici zokuphila kwakho ngemva kwenkinga yomzimba noma yezinzwa. Uma uthola ukwelashwa ngokomsebenzi kwe-BSS, uzofunda izindlela ezintsha zokwenza imisebenzi yansuku zonke, njengokuzihlanza, ukudla, nokugqoka, ngamadivayisi okusiza noma ngaphandle kwawo.

Ingabe lokhu kungavinjelwa ukuthi kwenzeke?

Indlela kuphela yokuvimbela i-Brown-Séquard syndrome ukulandela izinyathelo zokuphepha ezijwayelekile ukuze ugweme ukulimaza umgogodla wakho. Isibonelo, qaphela lapho ushayela futhi uhamba emgwaqweni.

Yimaphi amathuba okululama kulesi simo? (Isibikezelo)

Umbono wokululama ku-BSS uncike ezintweni eziningana, okuhlanganisa imbangela yokulimala komgogodla kanye nobukhulu bomonakalo.

Kodwa-ke, ngokuvamile, izinga lokululama kusuka ku-BSS lihle kakhulu . Abantu abane-BSS banethuba elihle lokuthola eminye yemisebenzi yabo, okuhlanganisa nokuhamba. Kodwa-ke, ukululama kuyinqubo ehamba kancane . Ukululama kuhamba kancane, kuthatha izinyanga ezintathu kuya kweziyisithupha kusukela ekuqaleni kwesifo, futhi kungathatha iminyaka emibili ukuthi imizwa ilulame ngokugcwele.

Yiziphi izinkinga ezingaba khona uma zingelashwa?

Uma i-Brown-Séquard syndrome ingelashwa, izinkinga ezifana nalezi:

• Ukuvuvukala kwesisu.
• Ukucindezeleka.
• Umfutho wegazi ophansi (i-Hypotension).
• I-embolism yamaphaphu.
• Izifo - ikakhulukazi emaphashini nasemgudwini womchamo.
• Ukukhubazeka okungapheli.

Yiziphi izikhathi ezinhle kakhulu zokuya kudokotela?

Uma ngokuzumayo uzwa ubuthakathaka bemisipha noma ukukhubazeka komzimba kanye/noma ulahlekelwa umuzwa ohlangothini olulodwa lomzimba wakho, iya ekamelweni lezimo eziphuthumayo eliseduze ngokushesha okukhulu .

Uma utholakale une-Brown-Séquard syndrome, kufanele ubonane nethimba lakho lezokwelapha njalo ukuqinisekisa ukuthi ukulimala komgogodla wakho kuphulukiswa kahle. Qiniseka ukuthi ugcina ama-aphoyintimenti akho okwelashwa ngokomzimba kanye nokwelashwa ngokomsebenzi ukuze kukusize ululame kahle futhi ngokushesha ngangokunokwenzeka.

Into ebaluleke kakhulu okufanele uyikhumbule (Umyalezo Wokuya Ekhaya)

I-Brown-Séquard syndrome ingaba yinto eyesabekayo ukuyizwa. Kodwa izindaba ezinhle ukuthi abantu abaningi abanalesi simo bayalulama noma bathuthukise amakhono abo okunyakaza kanye nokuzwa ngemva kwezinyanga ezimbalwa zokululama. Khumbula, ithimba lakho lezokwelapha lizohlala likhona ukukusiza ukuthi ubuyele endleleni efanele. Ngakho-ke hlala uqinile futhi ulandele iseluleko esinikeziwe.

I- Brown-Séquard Syndrome, umgogodla, umgogodla, imizwa, ukukhubazeka, ukulahlekelwa umuzwa, umonakalo womgogodla