Ingabe ingane yakho encane iqala ukudikiza ngokuzumayo? Ingabe yilokhu esikushoyo uma sikhuluma nge-Infantile Spasms? Ake sithole!

Wake wambona umntwana wakho eqhaqhazela futhi eqina ngokuzumayo? Lokhu kungenzeka izikhathi eziningana ngosuku. Ungase uzibuze ukuthi lokhu kuyinto evamile noma ngabe kuyisimo esithile esithinta izingane. Yilokho esizokhuluma ngakho namuhla. Lesi simo sibizwa ngokuthi `(Infantile Spasms)`. Ake sibone ukuthi siyini, kungani senzeka, yiziphi izimpawu, ukuthi singasithola kanjani, nokuthi yiziphi izindlela zokwelapha.

Kuyini lokhu (Ukuqaqamba Kwabantwana)?

Kalula nje, `(Infantile Spasms)` uhlobo lwesifo sokuwa oluvela ezinganeni ezingaphansi konyaka owodwa ubudala, okungukuthi, ezingaphansi kwezinyanga ezingu-12 ubudala . Isifo sokuwa yisimo (`izinkinga zemizwa`) esibangelwa inkinga engajwayelekile ngomsebenzi kagesi wobuchopho bomntwana wakho. Lapho kwenzeka lokhu `(Infantile Spasms)`, umzimba womntwana, ikakhulukazi isisu, ikhanda, intamo, izingalo, nemilenze, ngokuzumayo uqina futhi ubonakale sengathi uyagxumagxuma.

Lokhu kufinyela kuthatha isikhathi esifushane kakhulu, cishe umzuzwana owodwa noma emibili . Kodwa kungenzeka ngokulandelana, okusho ukuthi ukufinyela okukodwa kuza bese kuba okunye ngemva kwemizuzwana emi-5 noma eyi-10, noma 'ngeqembu'. Cabanga ngengane ikhahlela izikhathi eziningana zilandelana. Esikhathini esiningi, lokhu kufinyela kuza ngemva kokuba izingane zivuke ebuthongweni .

Into edabukisayo ukuthi, izingane eziningi ezihlushwa yilesi simo zingase zibe nokubambezeleka kokukhula, noma zingase zikhule kamuva. Okusho ukuthi, ingane yephuza ukwenza izinto ezifanele iminyaka yayo.

Uyini umehluko phakathi kwe-(Infantile Spasms) kanye ne-(West Syndrome)?

Manje ungase uzibuze ukuthi iyini le "West Syndrome". Ngezinye izikhathi odokotela bayibiza kanjalo. I-"West Syndrome" iqoqo lezimpawu eziningana. Lokho:

• Sinalokhu "Ukuqina Kwezintsana" esikhuluma ngakho.
• Kukhona iphethini engajwayelekile esimweni segagasi likagesi lobuchopho elibizwa ngokuthi `(Hypsarrhythmia)`. (Lokhu kutholakala ngokuhlolwa kwe-`(EEG)`, sizoxoxa ngakho kamuva).
• Kukhona ukubambezeleka kokuthuthukiswa noma ukulahlekelwa amakhono akhona ngaphambilini (`ukuhlehla kokuthuthukiswa`).

Kodwa-ke, akuwona wonke umntwana one-`(Infantile Spasms)` one-`(West Syndrome). Okusho ukuthi, kungenzeka ukuba ne-`(Infantile Spasms)` ngaphandle kokubambezeleka kokukhula.

Uyini umehluko phakathi kokuqina kwemisipha kanye nokuxhuzula?

Yebo, lo mbuzo ubalulekile. `(I-Infantile Spasms)` empeleni uhlobo lokuxhuzula. ``Ukuxhuzula`` kuwumsebenzi kagesi ongalawuleki ovele ngokungazelelwe phakathi kwamangqamuzana obuchopho. Lokhu kungabangela ukuqina kwemisipha okwesikhashana, izinguquko ekunyakazeni, ekuziphatheni, kanye nezinguquko ezingavamile emizweni. Akuzona zonke izixhuzula ezifanayo.

Uma kuqhathaniswa ne-tonic-clonic noma i-grand mal seizures esivame ukucabanga ngayo uma sicabanga nge-seizures, lezi spasms zezingane zimfushane kakhulu. I-spasms zezingane zihlala cishe umzuzwana owodwa noma emibili, kodwa ziza ngamaqoqo. Ezinye izinhlobo ze-seizures zingahlala noma kuphi kusukela kumasekhondi angu-30 kuya cishe emizuzwini emibili.

Uyini umehluko phakathi kwe-Infantile Spasms kanye ne-Startle Reflex?

Lokhu futhi kuyinto edida abazali abaningi, ngoba indlela "Izinhlungu Zezinsana" ezibonakala ngayo ingase ifane nendlela izingane ezivame ukunyakazisa ngayo.

Izingane zivame ukwethuka (okubizwa nangokuthi i-Moro reflex) lapho zizwa umsindo omkhulu noma lapho zishukunyiswa ngokuzumayo. Ingane ibe isiphonsa ikhanda layo emuva, yelula izingalo nemilenze yayo kabanzi, bese iphendulela ikhanda layo phezulu. Ngezinye izikhathi zingase zikhale, bese zibuyisela izingalo nemilenze yazo emzimbeni wazo.

Kodwa ku-`(Infantile Spasms)` ayikho imbangela enjalo yangaphandle . Okusho ukuthi, ukuqaqamba akwenzeki ngenxa yomsindo noma okunye. Okunye ukuthi `(Infantile Spasms)` kuza ngamaqoqo . Okusho ukuthi, kuza okunye, bese kuba okunye, bese kuba okunye. Ukuqaqamba okuvamile akuhlali isikhathi eside kangako. Futhi, lapho kuvela ukuqaqamba, amehlo engane angase aphenduke, noma kubonakale sengathi ibubula ubuso . Lokhu akuvamile kakhulu ekuqaqambeni okuvamile.

Ubuhlungu bokuqaqamba kwabantwana buqala nini?

Ngokusho kodokotela, ama-90% e-`(Infantile Spasms)` atholakala ezinganeni ezingaphansi kwezinyanga ezingu-12, okungukuthi, ezinganeni ezingaphansi konyaka owodwa ubudala. Kuvame kakhulu phakathi kweminyaka emine neyisikhombisa . Kodwa-ke, ngezinye izikhathi izingane ezingaphezu kwezinyanga ezingu-12 zingaba nalolu hlobo lwe-spasm. Kuleso simo, luhlukaniswa ngokuthi `(Epileptic Spasms)`.

Sivame kangakanani lesi simo?

Lesi akusona isimo esivamile kakhulu, kodwa futhi asiyona into engekho. Kulinganiselwa ukuthi cishe ingane eyodwa kwezingu-2,000 kuya kwezingu-4,000 ingathinteka yilesi simo (i-Infantile Spasms).

Ziyini izimpawu ze-Infantile Spasms?

Uma kufika lokhu kufinyela, umzimba wengane yakho uyaqina ngokuzumayo, noma uqhumuke. Kuthatha imizuzwana embalwa kuphela. Ingane ingase igobe umhlane wayo, igobe izingalo zayo, imilenze, bese iqonda phambili. Njengoba sishilo ngaphambili, lokhu kufinyela kuza ngamaqoqo, ngokulandelana, ngokuphumula kwemizuzwana emi-5-10.

Ngemva kokukhahlela noma ukukhahlela okumbalwa, umntwana angase athukuthele futhi akhale. Kodwa lokho akwenzeki njalo.

Ngezinye izikhathi lezi `(Izinhlungu Zokuqaqamba Kwabantwana)` zivela ngendlela ecashile kakhulu . Singase singaziboni kalula. Izimpawu ezinjalo ezicashile yilezi:

• Ukugingqa amehlo akho.
• Ubuhlungu besisu.
• Ukunyakaza kwesilevu.
• Ukuhlikihla.
• Ikhanda livuma ngekhanda.

Uma ukuzamazama kubangelwa ukungajwayelekile ebuchosheni bomntwana, kungase kuthinte uhlangothi olulodwa lomzimba kuphela. Noma ikhanda noma amehlo kungase kubonakale sengathi adonseleka ohlangothini olulodwa.

Into ebaluleke kakhulu ukuthi lokhu kukhahlela kwenzeka kaningi ngemva kokuba umntwana evukile ebuthongweni . Kwenzeka kaningi kakhulu ngesikhathi umntwana elele.

Kungakapheli isikhathi eside lokhu kukhahlela kuqalile, uzokwazi ukubona ezinye izinguquko enganeni yakho:

• Izinyathelo zokukhula ezifana nokugingqika, ukuhlala phansi, ukuguqa, kanye nokukhuluma kabi ziyalahleka.
• Ukuxhumana nabantu nabanye kuyancipha, futhi ukuhleka kuyancipha .
• Uvalo njalo, noma uthule njalo.

Uma kungenzeka, qopha ingane yakho ngevidiyo uma inalezi zinhlungu. Ungabe usuyibonisa udokotela wakho wezingane. Kubalulekile ukuqaphela lezi "zinhlungu zosana" kusenesikhathi. Uma ucabanga ukuthi ingane yakho inalezi zinhlungu zosana, bheka udokotela ngokushesha okukhulu.

Kukangaki ukuqaqamba kwengane kwenzeka?

Ingane ingaba nokuxhuzula okungafika ku-100 ngosuku. Kodwa ingane ngayinye ithinteka ngendlela ehlukile. Ngakho-ke, uma ubona ingane yakho ixhuzula, noma ngabe kube kanye noma kabili ngosuku, kungcono ukukhuluma nodokotela ngokushesha okukhulu .

Yiziphi izimbangela ze-Infantile Spasms?

Kunezimbangela eziningi ezingaba khona zokuqaqamba kwezinsana. Ososayensi bathole izimo zempilo ezingaphezu kuka-200 ezingaba imbangela yalokhu. Kodwa-ke, cishe kwengxenye yesithathu yamacala, odokotela abakwazi ukuthola imbangela eqondile.

Lesi sifo sohlangothi singabangelwa ukungajwayelekile engxenyeni encane yobuchopho bomntwana, noma singabangelwa inkinga ebuchosheni bonke.

Ezinye zezizathu eziyinhloko yilezi:

• Ukulimala kobuchopho noma ukutheleleka: Lokhu kushaywa yisifo kungabangelwa yinoma yiluphi uhlobo lokulimala kobuchopho. Izimbangela eziyinhloko `(Hypoxic-ischemic encephalopathy)` (okusho ukuthi ubuchopho abutholi umoya-mpilo noma igazi elanele isikhathi eside), `(Meningitis)` (meningitis), kanye `(Perinatal stroke)` (okusho ukushaywa yisifo okwenzeka phakathi nokukhulelwa komntwana kanye nenyanga yokuqala ngemva kokuzalwa).
• Izinkinga Zokukhula Kobuchopho: Lokhu kungabangelwa yizinto eziningi ezingavamile ohlelweni lwezinzwa oluphakathi (ubuchopho kanye nomgogodla) ezenzeka ngesikhathi umntwana esakhula esibelethweni. Isibonelo, izimo ezifana `(Focal cortical dysplasia)`, `(Lissencephaly)`, `(Holoprosencephaly)` kanye `(Aicardi syndrome)`. Kungabangelwa futhi yimithambo yegazi engajwayelekile ebuchosheni bomntwana (`(Arteriovenous malformations)`).
• Ukuguquka kwezakhi zofuzo: Ososayensi manje sebexhumanisa ukuguquka kwezakhi zofuzo okuningi nokuqina kwezinzwane. Ezinye izibonelo zifaka phakathi i-Trisomy 21 (Down syndrome), i-Tuberous sclerosis, i-Miller-Dieker syndrome, kanye ne-CDKL5 deficiency disorder.
• Izimo ze-Metabolic: Amaphutha okuzalwa e-metabolism (IEM) nawo angabangela lesi simo. Lezi yizimo zezakhi zofuzo ezivimba izindlela ze-metabolism eziphula ukudla esikudlayo futhi zikhiqize amandla. Akuvamile kakhulu, ukuntuleka kwe-vitamin B6 nakho kungabangela lesi simo.

Kuhlonzwa kanjani ukuqaqamba kwezinsana?

Udokotela wengane yakho uzokubuza ngezimpawu zengane yakho kanye nomlando wezokwelapha, futhi uzokwenza nokuhlolwa ngokomzimba.

Ingane yakho ingase idluliselwe kudokotela wezinzwa wezingane noma kudokotela wezithuthwane. Bazokwenza i-electroencephalogram (EEG) ukuqinisekisa ukuthi ingane inezinhlungu zosana. Bangase benze nezinye izivivinyo ukuthola imbangela.

Njengoba kungaba nezimbangela eziningi 'zokuqaqamba kwezinsana', kungaba nzima kancane kodokotela ukuthola imbangela.

Yiziphi izivivinyo zokuxilonga?

Udokotela wenza ikakhulukazi isivivinyo esithi "Electroencephalogram - EEG" ukuqinisekisa ukuthi kukhona yini "I-Infantile Spasms".

I-EEG ilinganisa futhi iqophe izimpawu zikagesi ebuchosheni bomntwana wakho. Uma kwenziwa i-EEG, uchwepheshe ubeka amapuleti amancane ensimbi (ama-electrode) ekhanda lomntwana. Lawa ma-electrode axhunywe emshinini. Umshini unikeza udokotela ulwazi mayelana nomsebenzi wobuchopho bomntwana. Kungcono uma umntwana eba nokuxhuzula ngesikhathi se-EEG futhi isikhathi esiphakathi kokuxhuzula singaqoshwa. Odokotela bafuna iphethini ethile ye-EEG ebizwa ngokuthi i-hypsarrhythmia. Le phethini iqondile kakhulu. Yingakho kuvame ukuba lula ngodokotela ukuxilonga ngokunembile ukuxhuzula kosana.

Udokotela angase acele ukuhlolwa okwengeziwe ukuthola imbangela yalokhu kuthuthumela:

• Ukuskena kobuchopho nge-magnetic resonance imaging (MRI): Ukuskena kwe-MRI kuwukuhlolwa okungenabuhlungu okungenza izithombe ezicacile zezicubu nezakhiwo ebuchosheni bomntwana wakho. I-MRI isebenzisa i-magnet enkulu, amaza omsakazo, kanye nekhompyutha ukudala lezi zithombe ezinemininingwane. Ayisebenzisi ama-X-ray. I-MRI ingasiza udokotela wakho ukuthola ukuthi yini ebangela ukuxhuzula komntwana wakho.
• Ukuhlolwa kwezakhi zofuzo kanye nokusetshenziswa kwezakhi zofuzo: Uma i-MRI yengane yakho ijwayelekile, udokotela wakho uvame ukwenza ezinye izivivinyo, njengokuhlolwa kwezakhi zofuzo kanye nokusetshenziswa kwezakhi zofuzo, ukuze azame ukuthola imbangela yokuquleka. Lezi zivivinyo ngokuvamile zidinga isampula yegazi, umchamo, noma uketshezi lomgogodla.

Iphathwa kanjani i-Infantile Spasms?

Kunemigomo emibili eyinhloko yokwelapha. Eyokuqala iwukumisa noma ukulawula isifo sohlangothi . Eyokuqala iwukwelapha imbangela yalesi sifo sohlangothi , uma kungenzeka.

Izindlela zokwelapha eziyinhloko ezinikezwa ukuqeda noma ukuphatha ukuxhuzula yilezi:

• I-hormone ye-Adrenocorticotropic (ACTH):I-ACTH iyi-hormone ekhiqizwa yi-pituitary gland yakho. Inomthelela omkhulu endleleni umzimba wakho osabela ngayo ekucindezelekeni. Lapho i-ACTH ikhishwa, izindlala ze-adrenal ziyakhuthazwa ukukhiqiza i-cortisol "ye-stress hormone". I-ACTH, esetshenziselwa ukwelapha ukuxhuzula, iyi-hormone yokwenziwa. Inikezwa njengomjovo. Imithamo embalwa yokuqala inikezwa esibhedlela. Udokotela uzobe eseqapha ngokucophelela ingane yakho ukuthola noma yimiphi imiphumela emibi engaba khona. Njengoba imijovo ye-ACTH izoqhubeka cishe amasonto ayisithupha, udokotela wakho uzokufundisa ukuthi ungayinika kanjani ingane yakho umjovo ekhaya.
• I-prednisolone yomlomo: Lo muthi uwuhlobo lokwenziwa lwe-hormone ye-corticosteroid ekhiqizwa yizindlala ze-adrenal. Usebenza kahle ekwelapheni ukuqaqamba kosana. Ungasetshenziswa lapho i-ACTH kunzima ukuyithola.
• I-Vigabatrin (`Vigabatrin - Sabril®`): Lona umuthi wokulwa nokuxhuzula. Unikezwa ngomlomo njengephilisi noma uketshezi.

Uma ingane yakho ingasabeli kulezi zindlela zokwelapha ngamahomoni noma i-Vigabatrin, kunezinye izindlela zokwelapha:

• Ukudla kwe-ketogenic.
• Eminye imithi yokulwa nokuxhuzula.
• Uma imbangela ye-'Infantile Spasms' iyinkinga endaweni eyodwa ebuchosheni ('focalized lesion'), kunconywa ukuhlinzwa kwesifo sokuwa.

Ukuqina kwezinsana ngezinye izikhathi kungaba nzima ukwelapha. Ezinye izingane zingadinga ukuphinda inkambo yokwelashwa noma inkambo yesibili yokwelashwa. Kuyo yonke inqubo yokwelashwa, umsebenzi wobuchopho bomntwana ungadinga ukubhekwa ngokuhlolwa kwe-EEG okuphindaphindiwe ukuze kubonakale ukuthi ukwelashwa kuyasebenza yini.

Uma udokotela engathola imbangela yokuxakeka komntwana, kufanele aphathe leyo nkinga uma kungenzeka. Lokhu kungafaka phakathi ukuhlinzwa noma ukwelashwa okuqondiswe ngqo kwesimo esiyisisekelo sezakhi zofuzo noma se-metabolic.

Ukubambezeleka kokukhula kanye nokubuyela emuva kuvamile nge-Infantile Spasms. Ithimba lezokwelapha lomntwana lizosikisela izindlela zokwelapha ezizosiza ekukhuleni ngangokunokwenzeka.

Iyini imiphumela emibi yokwelashwa kwe-spasms yezingane?

Kunemiphumela eminingana engaba khona yokwelashwa kwe-adrenocorticotropic hormone (ACTH):

• Umfutho wegazi ophezulu (i-Hypertension).
• Ubuthakathaka besimiso somzimba sokuzivikela (`(Immunosuppression)`).
• Ukuvuvukala (ngokuvamile ebusweni).
• Ukungahlaliseki nokucasuka.
• Izilonda zesisu kanye/noma zamathumbu.
• Ukukhishwa kwe-glucose emchameni.

Imiphumela emibi engaba khona yokwelashwa kwe-'Vigabatrin':

• Ukuncishiswa okungenakuguqulwa kwensimu yombono.
• Intukuthelo.

Ngenxa yale miphumela emibi, udokotela wengane yakho uzokhuluma nawe ukuze anqume indlela engcono kakhulu yokwelapha. Bazophinde baqaphe ingane yakho eduze ukuze babone ukuthi le miphumela emibi iyenzeka yini.

Iyini iphrojekthi ye-Infantile Spasms?

Ikusasa lalesi simo, noma 'isibikezelo', lincike ezintweni eziningana:

• Imbangela `(Ukuqaqamba Kwabantwana)`.
• Ingabe imbangela ingelashwa?
• Ukuthi ingane yasheshe yatholakala kanjani nokuthi yaqala kanjani ukwelashwa.
• Ukuthi ingane isifinyelele yini izigaba zokukhula ngaphambi kokuba kuqale ukukhahlela.

Cishe ama-50% ezingane ezinezinhlungu zobuntwana zingase zibe nezinkinga zesikhathi eside zokukhula kanye nezezinzwa. Ngisho noma izinhlungu zingaphela, izingane eziningi zingase zibe nezinye izinhlobo zokuxhuzula kanye nesifo sokuwa.

Kodwa-ke, uma kutholakala ukuthi isifo sikhona futhi selashwa ngokushesha nangempumelelo, umbono jikelele ungaba muhle . Izingane ezifinyelele izigaba zokukhula ngaphambi kokuqala kokuxhuzula zingakhula ngendlela evamile.

Ngingayinakekela kanjani ingane yami enezinhlungu zosana?

Uma ingane yakho ine-"Infantile Spasms", kufanele ulandele imiyalelo kadokotela ukuze uyisize:

• Nikeza yonke imithi njengoba uyalelwe.
• Bheka ukuhlolwa kokuthuthukiswa kanye nokwelashwa.
• Yiya kuzo zonke izinkambo zokwelashwa ezilandelanayo.

Ukuqaqamba Kwabantwana Abancane kungabangela izinkinga zengqondo, ze-neurologic, kanye/noma zezinzwa. Izingane eziningi ezine-Infantile Spasms zinezinkinga zokukhula futhi zingadinga usizo ngemisebenzi yansuku zonke empilweni yazo yonke.

Ithimba lezokwelapha lomntwana wakho lingaphendula imibuzo yakho futhi likunikeze ukwesekwa. Bangase bakwazi futhi ukukuqondisa emaqenjini okusekela endaweni yakini noma ku-inthanethi.

Kufanele ngimbone nini udokotela wengane yami mayelana nokuqaqamba kwengane?

Uma ingane yakho itholakale ine-Infantile Spasms, kuzodingeka ibone ithimba layo lezokwelapha njalo ukuqinisekisa ukuthi ukwelashwa kuyasebenza. Kuzodingeka futhi ukuthi ihlolwe nge-electroencephalogram (EEG) ukuze iqaphe ukusebenza kobuchopho kulo lonke ukwelashwa.

Uma ucabanga ukuthi ingane yakho ine-Infantile Spasms, kodwa ingakatholakali, kubaluleke kakhulu ukubona udokotela ngokushesha okukhulu .

Kuvamile ukuzizwa ukhathazekile lapho ingane yakho ingaziphathi kahle noma ingahlangabezani nezigaba zokukhula. Uyazi kahle ingane yakho . Uma ucabanga ukuthi ingane yakho inenkinga yokuqaqamba - umuzwa osheshayo, oqinile, onyakazayo, ovame ukuba ngamaqoqo - khuluma nodokotela ngokushesha okukhulu. Uma kungenzeka, thatha ividiyo yenkinga yokuqaqamba. Ungambonisa udokotela. Ukuqashelwa kusenesikhathi kwe-"Infantile Spasms" kungaholela emiphumeleni engcono .

Izinto okufanele sizikhumbule kule ndaba (Umyalezo Ohamba Nawo Ekhaya)

Kulungile, nansi izinto ezimbalwa okufanele uzikhumbule kulokho esikhulume ngakho:

• Ukuqaqamba kwezinsana uhlobo lwesifo sokuwa esibi kakhulu esenzeka ezinganeni ezingaphansi kwezinyanga ezingu-12 ubudala.
• Uma ingane yakho inyakaza futhi iqina ngokuzumayo, ikakhulukazi ngamaqoqo ngemva kokuvuka , ungayithathi kalula .
• Lokhu kuhlukile ekuziphendukeni okujwayelekile kwengane okuthuthumelayo.
• Uma kungenzeka, qopha ngevidiyo ukufinyela kwesisu bese ukukhombisa udokotela .
• Ukuxilongwa kusenesikhathi kanye nokwelashwa kungaba nomthelela omkhulu ekukhuleni kwengane esikhathini esizayo.
• Uma ubona noma yiziphi izinguquko ekuziphatheni kwengane yakho, ukumamatheka kwayo, noma ukukhula kwayo, khuluma nodokotela wakho ngalokho futhi.
• Lokhu kungaba yinto ecindezela kakhulu kubo bobabili abazali. Ngakho-ke, ngenkathi ulandela imiyalelo kadokotela ngqo, thola ukwesekwa. Ungakhathazeki, odokotela bazokusiza.

Ukuqaqamba kwezinsana , isithuthwane, ukudikiza kwengane, ukuquleka, i-West Syndrome, isithuthwane sezingane, i-EEG, i-MRI