Ingabe othandekayo wakho unalezi zimpawu ezingavamile? Ingabe kunzima ukukhuluma noma ukugwinya? Ake sifunde nge-(Pseudobulbar Palsy)!

Wake waphawula ukuthi ngezinye izikhathi abathandekayo bethu baqala ukuhleka ngaphandle kwesizathu, noma baqale ukukhala ngaphandle kokuzizwa bedabukile? Noma ingabe bayawakhuluma kabi amazwi abo bekhuluma, noma banenkinga yokugwinya ukudla? Uma unesinye salezi zinto ndawonye, ​​​​kungaba ngenxa yesimo esibizwa ngokuthi 'i-Pseudobulbar Palsy' esizokhuluma ngaso namuhla. Lokhu akusona isifo esihlukile, kodwa iqoqo lezimpawu ezibangelwa izifo ezithile zezinzwa. Ngakho-ke, ake sixoxe ngalokhu ngokuningiliziwe?

Kuyini i-Pseudobulbar Palsy?

Kalula nje, i-Pseudobulbar Palsy iqoqo lezimpawu zezinzwa ezibangelwa ukulimala kwengxenye ethile yobuchopho bethu ebizwa ngokuthi i-corticobulbar tract. Le ndlela ye-corticobulbar isiza ukulawula imisipha ekhanda nasebusweni bethu. Uma lokhu kulimele, kuvela izinkinga ezintathu eziyinhloko:

• Ubunzima bokukhuluma, ngokwezokwelapha sikubiza ngokuthi 'i-dysarthria' .
• Ubunzima bokugwinya ukudla noma uketshezi kubizwa ngokuthi i-dysphagia .
• Ukungakwazi ukulawula imizwa yakho, njengokuhleka noma ukukhala ngokuzumayo, kubizwa ngokuthi "i-pseudobulbar affect."

Into ebalulekile ukuthi lesi akusona isifo esisodwa, kodwa inkinga ebangelwa ezinye izifo zezinzwa noma izimo zemithambo yegazi. Ngezinye izikhathi odokotela bakubiza nangokuthi 'i-supranuclear bulbar palsy'.

Ziyini izimpawu zalesi simo?

Njengoba kushiwo ngaphambili, izimpawu ezintathu eziyinhloko ubunzima bokukhuluma, ubunzima bokugwinya, kanye nokungakwazi ukulawula imizwa. Kodwa-ke, ezinye izimpawu zingase zibonakale, njengalezi:

• Ukuvuza amathe noma ukuvuza amathe ngokweqile: Ngezinye izikhathi amathe angaphuma emlonyeni ungaqapheli.
• Izinguquko esitayeleni nasekukhulumeni: Inkulumo ingase ingacaci. Kungase kuzwakale sengathi ukhuluma ngekhala lakho (ithoni yekhala elingaphezu kwamandla).
• Ubuthakathaka bolimi noma ukukhubazeka: Lokhu kubizwa ngokuthi 'i-glossoplegia'. Lokhu kungenza kube nzima ukukhuluma nokuhlafuna ukudla.
• Ubuthakathaka bemisipha yobuso: Uhlangothi olulodwa noma zombili zobuso zingase zingabi nampilo.
• Ubunzima bokuhlafuna ukudla: Njengoba ungakwazi ukuhlafuna ukudla kahle, kuba nzima ukukugwinya.
• Ukuhleka noma ukukhala okungalawuleki noma okungafanele: Cabanga ukukhala ngokuzumayo ngaphandle kwesizathu esibonakalayo, noma ukuhlekela phezulu into encane, bese ungakwazi ukuyilawula. Lokhu kubizwa ngokuthi "i-pseudobulbar affect."
• Ukuqina noma ukuqina kwemisipha yomhlathi: Lokhu kubizwa nangokuthi 'i-trismus'. Kungaba nzima ukuvula nokuvala umlomo wakho.
• Ukwanda kokusabela kobuso: Isibonelo, ukugxumagxuma kwemihlathi kungase kwenzeke.

Kubikwa nokuthi cishe ama-85% ezingane ezine-Pseudobulbar Palsy zingase zibe nezimo ezifana nokukhubazeka kwengqondo kanye nokuquleka .

Kanye nalezi zimpawu, ezinye izimpawu zingase zivele kuye ngokuthi isifo esiyisisekelo sibangela i-pseudobulbar palsy.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Imbangela eyinhloko ye-Pseudobulbar Palsy ukulimala kuzo zombili izinhlangothi zendlela ye-corticobulbar ebuchosheni bethu. Umsebenzi walo mzila ukulawula imisipha ekhanda nasebusweni. Le ngxenye iphinde inikeze uvo emizweni ye-cranial enikeza imiyalezo edingekayo kule misipha.

Ngakho-ke, kunezimo eziningana ezingalimaza le "corticobulbar tract." Lezi yizi:

• Ukulimala okukhulu ekhanda (ukulimala kobuchopho okubuhlungu).
• Izimila ze-Brainstem .
• Ukuvuvukala kanye nezifo ezithinta ubuchopho.
• Izimo zezinzwa ezingapheli .
• Izifo ezihlobene nemithambo yegazi yobuchopho, isibonelo "ukushaywa yisifo sohlangothi" kanye "nokukhubazeka kwemithambo yegazi".

Ezinye izimo zemizwa ezivamile, ezihlala isikhathi eside ezivame ukubangela i-pseudobulbar palsy zifaka:

• I-Amyotrophic lateral sclerosis (ALS).
• Isifo sikaParkinson .
• Ukukhubazeka kwe-supranuclear okuqhubekayo.
• I-Multiple sclerosis (`I-Multiple sclerosis - MS`).

Ukubona kanjani lokhu?

Odokotela bavame ukuxilonga i-Pseudobulbar Palsy ngokusekelwe ezimpawini zakho. Isihluthulelo lapha ukuthola ukuthi yisiphi isimo esiyisisekelo esibangela lesi simo. Ungase ukwazi kakade ngaso, noma kungase kudingeke uthole okuthile okusha.

Udokotela uzokubuza ngezimpawu zakho, ukuthi zaqala nini, kanye nomlando wakho ophelele wezokwelapha, njengokuthi ngabe wake waba nesimo esifana nesifo sohlangothi yini. Bazobe sebekwenza ukuhlolwa ngokomzimba kanye nokuhlolwa kwezinzwa .

Njengoba kunezimo eziningana ezingabangela i-pseudobulbar palsy, udokotela wakho angase futhi ancome ukuhlolwa okuhlukahlukene. Ezinye zalezi zifo zifaka:

• Ukuhlolwa kwegazi .
• Umpompi womgogodla woketshezi lomgogodla (ukuhlaziywa kwe-CSF).
• Ukuhlolwa kwezithombe, njengokuskena kwe-MRI yobuchopho .
• Ukuhlolwa kwe-`EEG` (`EEG - electroencephalogram`), okulinganisa umsebenzi kagesi wobuchopho.
• Ukuhlolwa kwe-'Evoked Potential'(`Ukuhlolwa okungenzeka kuhoxiswe`).
• Ukuhlolwa kwenkulumo nokuqonda .

Lezi zivivinyo zizosisiza sithole ukuthi imbangela iyini ngempela.

Iphathwa kanjani?

Akukho ukwelashwa okuqondile kwe-Pseudobulbar Palsy. Kunalokho, ithimba lakho lezokwelapha lizoncoma izindlela zokwelapha ezahlukahlukene zokulawula izimpawu zalesi simo. Ngaphezu kwalokho, isimo esiyisisekelo singadinga ukwelashwa.

Ukuze wenze lokhu, uzodinga usizo lwethimba lodokotela eliqukethe ochwepheshe abahlukahlukene. Phakathi kwabo kukhona:

• Udokotela womndeni wakho (`udokotela wokunakekelwa okuyinhloko`).
• Odokotela bezinzwa.
• Izazi zezifo zolimi lokukhuluma.
• Abelaphi bokuphefumula.
• Izazi zengqondo noma odokotela bengqondo.
• Izisebenzi zezenhlalakahle.
• Osokhemisi.

Ukwelashwa kobunzima bokugwinya (i-Dysphagia)

Kunezindlela zokwelapha ezahlukene ezitholakalayo kuye ngokuthi ubunzima bokugwinya bubucayi kangakanani. Ezinye zazo zifaka:

• Ukushintsha izindawo zokudla, ukushintsha izitsha zokudla, nokushintsha ukuqina kokudla. Isibonelo, ungakuhlikihla kahle ukudla futhi ukwenze kube uketshezi oluningi ukuze kube lula ukugwinya.
• Ukuzivocavoca ukuqinisa imisipha okusiza ekugwinyeni (`Ukuqeqeshwa kwemisipha yokugwinya`).
• Ukwelashwa nge-physiotherapy, njengokukhuthaza ngogesi, nge-magnetic noma ngokushisa.
• Imithi, isibonelo, imithi efana ne-`nifedipine` kanye ne-`metoclopramide`.

Khumbula, uma ungakwazi ukudla noma ukuphuza kahle, noma uma usengozini yokuminza, udokotela wakho angase akuncome ukuthi ukuphe ukudla ngepayipi ('ipayipi lokuncelisa') elifakwa ngqo ekhaleni noma esiswini sakho .

Ukwelashwa kwezinkinga zokukhuluma

Uma unenkinga yokukhuluma, ukwelashwa ngenkulumo kungaba usizo kakhulu. Uchwepheshe wezokukhuluma akafundisi wena kuphela, kodwa nomndeni wakho indlela yokukhulumisana kangcono nawe.

Ngesikhathi seseshini yokwelapha ngenkulumo, ungafunda izinto ezifana nalezi:

• Ukuzivocavoca okuqinisa ulimi, izindebe, kanye nemisipha yomhlathi (uma kungenzeka).
• Amasu okukhuluma ngokucacile, njengokunciphisa isivinini sakho sokukhuluma nokusebenzisa ngamabomu imisipha ethile ukuphimisela imisindo namagama.
• Izindlela zokuveza imibono ngaphandle kwamagama, njengolimi lwezandla noma ukubhala.

Ukwelashwa kokubonakaliswa kwemizwa okungalawulwa (`I-Pseudobulbar Affect - PBA`)

Imithi yokulawula i-"Pseudobulbar Affect (PBA)", isimo lapho uhleka futhi ukhala khona ngokungalawulekiKungasiza. Udokotela wakho angase akunike imithi efana nalokhu:

• I-Dextromethorphan/quinidine sulfate (Nuedexta®): I-U.S. Food and Drug Administration (FDA) ivumile lo muthi njengomuthi wokuqala owenzelwe ngqo ukwelapha i-PBA. Uqukethe umuthi wokukhwehlela kanye nomthamo ophansi womuthi owawusetshenziswa ngaphambilini ukwelapha izinkinga zesigqi senhliziyo.
• Ama-antidepressants : Imithi efana nama-antidepressants e-tricyclic, ama-SSRI (ama-Selective serotonin reuptake inhibitors), kanye nama-SNRI (ama-Serotonin kanye nama-norepinephrine reuptake inhibitors) ingasiza futhi ekulawuleni izimpawu ze-PBA.

Sizoba njani lesi simo? Ingabe singelapheka?

Ukubikezela komuntu one-pseudobulbar palsy kunqunywa kakhulu yisifo esiyisisekelo.

Cabanga nje, uma ubunalesi simo ngenxa "yokushaywa yisifo sohlangothi" noma "ukulimala kobuchopho okubuhlungu", kungenzeka ukuthi ukusebenza kwezinzwa kuzobuyela kancane kancane esimweni esijwayelekile. Okusho ukuthi, izimpawu ze-pseudobulbar palsy zingase zinciphe kancane kancane.

Kodwa-ke, uma lesi simo sibangelwa yizimo eziwohlokayo ezingamahlalakhona njenge-multiple sclerosis (MS), isifo sikaParkinson, kanye ne-ALS, ngokuvamile kunzima ukulindela ukwelashwa.

Ithimba lakho lezokwelapha lizokwazi ukukunikeza umbono ocacile wokuthi ikusasa liphetheni ngesimo sakho esithile.

Yiziphi ezinye izinkinga ezingabangelwa yilokhu?

I-Pseudobulbar palsy ingabangela izinkinga ezifana nalezi:

• I-Aspiration pneumonia: Ngenxa yokuthi imisipha yolimi nomlomo kunzima ukuyilawula, inani elincane lokudla noma isiphuzo lingangena emaphashini, okubangela isimo esibizwa ngokuthi i-aspiration pneumonia. Lokhu kungaba yingozi.
• Ukungondleki kahle kanye nokuphelelwa ngamanzi emzimbeni: Uma i-dysphagia inzima, ukungondleki kahle kanye nokuphelelwa ngamanzi emzimbeni kungenzeka ngenxa yokungakwazi ukudla nokuphuza kahle. Ezimweni ezimbi kakhulu, kungadingeka ipayipi lokudla.
• Izimo zempilo yengqondo: I-Pseudobulbar palsy ingaba nomthelela omkhulu empilweni yakho yansuku zonke. Ungase ube nobudlelwano nabantu ngenxa yezinto ezifana nobunzima bokukhuluma kanye nokuqhuma kwemizwa okungalawuleki. Lokhu kungaholela ezinkingeni zempilo yengqondo njengokucindezeleka nokukhathazeka .

Ingabe i-Pseudobulbar Palsy iyabulala?

I-Pseudobulbar palsy ayibulali ngokuqondile. Kodwa-ke, isifo esibangela lokhu (isb. ukukhubazeka )`, `ALS`) ingaba yingozi. Futhi, izinkinga ezifana ne-`aspiration pneumonia` zingaba yingozi empilweni uma zingelashwa kahle.

Ingabe ikhona indlela yokuvimbela lokhu?

Njengoba kunezici eziningi ezingabangela i-pseudobulbar palsy, ayikho indlela eqondile yokuyivimbela. Kodwa-ke, ukulandela imikhuba yezempilo engavimbela izici eziyingozi ezifana "nokukhubazeka" kungaba usizo olungaqondile.

Kufanele ngimbone nini udokotela?

Uma une-Pseudobulbar Palsy, kufanele uhlangane nethimba lakho lezokwelapha njalo ukuqinisekisa ukuthi uhlelo lwakho lokwelashwa lusebenza kahle.

Lesi simo singaba nomthelela omkhulu empilweni yakho yansuku zonke, futhi ungase uzizwe ukhungathekile. Ngezikhathi ezinjalo , ungangabazi ukufuna usizo kwabathandekayo bakho, kanye nomeluleki wezempilo yengqondo . Khumbula, ithimba lakho lezokwelapha lihlala linawe ukuthola uhlelo lokwelashwa olukufanele kakhulu.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke masikhumbule lokhu njengesifinyezo se-Pseudobulbar Palsy esikhulume ngayo namuhla:

• Lesi akusona isifo esihlukile, kodwa iqoqo lezimpawu ezibangelwa ukulimala kwengxenye ethile yobuchopho.
• Izimpawu eziyinhloko ubunzima bokukhuluma, ubunzima bokugwinya, kanye nokuhleka noma ukukhala okungalawuleki.
• Izimbangela zifaka phakathi izifo zezinzwa ezifana nokukhubazeka, isifo sikaParkinson, i-MS, noma ukulimala ekhanda .
• Ukwelashwa kuhloswe ukwelapha isimo esiyisisekelo nokulawula izimpawu. Ukwelashwa ngenkulumo, ukugwinya, kanye nemithi kungasiza kulokhu.
• Kubaluleke kakhulu ukuqaphela izimpawu ngokushesha nokufuna iseluleko sezokwelapha.
• Uthando lwakho, ukwesekwa kwakho, nokuqonda kwakho kubaluleke kakhulu kumuntu ophila nalesi simo.

Uma wena noma othile oseduze nawe ebhekene nanoma yiziphi zalezi zimpawu, sicela ubonane nodokotela ukuze akunike iseluleko. Yilokho okungcono kakhulu ongakwenza.

Ukukhubazeka kwe - Pseudobulbar, ukuphazamiseka kobuchopho, ubunzima bokukhuluma, ubunzima bokugwinya, izifo zezinzwa, ukulawula ngokomzwelo, i-PBA