I-Focal Epilepsy, eyaziwa nangokuthi i-partial Epilepsy, iwuhlobo lwesithuthwane olubonakala ngokuquleka oluqala endaweni ethile yobuchopho. Izimbangela zesithuthwane esigxile kuzo zingahluka, kusukela ekulimaleni okubuhlungu kobuchopho kuya kuzimo zofuzo. Izimpawu zingabandakanya ukuquleka, ukushintsha kwezinzwa, ukunyakaza okungahleliwe, nokulahlekelwa ukwazi ingxenye noma okuphelele.
Ukwelashwa kwesithuthwane esigxile kakhulu ngokuvamile kuhilela ukusetshenziswa kwemithi ye-antiepileptic ukulawula ukuquleka. Kwezinye izimo, ukuhlinzwa kungase kube inketho yokususa indawo yobuchopho ebhekene nokuquleka. Ukwengeza, ezinye izindlela zokwelapha, ezifana nokuvuselela i-vagus nerve, zingasetshenziswa futhi ukusiza ukulawula isithuthwane esigxile kakhulu. Kubalulekile ukuthi iziguli ezine-focal epilepsy ziqashwe udokotela wezinzwa ukuze zixilongwe kahle kanye nohlelo olufanele lokwelapha.
Yini ebangela isithuthwane esigxilile?
I-Focal Epilepsy, eyaziwa nangokuthi i-partial Epilepsy, ibonakala ngokuphuma kukagesi okungavamile endaweni ethile yobuchopho. Lokhu kukhishwa kungabangelwa izici eziningana, okuyinhloko ukuthambekela kofuzo kanye nokulimala kwengqondo.
I-Genetic predisposition I-Focal Epilepsy ingenye yezinto eziyingozi kakhulu ekuthuthukiseni lesi simo. Abantu abanomlando wokuba nesifo sokuwa emathubeni amaningi okuba nalesi sifo esikhathini esithile ekuphileni kwabo. Ngaphezu kwalokho, ukungahambi kahle kwezakhi zofuzo kungabangela ubuchopho ekubanjweni.
As ukulimala kwengqondo kungase futhi kubangele i-focal isithuthwane. Ukulimala ekhanda, ukushaywa unhlangothi, izimila ebuchosheni, izifo zesimiso sezinzwa, nokukhubazeka kokuzalwa ngezinye zezinto ezingaholela ekukhuleni kwalesi simo.
Ezinye izinto ezingaba izimbangela zesithuthwane esigxile kuzo zihlanganisa ukuphazamiseka kwe-metabolic, ukuphazamiseka kokukhula kobuchopho e izinguquko zesakhiwo ebuchosheni. Kubalulekile ukugcizelela ukuthi, ezimweni eziningi, imbangela ethile yesithuthwane esigxile kakhulu ingase ingahlonzwa.
Ukuze uthole ukuxilongwa okunembile nokwelashwa okusebenzayo, kubalulekile ukubonana nodokotela wezinzwa onguchwepheshe besifo sokuwa. Udokotela uzokwenza ukuhlola okuphelele kwesiguli, okuhlanganisa ukuthwebula izithombe kanye nokuhlola okuqondile ukuze abone umsuka wokuquleka. Ukwelashwa kwesithuthwane esigxile kakhulu kungase kuhlanganise ukusetshenziswa kwe izidakamizwa ze-antiepileptic, ukuhlinzwa kobuchopho e izindlela zokwelapha ezihambisanayo, kuye ngobunzima nembangela ewumsuka yesimo.
Ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele kubalulekile ukuze kulawulwe ukuquleka kanye nokwenza ngcono izinga lempilo yeziguli.
Izimpawu zesithuthwane esiyingxenye: okudingeka ukwazi ngazo.
I-Focal Epilepsy, eyaziwa nangokuthi i-partial Epilepsy, isifo sezinzwa esibonakala ngokuphuma okungavamile komsebenzi kagesi engxenyeni ethile yobuchopho. Lokhu kukhishwa kungabangela izimpawu ezihlukahlukene kuye ngokuthi isifunda esithintekile. Kubalulekile ukuqaphela izimpawu zesithuthwane esingaphelele ukuze uthole ukwelashwa okufanele futhi uthuthukise izinga lempilo yesiguli.
Izimpawu zesithuthwane esiyingxenye zingase zihlanganise ukuquleka okulula okuyingxenye, okubonakala njengokunyakaza okuzenzakalelayo kwengxenye yomzimba, imizwa eyinqaba njengokuntweza noma isiyezi, kanye nezinguquko zombono njengokuhlanekezela okubukwayo noma kokuzwayo. Ngaphezu kwalokho, ukuquleka okuyingxenye okuyinkimbinkimbi, okuhlanganisa izinguquko ekuziphatheni, njengokunyakaza okuphindaphindayo, inkulumo engaqondakali nokulahlekelwa ukwazi ingxenye.
Ezinye izimpawu zesithuthwane esingaphelele zingase zihlanganisa i-automatism, njengokuhlafuna ngokuphindaphindiwe, unyakazisa izandla, noma unyakazisa izindebe zakho, kanye izinguquko ezingokomzwelo, njengokwesaba okukhulu, umuzwa we-déjà vu, noma injabulo engachazwanga. Kubalulekile ukuqaphela ukuvama nobude balezi zimpawu, njengoba zingahluka kumuntu nomuntu.
Ukuxilongwa kwengxenye yesithuthwane kusekelwe emlandweni womtholampilo wesiguli, ukuhlolwa kwe-imaging okufana ne-MRI ne-electroencephalogram, nokuhlolwa kwezinzwa. Ukwelashwa kungase kuhlanganise imishanguzo ye-antiepileptic, ukuhlinzwa ukuze kukhishwe izicubu zobuchopho ezithintekile, noma ukuvuselela inzwa ye-vagus.
Kubalulekile ukuqaphela lezi zimpawu futhi ufune usizo lwezokwelapha olukhethekile ukuze uthole ukuxilongwa okunembile kanye nokwelashwa okufanele.
Zitholele izinhlobo ezintathu eziyinhloko zesithuthwane kanye nezici zazo ezihlukene.
Isifo sokuwa yisifo sezinzwa esithinta izigidi zabantu emhlabeni wonke. Kunezinhlobo ezahlukene zesithuthwane, esinye sazo okuyisithuthwane esigxile noma esiyingxenye. Kulesi sihloko, sizohlola izimbangela, izimpawu, kanye nokwelashwa kwalolu hlobo oluthile lwesithuthwane.
I-Focal Epilepsy ibonakala ngokuquleka okuqala endaweni ethile yobuchopho. Lokhu kudlikiza kungabonakala ngezindlela ezahlukene, kuye ngendawo ethintekile. Ezinye zezimpawu ezivame kakhulu zihlanganisa ukudlikizeka, ukushintsha kwezinzwa, ukunyakaza okungahleliwe, nokushintsha kokuziphatha.
Izimbangela zesithuthwane esigxile kuzo zingahluka, futhi kungenzeka ngenxa yokulimala kobuchopho, izimila, izifo, noma izinkinga zofuzo. Kubalulekile ukuhlola udokotela ukuze kutholakale imbangela eyinhloko yesithuthwane ukuze kutholakale uhlelo olungcono kakhulu lokwelapha.
Ukwelashwa kwesithuthwane esigxile kakhulu ngokuvamile kuhilela ukusetshenziswa kwemithi ye-antiepileptic ukulawula ukuquleka. Kwezinye izimo, ukuhlinzwa kungase kube inketho yokususa indawo yobuchopho ebangela ukuquleka. Ezinye izindlela zokwelapha ezifana nokudla kwe-ketogenic kanye nokuvuselela i-vagus nerve kungase kucatshangelwe.
Ngokuhlonzwa okufanele kwezimbangela kanye nohlelo olufanele lokwelapha, kungenzeka ukulawula izimpawu nokuthuthukisa izinga lempilo yeziguli ezithintwe yilesi simo.
I-focal seizure ihlala isikhathi esingakanani?
Ubude besikhathi sokubanjwa okugxilwe kukho kungahluka kumuntu nomuntu, kodwa ngokuvamile kuthatha imizuzu embalwa kuphela. Ngesikhathi sokudlidliza okugxilwe kukho, ukusebenza kukagesi okungavamile ebuchosheni kuthinta kuphela ingxenye ethile yobuchopho, okuholela ezimpawini ezingase zihlanganise ukunyakaza okuzenzakalelayo, imizwa eyinqaba, ukushintshashintsha kwemizwa, noma izinkinga zolimi.
Isifo sokuwa esigxilile singabangelwa ukulimala kwengqondo, izifo, izimila, noma izimo zofuzo. Izimpawu zingaba mnene noma zibe nzima, kuye ngendawo yobuchopho ethintekile kanye nobukhulu bomsebenzi kagesi ongajwayelekile.
Ukwelashwa kwesithuthwane okugxilwe kukho kungabandakanya imishanguzo ye-antiepileptic, ukuhlinzwa, noma ukuvuselela ubuchopho obujulile. Kubalulekile ukubonana nodokotela wezinzwa noma i-epileptologist ukuze uthole ukuxilongwa okunembile kanye nohlelo olufanele lokwelashwa.
Isithuthwane esigxile noma esiyingxenye: izimbangela, izimpawu kanye nokwelashwa
Sazi "isithuthwane" njengeqembu lokuphazamiseka kwesistimu yezinzwa ezibonakala ngokuthambekela kweziqephu zomsebenzi kagesi wobuchopho obungajwayelekile obudala ukuquleka nezinye izimpawu. Ngezinye izikhathi, ezinye iziyaluyalu zobuchopho ezihlobene nesifo sokuwa nazo ziyavela, njengokulibaziseka kokukhula komqondo.
Kulesi sihloko, sizochaza izimbangela, izimpawu kanye nokwelashwa kwesithuthwane esigxile noma esiyingxenye , uhlobo oluncane oluvame kakhulu lwalesi sifo, oluchazwa izinguquko emisebenzini kagesi ezindaweni ezilinganiselwe zobuchopho.
Siyini isithuthwane esigxilile?
Izinhlobo ezahlukene zesithuthwane zihlukaniswa ngobukhulu obuhlukahlukene bomtholampilo. Enye yezinto ezifanele kakhulu yizinga lokujwayelekile kokungasebenzi kahle kwe-electrochemical ngokombono wobuchopho; ngalo mqondo, ukuhlukana okuyisisekelo yilokho phakathi isithuthwane esigxile noma esiyingxenye kanye nesithuthwane esijwayelekile .
Sikhuluma ngesithuthwane esingaphelele lapho kusobala ukuthi kukhona ukuquleka okuncane. Lokhu kusho ukuthi iziqephu zokungasebenzi kahle kobuchopho, imbangela yokuquleka, ziqala endaweni ethile yobuchopho, nakuba zingasakazeka kamuva ebuchosheni. Uma kwenzeka lesi simo, sikhuluma "ngokujwayelekile okwesibili."
Por Ngakolunye uhlangothi, ukuquleka okujwayelekile noma “okukhulu” kuthinta ubuchopho bonke , noma ingxenye enkulu yawo, kusukela ziqala nje. Isifo sokuwa esivamile sihlotshaniswa nesilinganiso esikhulu kune-focal epileptic aura, isethi yama-prodrome ahlanganisa izinguquko ekuboneni kwezinzwa noma ukudideka kwengqondo.
Ezincwadini, singathola futhi izinkomba zokubandakanyeka kwe-hemispheres eyodwa noma zombili, ukuhlukanisa phakathi kwesithuthwane esigxile kanye nesijwayelekile. Ukulahlekelwa ukwazi kanye ne-epileptic aura kuyisici esikhulu sokuquleka okuvamile, nakuba kungase kwenzeke nasekubanjweni okungaphelele, ikakhulukazi uma kuthinta indawo enkulu yobuchopho.
- Ungase ube nesithakazelo: "Kwenzekani ebuchosheni bomuntu lapho eba nokuquleka?"
Izimpawu zokuquleka ingxenye
Kwesinye isikhathi, ukuquleka okugxilwe kukho kwesifo sokuwa kuthinta ukuphaphama, ukwazi, kanye nenkumbulo, futhi kungaba nomthelela ekuziphatheni okuqaphelekayo. Kulezi zimo, , sikhuluma ngokuquleka okuyinkimbinkimbi noma okuyingxenye , kanti uma zingekho izinguquko enkumbulweni nasekuqapheleni, zizobhekwa njengokuquleka okugxilile.
Omunye umehluko obalulekile ukuthi i-epileptic aura ivame kakhulu ekubanjweni okuyinkimbinkimbi kunezilula. Izimpawu nezimpawu zesithuthwane esigxile futhi ingahluka kakhulu kuye ngezifunda zobuchopho ezithintekile.
Izenzakalo ezivame ukuhlotshaniswa nokuquleka okuncane yilezi ezilandelayo:
- Ukuvela okungazelelwe kwemizwa enamandla
- Ukuzwa isicanucanu
- Ukuzwa ukunyakaza noma ukuwa phansi, umbono osontekile wendawo
- Izinguquko zemizwa kanye nokuhogela, okuzwayo, okuthintayo, okuguquguqukayo nokubonwayo
- I-dissociative phenomena: i-depersonalization kanye ne-derealization
- Ukufinyela kwemisipha okungavamile
- I-automatisms yokuziphatha, isibonelo, ukuhamba noma ukuhlafuna
- Ukunyakaza kwamehlo okulandelanayo, ukunwebeka kwe-pupillary
- Ukushaya kwenhliziyo okunyukile
- Ukujuluka
- Ubuhlungu besisu nokungaphatheki kahle
- Ubunzima noma ukungakwazi ukukhuluma
Futhi, izimpawu zincike ezingxenyeni zobuchopho ezithintekile Uma inkinga yenzeka engxenyeni engaphambili, ukunyakaza okungajwayelekile kanye nobunzima bokukhuluma kungase kuvele; uma kunesiphepho, ukwesaba, i-automatisms, ne-déjà vu; uma ku-lobe ye-parietal, izinzwa ezithintekayo kanye nokuhlanekezela ekuboneni; futhi uma ku-lobe ye-occipital, ukungasebenzi kanye nezinzwa emehlweni.
Njengoba kushiwo ngaphambili, okunye ukuquleka okuncane kwasakazekela kuwo wonke ubuchopho ngemva kokuqala endaweni ethile yobuchopho; yilesi sici sokugcina esibanika isimo sezindawo okugxilwe kuzo. Ubukhulu bendawo yobuchopho ethintekile ukuphazamiseka kukagesi buthonya ubunzima bezimpawu.
Izimbangela zalolu hlobo lwesithuthwane
Ingxenye yesithuthwane uhlobo oluvame kakhulu lwalesi sifo . Kuvame kakhulu kubantu asebekhulile (abaneminyaka engaba ngu-65 noma ngaphezulu), futhi ukuba khona kokuphazamiseka kwe-cerebrovascular noma izimila zobuchopho kuyisici esiyingozi esibaluleke kakhulu.
Isifo sokuwa esigxilile, ikakhulukazi lapho siqala ebudaleni, ngokuvamile sibangelwa izici ezihlukahlukene ezilimaza ubuchopho. Lokhu kubandakanya: imivimbo ye-ischemic, ukulimala ekhanda , izimila, kanye nezifo zobuchopho. Kwezinye izimo, imbangela yesithuthwane esigxile kakhulu ayaziwa.
Ezinganeni, imbangela ivame kakhulu kunokuba ingaveli kulezi zici, kodwa kunalokho iyinhloko ngokwemvelo; kulezi zimo, sikhuluma "ngesithuthwane se-idiopathic." Kuyafaneleka ukuqaphela ukuba khona kwe-benign focal isithuthwane ebuntwaneni, ebonakala ngokuba khona kwe-focal sezures, ubumnene babo obuhlobene, nokunyamalala kwabo ngesikhathi sokukhula.
Ukwelashwa kwalolu shintsho
Isifo sokuwa, esigxile kakhulu nesijwayelekile, ngokuvamile siphathwa ngemithi yokwelapha. Imithi evame kakhulu ye-antiepileptic ihlanganisa i-gabapentin, i-lamotrigine, i-topiramate, i-valproate, ne-oxcarbazepine. Ukwamukela a Ukudla kwe-ketogenic (okuncane kwama-carbohydrate kanye namaprotheni amaningi) .
Kwezinye izimo ezimbi kakhulu zesithuthwane esigxile kakhulu, kungase kutuswe ukuhlinzwa ukuze kugwenywe ezinye izingozi noma kuncishiswe ukuphazamiseka kokuphila. Lolu hlobo lokuhlinzwa luhilela ukususwa kwengxenye yobuchopho okuhlotshaniswa nayo isithuthwane, ukuze iziqephu zokungasebenzi kahle kobuchopho zinyamalale.
Nokho, ukuhlukahluka kokwelashwa kuphezulu; lapho ukubonakaliswa kwabo kuyingozi ikakhulukazi, ukuphazamiseka kwe-spectrum yesithuthwane kungase kungabi nemiphumela ephawulekayo noma kudinga noma yiluphi uhlobo lokwelashwa.