Dyskinesia ndi mtundu wa chisokonezo choyendayenda chomwe chimadziwika ndi zizoloŵezi zosasunthika za kupotoza kapena kupotoza thupi. Kusunthira kawirikawiri kumaphatikizapo mikono kapena miyendo, koma ikhonza kuphatikizapo mutu, mutu, kapena nkhope. Mipukutuyi imatha kuchokera kwa masekondi pang'ono mpaka mphindi 15 kapena kupitirira ndipo nthawi zambiri imathetsa ndekha. M'kupita kwa nthawi, zigawozi zimakula mobwerezabwereza ndipo zimakula kwambiri.
Kukhala ndi Dyskinesia
Dyskinesias sichimasokoneza chidziwitso, ndipo sichikugwirizana ndi kugwidwa kapena kugwedezeka , ngakhale kuti poyamba kumawoneka ngati ofanana ndi owona.
Ngati muli ndi dyskinesias, mutha kuyembekezera kuti mukhale osamala komanso mukudziwa kayendetsedwe kake, ndipo nthawi zina mukhoza kunena kuti ayandikira. Nthawi zambiri, anthu omwe ali ndi dyskinesia alibe mphamvu kapena kuchepetsa zochepa.
Pali zinthu zambiri zovuta za matenda a dyskinesia omwe amakhudza moyo wa tsiku ndi tsiku. Zimakhala zooneka mwachiwonekedwe ndipo zingachititse chidwi kwa ena. Kusinthasintha kosasangalatsa kumeneku kungakhale kusokoneza kwa inu ngakhale pamene muli nokha. Dyskinesias amatha mosayembekezereka ndipo mosayembekezereka zimalepheretsa kuti muzitha kulamulira thupi lanu momwe mukufunira. Amatha kusokoneza ntchito zanu komanso kusuntha kwanu. Nthawi zina, dyskinesias ikhoza kukhala yosasangalatsa, ndipo ikhoza kukhala yopweteka, ngakhale kuti izi si zachilendo.
Zifukwa za Dyskinesia
Pali zifukwa zingapo zomwe zimayambitsa dyskinesia; izi zikuphatikizapo kupwetekedwa, kupweteka kwa ubongo , multiple sclerosis , ndi mankhwala oletsa antipsychotic. Chinthu chofala kwambiri cha dyskinesia chimatchedwa levodopa-inachititsa dyskinesia (LID.) LID imafotokoza dyskinesias yomwe imakhala ngati zotsatira za mankhwala omwe amachiza matenda a Parkinson .
Chifukwa chake Dyskinesia imayamba chifukwa cha mankhwala a Parkinson
Matenda a Parkinson ndi matenda osokonezeka omwe amadziwika ndi kupuma kwa mitsempha ndi kupsinjika kwa minofu. Mankhwala ogwiritsidwa ntchito pa matenda a Parkinson ndi ena mwa zifukwa zomwe zimayambitsa matenda a dyskinesia. Mankhwala omwe amagwiritsidwa ntchito pofuna kuchepetsa zizindikiro za matenda a Parkinson amatchedwa mankhwala a dopaminergic. Pamene mankhwalawa amachititsa kuchuluka kwa dopamine mu ubongo, amachepetsa kwambiri zizindikiro za matenda a Parkinson.
Dyskinesia sizimachitika ngati zotsatira za mankhwala ochepa chabe a mankhwala a dopaminergic kapena kugwiritsa ntchito mankhwalawa kwa kanthaŵi kochepa. Chifukwa cha matenda a Parkinson ndi moyo wonse, anthu omwe ali ndi matendawa amafunika kumwa mankhwala a dopaminergic kwa zaka zambiri. Pambuyo pa zaka zingapo za kumwa mankhwalawa, anthu omwe ali ndi matenda a Parkinson akhoza kukhala ndi vuto lodziwika bwino lomwe lachedwa kuchepetsa vuto la dyskinesia.
Pakhala kafukufuku wambiri ngati zingatheke kuti dyskinesias zisapangidwe ndipo ngati kupatsira mankhwala a dopaminergic kungachedwe kapena kuchepetsa kukula kwa dyskinesia. Koma palibe umboni uliwonse wosonyeza kuti kuchepetsa mankhwala a dopaminergic amatha kulepheretsa mbali iyi kumapeto kapena kumapeto kwake.
Anthu ambiri omwe ali ndi matenda a Parkinson amapatsidwa tsatanetsatane wokhudzana ndi kuthekera kwa kuchepetsa kuchepa kwa mbali ya dyskinesia pasadakhale. Kwenikweni, chifukwa mankhwala a dopaminergic ndi othandiza kuchepetsa zizindikilo za matenda a Parkinson, anthu omwe ali ndi matenda a Parkinson amaona kuti moyo wabwino umakhala wotheka kuika pangozi pangozi ya dyskinesia mumsewu.
Kuchiza kwa Dyskinesias
Kawirikawiri, ngati mutayamba kudwala mankhwala a dyskinesias patatha zaka zambiri mutatenga mankhwala a Parkinson, madokotala anu akhoza kuthana ndi mankhwalawa .
Kusintha kungaphatikizepo kumwa mankhwala othandiza nthawi yaitali kapena kukhazikitsa ndondomeko ya mankhwala tsiku lonse. Madokotala anu akhoza kuwonjezera mankhwala osiyana pamagulu otsika omwe amagwira ntchito pamodzi m'malo mogwiritsa ntchito mlingo waukulu, mankhwala opangira mankhwala. Kusintha kumeneku kumathandiza kuchepetsa zizindikiro za Parkinson komanso kuchepetsa dyskinesia.
Njirazi zimagwira ntchito kwa anthu ena omwe ali ndi chigoba, koma sagwira ntchito kwa aliyense. Pamene kusintha kwa mankhwala sikukwanira kuthetsa kuchepetsa pakati pa kuchepetsa zizindikiro ndi kuchepetsa zotsatira zoyipa, pali njira zopaleshoni zomwe zingachepetse dyskinesias zomwe zimayamba chifukwa chomwa mankhwala a dopaminergic.
Kulimbikitsidwa Kwambiri kwa Ubongo (DBS) kwa Dyskinesia
DBS ndi njira yopaleshoni yomwe imagwiritsidwa ntchito poletsa matenda a dyskinesia omwe amachokera ku matenda a Parkinson. Njirayi imaphatikizapo kuyika mothandizira zamagetsi m'dera la ubongo.
Pali malo angapo omwe amaonedwa kuti ndi abwino kwambiri kuyika malo a DBS, ndipo mayeso ena asanatenge opaleshoni amatha kuwunikira malo abwino omwe muli nawo. Mbali izi zikuphatikizapo globus pallidus internus ndi phokoso lachidziwitso, zomwe zonsezi ndi zigawo zochepa zomwe zili mkati mwa ubongo.
Zipangizo za DBS zimaphatikizapo magetsi, omwe ali pambali imodzi kapena mbali zonse za globus pallidus kapena puloteni ya subthalamic. Jenereta, yomwe ikukonzekera kuyendetsa kukonzekera koyenera kwa magetsi, imayikidwa mu chapamwamba chapachigawo. Chipangizochi chili ndi batri kuti apitirize kugwira ntchito, ndipo bateriyi imafuna kuti mutengeke zaka zingapo.
Momwe DBS imathandizira Dyskinesia
Njira yomwe DBS imathandizira kuchepetsa dyskineia ndi yogwirizana. Chipangizochi chimapangitsa chidwi cha ubongo, chomwe chingasangalatse kapena kupondereza ntchito ya ubongo. Malingana ndi malo a electrode, kuyambitsa magetsi kungachepetse dyskinesia mwachindunji ku ubongo, kapena kungachepetseretsa dyskinesia mwa kuchepetsa kufunikira kwa mankhwala a dopaminergic, omwe amachepetsanso dopaminergic zotsatira za dyskinesia.
Zotsitsimutsa zomwe zimayikidwa pa globus pallidus zimakhudza kwambiri dyskinesias, pamene zolimbikitsa zowikidwa muchisumbu cha subthalamic zingachepetse kufunika kwa mankhwala a dopaminergic, kuchepetsa zotsatira za dyskinesia.
Chitetezo cha DBS
Zonsezi, njirayi ndi yotetezeka, koma monga njira zonse, pangakhale zovuta. Zovuta zogwirizana ndi DBS zimaphatikizapo matenda ndi magazi.
Matendawa amatha kupweteka mutu, kuthamanga, kusokonezeka, ndi malungo. Kutaya magazi kungapweteke mutu, masomphenya amasintha, kapena kutaya chidziwitso. Ngati mukufuna kukhala opaleshoni ya DBS, ndiye kuti gulu lanu lachipatala lidzakuyang'anirani mwatsatanetsatane. Pali zifukwa zosiyanasiyana zowunika ntchito yanu, kuphatikizapo kuyang'anira ntchito ya wotulutsira, ndi kugwira zovuta zilizonse musanabweretse mavuto osatha.
Njira Zopangitsira Zina za Parkinson-Associated Dyskinesia
Pali njira zingapo zopangira opaleshoni zomwe zingathenso kuganiziridwa kuti azisamalira. Njira izi sizimaphatikizapo kukhazikitsidwa kwa wotulutsira; zimaphatikizapo kulenga chipsinjo chimodzi mwa zigawo za ubongo zomwe zimayambitsa zizindikiro za Parkinson kapena dyskinesias.
Kawirikawiri, opaleshoni ya lesional imalowanso globus pallidus kapena puloteni, ndipo ingakhale mbali zonse ziwiri ngati kuli kofunikira. Njirazi ndi, monga DBS, zimawoneka kuti ndi zotetezeka. Ngati muli ovomerezeka pa opaleshoni ya DBS, ndiye kuti mwinamwake gulu lanu lachipatala lidzakambirana nanu njira zosiyanasiyana zopangira opaleshoni, kuphatikizapo DBS.
Mawu Ochokera
Matenda a Parkinson ndi matenda ozunguza anthu ambiri. Ndi moyo wonse umene ukuyembekezeka kuwonjezereka m'zaka zonsezi. Chifukwa cha zizindikiro zowonjezereka, anthu omwe ali ndi matenda a Parkinson nthawi zambiri amafunika kusintha mankhwala pamene matendawa amayamba komanso zotsatira zake zimakhala zowawa.
Chodabwitsa n'chakuti zotsatira za mankhwala omwe amagwiritsidwa ntchito pa matenda a Parkinson ndi matenda ena osokoneza bongo, dyskinesia. Kwa anthu ena omwe ali ndi matenda a Parkinson, pamakhala mfundo yomwe mankhwala sangathe kulekerera, ndipo njira zopangira opaleshoni zingaoneke ngati zabwino kwambiri.
Uthenga wabwino, komabe, ndikuti matenda a Parkinson kapena dyskinesias ndi owopsa kapena akuopseza moyo. Kuchita opaleshoni ya DBS ndi njira yomwe yakhala ikuyandikira kwa zaka zambiri, imamvetsetsedwa bwino, ndipo imaonedwa kuti ndi yotetezeka. Pazaka zapitazi, pakhala pali zikwi zambiri za anthu omwe ali ndi matenda a Parkinson amene adachitidwa opaleshoni ya LID, ndipo zotsatira zake zakhala zabwino. Ngati muli ovomerezeka ku DBS, muyembekezere kukhala ndi opaleshoni yokonzekera bwino ndikutsata mwatsatanetsatane mutatha njira yanu, chifukwa izi zidzakuthandizani kuti mupeze zotsatira zabwino komanso zowonjezera.
> Chitsime:
> Zani ZG, Zhou Q, Huang T, Jiang Y. Zochita za globus pallidus zolimbikitsa komanso zolimbikitsa zokhudzana ndi matenda a Parkinson: meta-analysis of trial randomized, Clin Interv Aging. 2016 Jun 21; 11: 777-86.