Mtundu wochepa wa MS umene ungatengere nthawi yaitali kuti udziwe
Kuzindikira kwa pulasitiki ya pulasitiki yapadera (PPMS) ili ndi mavuto apadera, popeza anthu omwe ali ndi PPMS amalephera kupitirizabe kugwira ntchito kwa miyezi ndi zaka. Izi zikusiyana ndi kubwezeretsa-MS kusinthidwa, komwe munthu angayambitse matenda a ubongo pambuyo pobwezera.
Kusiyanitsa pakati pa mitundu iwiriyi ya MS kumakhala kofanana ndi biology yapadera kumbuyo kwawo.
Kafukufuku akusonyeza kuti kubwezeretsa-MS kumatulutsa njira yotupa (chitetezo cha mthupi chitetezera mitsempha ya mitsempha) pamene njira yoyamba yopitilira MS ndiyo njira yowonongeka kwambiri, pamene mitsempha ya mitsempha imachepa pang'onopang'ono. Chifukwa chake munthu mmodzi akukula PPMS mosiyana ndi kubwezeretsa kachilombo ka MS kosadziwika, koma akatswiri amakhulupirira kuti majeremusi akhoza kugwira ntchito, ngakhale kuti umboni wa sayansi umatsimikiziransobe.
Kusanthula kwa MS Primary Progressive MS
Definite PPMS ikhoza kupezeka pamene izi zikuchitika:
- Munthu ali ndi chaka chimodzi chotsatira chithandizo chachipatala (kutanthauza kuwonjezereka kwa zizindikiro zake za MS ).
- Osachepera awiri mwa zotsatirazi:
- Mphungu ya MRI yeniyeni yomwe imakhala ya MS
- Zilonda ziwiri kapena zambiri za MS mu msana
- Kupatsa mpweya wabwino, kutanthauza kuti pali umboni wa magulu a oligoclonal kapena gulu lapamwamba la antigG (izi ndi mapuloteni omwe amasonyeza kuti kutupa kumachitika m'thupi)
Anthu ambiri omwe ali ndi PPMS amayamba ndi chizindikiro cha kuwonjezereka mavuto pang'onopang'ono poyenda, otchedwa "papa epastic spastic paraparesis."
Komabe, anthu ena ali ndi zomwe zimatchedwa "cerebellar syndrome," zomwe zimakhala ndi ataxia ovuta komanso mavuto. Mosasamala kuti ndi zizindikiro ziti zomwe ziri, ziyenera kuwonetseredwa kuti zotsatirazi zakhala zowonjezereka kwa chaka chimodzi, popanda kubwereranso, kuti apeze PPMS.
MRI pakuzindikira PPMS
Kutulukira kwa multiple sclerosis kumafuna kufalitsa (ziwonjezereka) za zizindikiro ndi zilonda mu danga ndi nthawi. "Kufalitsa nthawi" kumasamalidwa ndi kuwonjezereka kwa zizindikiro kwa chaka chimodzi (monga momwe tafotokozera pamwambapa). Majekesi a MRI amagwiritsidwa ntchito pofuna kudziwa "kufalitsa kwa zilonda m'mlengalenga."
Izi zinkati, kugwiritsa ntchito MRI kuyesa kufufuza kuti PPMS ili ndi mavuto ake. Chinthu chimodzi chovuta ndi chakuti zotsatira za kuyang'ana kwa MRI za ubongo wa anthu omwe ali ndi PPMS kungakhale "yochenjera" kuposa ya anthu omwe ali ndi RRMS, okhala ndi zilonda zochepa kwambiri za gadolinium-enhancing (active) .
Komabe, MRI ya msana wamtundu wa anthu omwe ali ndi PPMS idzaonetsa atrophy . Popeza kuti msana wamtunduwu umakhudzidwa kwambiri ndi PPMS, anthu amakhala ndi mavuto ndi kuyenda, komanso chikhodzodzo ndi chifuwa.
Lumbar Nthawi Yodziwunika PPMS
Zomwe zimatchulidwanso ngati phokoso la m'mphepete, mapuloteni a lumbar angakhale othandiza kwambiri popanga matenda a PPMS ndikuwongolera zina.
Zotsatira ziwiri ndizofunikira pozindikira kuti matenda a PPMS:
- Kukhalapo kwa Maolivi Oligoclonal: Izi zikutanthauza kuti "magulu" a mapuloteni ena (immunoglobulins) amasonyeza pamene mthenda yamtsempha imayesedwa. Umboni wa magulu a oligoclonal mu CSF angawoneke pa 90 peresenti ya anthu omwe ali ndi MS koma angapezedwe m'mavuto ena.
- Kupanga Mankhwala a Intrathecal IgG: Izi zikutanthauza kuti IgG imapangidwira mkati mwa chipinda cham'madzi. Ichi ndi chizindikiro chakuti pali chitetezo cha mthupi.
VEP Yothandiza Kutsimikizira Kuzindikira kwa PPMS
Zowonongeka zowonongeka ndi mayesero omwe amafunika kuvala magetsi a EEG (electroencephalogram) pamphuno pomwe akuyang'ana pazithunzi. Makhalidwe a EEG adachepetsa mayankho ku zochitika zowonekera, zomwe zimasonyeza kusagwirizana kwa ubongo. VEPs zathandizanso pakulimbitsa chidziwitso cha PPMS, makamaka pamene zina sizikugwirizana bwinobwino.
Kupitiliza-Kubwezeretsa MS
Ndikofunika kuzindikira kuti anthu ena omwe amayamba ndi matenda a PPMS amatha kubwereranso pambuyo pozindikira.
Pamene izo zikuyamba kuchitika, kusanthula kwa munthu ameneyo kumasinthidwa kukhala pang'onopang'ono-kubwezeretsanso MS (PRMS). Komabe, aliyense amene ali ndi PRMS amayamba ndi matenda a PPMS. Kuwonjezereka kwa MS ndi njira yovuta ya MS, ndipo ndi 5 peresenti ya anthu omwe ali ndi MS.
Mawu Ochokera
Pamapeto pake, matenda ambiri a ubongo amatsanzira MS , cholemetsa chachikulu chozindikira mtundu uliwonse wa MS ndicho kuthetsa kuthekera kuti kungakhale chinthu china. Matenda ena omwe amayenera kutulutsidwa ndi awa: Matenda a Vitamini B12, Matenda a Lyme, kupanikizika kwa msana, neurosyphilis kapena matenda a neuron, kutchula pang'ono.
Ichi ndi chifukwa chake nkofunika kuona dokotala kuti apeze matenda oyenera ngati muli ndi zizindikiro za ubongo. Ngakhale njira yothetsera matenda ikhoza kukhala yovuta, khalani oleza mtima komanso ochita bwino mu chisamaliro chanu.
> Zotsatira:
> Coyle, Patricia K. ndi Haper, June. Kukhala ndi Mafupa Ambiri Ambiri: Kugonjetsa Mavuto (2nd ed.). New York: Demos Publishing. 2008.
> Cree BA. Ma Genetics of primary epistle multiple sclerosis. Chipatala cha Handb Neurol. 2014; 122: 211-30.
> National MS Society. Kuzindikira PPMS.