Mtundu Wodabwitsa Womwe Ungakudabwe
Anthu ambiri amakhulupirira kuti amadziwa momwe kugwedeza kumawonekera. Wina amene akudwala matendawa akuyamba kugwedezeka mosavuta, kugwa pansi, ndi kutaya nzeru. Koma izi sizili choncho nthawi zonse. Zokhumudwitsa zingathe kupezeka m'njira zosazolowereka, nthawi zina zimakhudza gawo limodzi la thupi, ndipo nthawi zina zimangokhudza mbali imodzi ya ubongo popanda kugwedezeka.
Mtundu wa khunyu ndiwopseza kwambiri - ndi kulanda komwe sikudzatha. Kuwonjezera pa kuika bwino wodwalayo ku coma , matenda a khunyu amatha kupha ndikuwongolera kuwonongeka kwa ubongo. Matenda a khunyu ndi matenda oopsa.
Pafupifupi zaka khumi zapitazo, ofufuza a ku Columbia University ku New York adayambitsa chisokonezo kuchipatala pamene adafufuza odwala ku ICU ndi electroencephalography . Ngakhale kuti panalibe kukayikira kuti odwalawa anali atagonjetsedwa, ndizo zomwe asayansiwa adapeza. Pafupifupi 10 peresenti ya odwala omwe sali omvera ku ICU analidi odwala matenda a khunyu, NCSE.
Kodi Kupanda Thupi Kumeneko N'koopsa Bwanji?
Popanda kupwetekedwa mtima khunyu, ubongo nthawi zonse umagwira, kapena kugwira nthawi zambiri kuti wodwalayo asakhale ndi mwayi wowonongeka kuchokera nthawi ya chisokonezo chomwe chimangotenga katemera.
Nthawi yowonzanso imatchedwa dziko lachidziwitso .
Kawirikawiri, anthu omwe ali ndi matenda a khunyu amaoneka ngati odwala ambiri a ICU omwe samvera chifukwa cha kuvutika maganizo kapena vuto lina lililonse la chidziwitso . Komabe, ngati tiyang'aniridwa ndi EEG, tikutha kuona kuti pakali pano, wodwalayo ali ndi matenda a khunyu.
Kusiyanitsa n'kofunika, chifukwa chifukwatu chifukwatu munthu amatha kumwa mankhwala. Kawirikawiri, zingakhale zovuta kupereka odwala encephalopathic benzodiazepine monga Ativan (lorazepam), chifukwa mankhwalawa amachepetsa ubongo. Kwa wodwala yemwe saganizira bwino, benzodiazepines angapangitse vutoli kukhala loipitsitsa.
Kugonjetsa, kumbali inayo, kumayambitsidwa ndi ntchito yolakwika kwambiri ya ubongo. Pazochitikazi, mankhwala odana ndi khunyu, monga benzodiazepine, angathandize kwenikweni wodwalayo kuti adziŵe pambuyo pake pamene matenda a khunyu asokonezeka.
Kusanthula kwa Kusagwirizana ndi Matenda Odwala Matenda a Epilepticus
Inde, kuti mupewe matenda osokoneza bongo, muyenera kudziwa choyamba kuti wodwala akugwira. Kwachidziwikire, matenda osagwidwa ndi matendawa amatha kusinthidwa, kutanthauza kuti odwala ambiri samatengedwa. Chifukwa chimodzi ndi chakuti NCSE ndi chodabwitsa chomwe chatchulidwa posachedwa, ndipo ndi chikhalidwe chake, sizowonekera kwambiri ngati chifuwa cha matenda a khunyu.
Chifukwa china cha matenda a underseagnosis a NCSE ndi chakuti akhoza kuwonekera m'njira zosiyanasiyana, zomwe zambiri zimayambitsidwa ndi chinthu chofala kwambiri. Mwachitsanzo, pafupifupi theka la odwala kuchipatala akuvutika ndi delirium , zomwe zingafanane ndi NCSE koma zimakhala zofala kwambiri.
M'zinthu zina zazikulu zophunzirira za ubongo, zizoloŵezi zofala zogwirizana ndi EEG zimatsogolera odwala onse a ICU. Komabe, muzipatala zambiri, dokotala amafunika kusamala mosamala kuti wodwalayo amayenera kuyang'anitsitsa pafupi ndi EEG.
Kuchiza kwa Matenda Osakanikirana ndi Epilepticus
Momwe mungagwiritsire ntchito chithandizo cha NCSE ndi dera losandulika la mankhwala. Njira yabwino imasiyanasiyana ndi msinkhu wodwala, matenda ena, ndi zina za kugwidwa. Mwachitsanzo, nthawi zina NCSE ikutsatira khunyu. Pazochitikazi, pali ngozi yeniyeni kwa NCSE, ndi chithandizo chamwano mu chipatala chachikulu (ICU) akuyitanidwa.
Komabe, nthawi zina pamene NCSE sichikugwedezeka, zikhoza kukhala bwino kwa odwala kuti asakhale ndi ICU, makamaka ngati odwala ali okalamba. Izi zikhoza kukhala chifukwa mankhwala osokoneza bongo amakhalanso ndi zotsatira, komanso chifukwa cha zoopsa zowonjezera ku ICU.
Ukalamba umakhudzidwanso mukamachitira NCSE ali wamng'ono kwambiri, chifukwa zomwe zimayambitsa kugwidwa ndizosiyana kwambiri ndi okalamba. Nthawi zambiri ana amadwala chifukwa cha matenda, pamene okalamba amatha kugwidwa chifukwa cha vuto lomwe amapeza, monga matenda a stroke.
Zikakhala kuti matenda a khunyu amatsatana ndi mavuto ena azachipatala, imodzi mwa miyala yamakona ya mankhwala ndiyo kuthana ndi mavuto. Kugonjetsedwa kumawonjezereka kwambiri pamene thupi liri loyenerera ndi matenda kapena mavuto ena azachipatala. Mwachitsanzo, ngati wodwala ali ndi vuto lalikulu la impso ndi chiwindi, kuwonjezera tizilombo toyambitsa matenda kungachititse kuti vutoli likhale loipa kwambiri. Monga momwe zilili, mankhwala a NCSE ayenera kulumikizana ndi zosowa za wodwala aliyense payekha.
Zotsatira:
J Claassen, Mayer SA, Kowalski RG, Emerson RG, Hirsch LJ. Kuzindikira kwa kugwidwa kwa electrographic ndi odwala omwe akudwala kwambiri. Neurology. 2004 May 25; 62 (10): 1743-8.
Frank W. Drislane, MD1 Chiwonetsero, Kufufuza, ndi Chithandizo cha Kusagwirizana Kwambiri ndi Epilepticus Khunyu ndi Khalidwe 1, 301-314 (2000)
Simon Shorvon Ndi chiyani chomwe chiribe vuto la khunyu, ndipo ndi chiyani? Epilepsia, 48 (Suppl 8): 35-38, 2007
Litt B, Wityk RJ, Hertz SH, Mullen PD, Weiss H, Ryan DD, Henry TR. Epilepsia. Osagwidwa ndi matenda a khunyu kwa okalamba odwala kwambiri. 1998 Nov; 39 (11): 1194-202.