Ukubona ukubola kwesibindi (MS) kuyinkimbinkimbi futhi kuyinselele, ikakhulukazi ngoba izimpawu ze-MS zihlukile kumuntu ngamunye, futhi zingalingisa ezinye zezifo eziningi. Ngaphezu kwalokho, akukho ukuhlolwa kwegazi olulodwa, ukuhlolwa ngokomzimba ukuthola, noma ukuhlolwa kwesithombe sokuhlola i-MS.
Namuhla, izazi ze-neurologists zisebenzisa iMcdonald Criteria ukuze zihlolwe MS. Lesi setha semikhombandlela senziwa kabusha ngo-2010 ukufaka i-MRIs kwinqubo yokuxilongwa.
Izindaba ezinhle ngalokhu ukuthi abantu abane-MS manje bathola ukuthi baqala-lokhu kusho ukuthi abantu bangakwazi ukuqala ukwelashwa ekuqaleni futhi bangase bahlehlise isifo sabo.
Imigomo kaMcDonald for Ukuhlonza MS
I-McDonald Criteria igxile ekufikeni kwe- MS ebuyela emuva , eyaziwa nangokuthi ukuhlaselwa, ama-flares, ama-exacerbations, noma ama-bouts.
Ukuphindaphindiwe kwe-MS kubhekisela kokungajwayelekile kwesifo sengqondo noma ukungajwayelekile kwemvelo okubonwa ekuhloleni ngokomzimba. Lokhu okungavamile kwezinzwa kufanele kube okujwayelekile kwe-MS lesion ohlelweni lwezinzwa oluphakathi, okuyinto ebuchosheni, intambo yomgogodla kanye ne-optic nererve. Lokhu kuyinto engazi ukuthi izazi zakho zegazi zizokwazi.
Ngokwenqubo ye-McDonald, ukuze kutholakale ukuthi une-MS, kufanele kube nobufakazi bokuphindaphinda kwe-MS okwenzeke okungenani ezindaweni ezimbili ezihlukene zesistimu yenzwa yomphakathi. Ngaphezu kwalokho, lawa ma-MS abuyela emuva kumele ahlukaniswe isikhathi senyanga.
Ukuxilongwa kwe-MS kungenziwa emtholampilo, okusho ngokumane nje ngezibonakaliso zomuntu, noma ngabe ukuphindaphinda kwabo kwenzeka esikhathini esedlule-nakuba lokhu kungaba kuphela ukuphindaphinda okunye, okunye kufanele kube khona okwamanje. Futhi, enye yokubuyela kwawo kufanele iqinisekiswe noma ukuhlolwa kwegazi, ukubonakala okubonakalayo, noma i-MRI.
Ngaphandle kwalokho, ukuxilongwa kungenziwa ngokusebenzisa inhlanganisela yezibalo zomtholampilo nobufakazi be- MS lesion kwi-MRI. Ngisho noma umuntu ehlangabezana nezimiso zeMcDonald, izazi zezinzwa zizokwenza ezinye izivivinyo ezifana nomsebenzi wegazi, ukukhishwa kwe-lumbar, nokubonakala okubonakalayo okubonakalayo ukuqinisekisa ukuxilongwa nokulawula izifo ezingase zilingise i-MS .
Ngamanye amazwi, i-neurologist ifuna ukuqinisekisa ukuthi yenza isifo esifanelekile nokuthi ayikho incazelo ehlukile-inengqondo, akunjalo? Into yokugcina oyifunayo kufanele itholakale ene-MS uma ungenayo ngempela. Ngakho-ke i-neurologist ifuna ukuqinisekisa, futhi siyajabula ngalokho, ngisho noma kusho ukuhlolwa okuningi.
Izinto ezicutshangwayo kanye nezindlela ezisetshenziselwa ukuxilonga MS
Nakhu ukubuka okusheshayo amathuluzi udokotela wakho azowasebenzisa kokubili ukuxilongwa MS nokulawula okunye ukuxilongwa:
Umlando Wezokwelapha
Udokotela uzobuza imibuzo eningi mayelana nezimpawu ozitholayo njengamanje nanoma yikuphi okuhlangenwe nakho esikhathini esidlule. Kungumqondo omuhle ukwenza "ilogi yezimpawu" ngaphambi kokubona udokotela, ukubhala noma yiluphi uhlobo lwezimpawu ozenzile esikhathini esidlule, ukuthi luhlala isikhathi eside kangakanani, nolunye ulwazi mayelana nalo. Qinisekisa ukuthi uhlunga zonke izimpawu, noma ngabe odokotela basendulo bakutshele ukuthi akukho okungahambi kahle.
Ngaphezu kwalokho, thatha lonke ulwazi lwezokwelapha, kuhlanganise nokuthi yimiphi imithi kadokotela okhona, nanoma yimiphi imiphumela yokuhlolwa kwezokwelapha okungenzeka ukuthi wayenayo esikhathini esidlule.
Uzobuzwa futhi imibuzo eminingana mayelana nomlando wezokwelapha wezihlobo, ukusetshenziswa kwezidakamizwa nokusetshenziswa kotshwala, kanye nezinye izinkinga zangaphambi kwezempilo. Lonke lolu lwazi luzosiza isazi sezinzwa zezinhlangothi ndawonye isithombe ukuze kusize ukuthi ngabe i-MS iyatholakala yini.
Ukuhlolwa kwe-Neurological
Udokotela uzohlolwa lokhu okulandelayo:
- Ukusebenza kwezinzwa ze-cranial (lezi zilawula izinzwa, nokuthi ukhuluma kanjani futhi ugwinya)
- Ukulungiswa
- Amandla
- I-Reflexes
- Ukuzwela
Uzokwenza lokhu ngokukwenza imisebenzi (njengokuthinta ikhala lakho, umunwe wakhe ngokulandelana), ekuthinta ngezinsimbi ezihlukahlukene (futhi ubika umbiko noma ufune impendulo uqobo) futhi wenze ukuhlolwa kwamehlo akho. Qinisekisa ukuthi lezi zivivinyo azilimazi. Uhlolo lonke luzohlala luba nemaminithi angu-45 kodwa lungase luhlale isikhathi eside amahora amabili.
I-Magnetic Resonance Imaging (MRI) Skena
I-MRIs isebenzisa amagagasi amakhulu ukukhiqiza izithombe zobuchopho nomgogodla. Uma i-MS icatshangwa, umjovo okhethekile wokuhlukanisa (gadolinium) uvame ukukhipha ngesikhathi sokuskena, njengoba uphendula ezindaweni zokuvuvukala futhi "uzokhanya" uma isilonda sisebenza. Lokhu kubonisa ukuthi ukuxoshwa komzimba kubonakala manje noma phakathi kwamasonto ambalwa adlule.
I-MRI ayilimazi, kodwa kungaba yinto engavamile. Kuyasiza uma wazi ukuthi yini ongayilindela phakathi nalesi sivivinyo. Kukhona nezinye izinto ongayenza ukuze wenze isipiliyoni sakho sibe ngcono .
Njengoba kukhonjisiwe, lokhu kubhekwa njengesivivinyo esihle kakhulu sokuthola i-MS, njengoba izilonda ezingavamile zivela kuma-MRIs ezingaphezu kuka-95 amaphesenti abantu abane-MS. Kodwa-ke, amaphesenti angu-5 abantu abane-MS abanalo okungajwayelekile okungatholakala ku-MRI (ukukhiqiza okungalungile okungamanga), kanti umonakalo ohlobene neminyaka noma ezinye izimo, njenge-migraine noma ukuhlukunyezwa kwengqondo, kubonakala njengezilonda ze-MS (ukukhiqiza amanga positive).
I-Lumbar Ukuvala
Ebizwa nangokuthi iphepheni yomgogodla , lokhu kuhlolwa kudinga ukuthi inqwaba ye-cerebrospinal fluid (CSF) ithathwe kukholomu lomgogodla ngokusebenzisa inaliti efakwe phakathi kwe-vertebrae yakho. Udokotela uzothumela umkhuhlane ukuze ahlolwe, afune ukuba khona kwama-oligoclonal bands (inani elikhulayo lama-antibodies athile) - isibonakaliso sokwanda komzimba wamagciwane emgodini wamagogasi.
Lokhu kuvivinywa kunamaphesenti angaba ngu-90 kubantu abane-MS kodwa akucaci ku-MS, ngakho-ke umphumela omuhle ungabonisa esinye isifo noma isifo. Kuye ngemiphumela evela ku-MRI, ukuhlolwa kwegazi, nomlando wompawu, kungenzeka ukuthi akudingeki uthole ukukhishwa kwe-lumbar ukuze uthole ukuxilongwa okucacile kwe-MS (angizange ngikuthole). Kodwa-ke, imiphumela yokweqa i-lumbar ingasiza ekulawuleni ezinye izinto uma kusekhona umbuzo mayelana nokuxilongwa.
Ukuvivinya Okungavamile Okubonakalayo
Izinhlobo ezintathu eziyinhloko zokuhlolwa okungahle zikhishwe zisetshenziselwa ukuxilongwa kwe-MS. Ngayinye yalezi zivivinyo zidinga ukuthi ama-electrode anamathele esikhwameni sakho futhi axhunywe ku-electroencephalograph (EEG) ukurekhoda ama-brainwaves ekuphenduleni imibono ehlukene. Ukuhlolwa okuhlukile:
- I-Brainstem Auditory Evoked Potentials (BAEP): Uchungechunge lokuchofoza ludlalwa endlebeni ngayinye nge-headphones.
- Izithako ezivame ukubukeka (VEP): Uchungechunge lwamaphethini wokuhlola lukhonjiswa esikrinini.
- Amandla Okubamba Amandla (SEP): Ukwethuka kwamandla kagesi kunesandla noma umlenze.
Udokotela ubheka kokubili ubukhulu bempendulo kanye nesivinini lapho ubuchopho buthola khona isignali. Ama-weaker noma izimpawu eziphuthumayo zingase zibonise ukuthi ukudilizwa kwe-demyelination kwenzeka futhi ukuthi kungenzeka ukuthi i-MS. Noma kunjalo, lokhu kuhlolwa akukona okucacile ku-MS, okusho ukuthi ukungajwayelekile kungabonisa enye inkinga. Uchungechunge lwazo zonke izivivinyo ezintathu zingathatha amahora amabili ukuqedela.
Izivivinyo zegazi
Okwamanje akukho ukuhlolwa kwegazi ku-MS. Noma kunjalo, uchungechunge lwezivivinyo luzosebenza egazini lakho ukulawula ezinye izinto, ezifana nesifo seLyme , i-HIV, ezinye izifo ezingavamile zofuzo, neqembu lezifo ezibizwa ngokuthi izifo ze-collagen-vascular, njenge-lupus.
Izwi elivela
I-MS ingaba yisifo esiyinkinga sokuthola ukuhlolisisa ngokuqondile, futhi inqubo idinga ukubekezela. Ngalokho, kubalulekile ukuthola i-neurologist ukuthi uzizwa ukhululekile futhi unethemba lokusebenza osebenzayo ekuxilongweni kwakho. Ngempela, uma unayo i-MS, lo muntu cishe uzoba umngane wakho empilweni isikhathi eside.
Imithombo
I-National MS Society. Ukuthola i-MS.
I-Polman, CH, et al. (2011). I-diagnostic criteria ye-multiple sclerosis: ukubuyekezwa kuka-2010 kwemigomo kaMcDonald. Ama-Annal of Neurology , Feb; 69 (2): 292-302.