Ukukhubazeka kwesifo sofuba yisimo esivela ngesikhathi sokuzalwa noma ngemva nje kokuzalwa. Esinye sezici eziyinhloko ekuxilongweni ukuthi izingane azifinyeleli emathunjini okuthuthukiswa, kanti, ngezinye izimo zezinzwa, izingane zifinyelela ezinyathelweni futhi ziyehla ngokuhamba kwesikhathi.
Ukuxilongwa kwe-cerebral palsy kudinga inqubo eqaphele neyinkimbinkimbi exhomeke kakhulu ekubukeni nasekuhlolweni komtholampilo.
Uma usola ukuxilongwa, ukuqonda inqubo kungasiza ekunciphiseni ukukhathazeka.
Ukuzihlola
Izingane ezine-cerebral palsy zingabonisa izimpawu ezihlukahlukene eziphambili ekutholeni isimo. Izimpawu zihlanganisa ubunzima bomzimba obusweni, izingalo, izandla, imilenze noma i-trunk, ukunyakaza okunamandla noma okunamandla noma imisipha ye-floppy, inkulumo evulekile futhi enzima ukuyiqonda, izinkinga zokuhlafuna nokugwinya, nokulahlekelwa kwengqondo.
Njengomzali noma umnakekeli, ukuqaphela lezi zimpawu kungase kube ukucindezeleka nokuphathelene. Ukuze uqiniseke ukuthi zibhekiswe ngokufanele, kungase kube usizo ukufaka imininingwane ethile mayelana nokuzikhandla kwesikhathi, imisebenzi ngaphambi / ngemuva, nokuningi kungasiza kudokotela ngesikhathi sokuxhumana kwakho.
Ama-Labs nezivivinyo
Kunezivivinyo eziningana ezisekelayo futhi ziqinisekisa ukuxilongwa kwe-cerebral palsy, okubaluleke kakhulu kuwo umlando womtholampilo nokuhlolwa komzimba.
Umlando Wemitholampilo kanye Nokuhlolwa Kwemvelo.
Umlando womtholampilo ungabonisa imicimbi efana nokulimala okubuhlungu, ukugula kwezingane kanye nezifo ezifana nokugaya ukudla, ukuphefumula nenhliziyo okungabangela izimpawu ezibonakala zifana ne-cerebral palsy, ikakhulukazi ezinsaneni ezincane kakhulu.
Ukuhlaziywa kwamakhono wengane ngokusebenzisa ukuhlolwa okuningiliziwe kwezinzwa kuphakathi kwamaphesenti angama-90 kuya kwangu-98 ekutholeni ukukhubazeka kwesifo sofuba.
Ezinye izindlela ezimbalwa zokuhlola amakhono wengane zibandakanya ukuhlolwa kwe-Prechtl okufanelekile kokuHlola Okujwayelekile kanye nokuhlolwa kwezingane ezincane ze-Hammersmith Neurological, kokubili okuhlolisisa nokwenza amaphuzu omzimba nokuqonda kwengane ngokulinganisela.
Izivivinyo zegazi
Ukuhlolwa kwegazi akulindelekile ukukhombisa okungavamile kokukhubazeka kwengqondo. Ama-syndromes ezinama-metabolic ezibonakaliswa izimpawu ezifana ne-cerebral palsy kulindeleke ukuthi zibonise ukungahlolelwa kwegazi okungavamile, okungasiza ekuhlukaniseni izimo. Ukuhlolwa kwegazi kungacatshangwa uma ingane enezimpawu zokukhubazeka kwe-cerebral palsy inezimpawu zokugula, ukwehluleka komzimba noma ukutheleleka.
Izivivinyo Zomzimba
Izivivinyo ze-Genetic zingasiza ekuboneni ukungalingani kwezakhi zofuzo ezihlobene nokukhubazeka kwesibindi. I-cerebral palsy ngokuvamile ayihlotshaniswa nokukhubazeka kofuzo okuqinisekisiwe, futhi inani elikhulu lokuhlolwa kwezakhi zofuzo likhona lapho kutholakala khona ezinye izimo ezisemtholampilo efana ne-cerebral palsy futhi eziye zaziwa amaphethini ezakhi zofuzo.
Akuwona wonke umuntu ovulekile ukuba nokuhlolwa kofuzo. Uma unenkinga, khuluma nodokotela wakho. Futhi, xoxisana nomlingani wakho-ukuhlela lokho okufanele ukwenze lapho imiphumela isilungile kungakusiza kokubili ukubhekana nokuxhasana kangcono.
I-Electroencephalogram EEG
Ezinye izingane ezine-cerebral palsy ziye zahlupha. Ezinye izinhlobo zesithuthwane ezingathintwa ne-cerebral palsy zingathinta kakhulu ekuthuthukiseni izingane. Kulezi zinhlobo zokuhlukunyezwa kwe-seizure, ukuqonda kungase kuphazamiseke ngendlela emtholampilo efana nokulahlekelwa kwengqondo okubonwe ekukhubazekeni kwe-cerebral, kanti i-EEG ingasiza ekutholeni ukuhlukumeza okungaqondakali (okungacacile).
Izifundo Zokuqhuba Izinzwa (NCV) ne-Electromyography (EMG)
Ezinye izifo ze-muscle nezimpumputhe zingabangela ubuthakathaka obuqala ngesikhathi esencane kakhulu. Ukukhubazeka kwemisipha ne-muscle akuyona into efana ne-cerebral palsy, ngakho-ke amaphethini angavamile kulezi zivivinyo angasiza ekulawuleni kwezinye izimo futhi akhiphe ukukhubazeka kwesifo se-cerebral.
Ukucabanga
Ukucabanga nge-Brain ngokuvamile akuqinisekisi ukukhubazeka kwe-cerebral ngokwayo, kodwa kungabona enye yezinye izimo ezingase ziveze izimpawu ezifana ne-cerebral palsy.
I-Brain CT
Ukuhlolwa kwengane ye- CT nge-cerebral palsy ingase ibe yinto evamile noma ingabonisa ubufakazi bokushaywa komzimba, noma ukukhubazeka okungokwemvelo. Amaphethini okuphakamisa ukuthi izimpawu zezingane akuzona ukukhubazeka kwe-cerebral kuhlanganisa ukutheleleka, ukuphuka, ukuphuma, isisu noma i- hydrocephalus .
I-Brain MRI
I- MRI yobuchopho isifundo esicacile sokucabangela kobuchopho kunesisindo se-CT. Ukuba khona kwezinhlobo ezithile zezinkinga, kanye nokungajwayelekile okusikisela ukulimala kwe-ischemic ngaphambili (ukuntuleka kokugeleza kwegazi) kuya emhlophe noma ephuzi indaba yobuchopho, kungase kusekele ukuxilongwa kwe-cerebral palsy. Ubufakazi bokuvuvukala okusebenzayo kungabhekisela kwezinye izimo ezifana ne-cerebral adrenoleukodystrophy.
Kuzo zombili lezi zivivinyo ze-imaging, ingane (nomnakekeli) ingase izwe ingesabi. Buza ukuthi kukhona yini engayenza ukuze kusize ukunciphisa okuhlangenwe nakho kwemisebenzi yengane, ukuba nomunye umuntu oseduzane, noma ukusebenzisa ulimi oluthile lwezingane ezinobungane kungase kube yinto ongayinikeza udokotela.
Ukuhlonza okuhlukile
Ukwelashwa, ukuphathwa, nokuchazwa kwe-cerebral palsy kuyahluka kunezinye izimo ezifanayo, futhi lokhu kungenye yezizathu zokuthi ukuxilongwa okunembile kubaluleke kakhulu. Ezinye zalezi zimo zihlobene nengozi ecacile yokufa, ngakho-ke ukuhlonza isimo esimweni esisodwa kwengane kungasiza abazali ukuba baqaphele futhi baphathe ukwelashwa kwezingane zabo, ngaphezu kokunikeza ulwazi emndenini wonke ongasiza ekuhlelweni kokuzala .
I-Shaken Baby Syndrome
Isimo esabangelwa yi-baby-syndrome esithukuthele ngokuphindaphindiwe-singasithinta izingane ezincane zonyaka wonke, futhi zivame kakhulu ezinganeni ezindala kunamazinsana. I-shaken baby syndrome ibonakala yi-skull fractures, i-hemorrhage (ukuphuma kwegazi) ebuchosheni, futhi ngokuvamile ihlukumeza kwezinye izindawo zomzimba.
Kuncike ekutheni i-trauma iqala, ukuzamazama kwe-baby syndrome kungaholela ekulahlekelweni kwamakhono okuqonda okuseqalile ukuvela, kuyilapho ukukhubazeka kwengqondo kubonakala ngokungabi namakhono akhulayo.
I-Rett Syndrome
Isimo esingavamile esithinta amantombazane, i-Rett syndrome ingabangela ukungabi nokulawulwa kwezimoto nokulahlekelwa kwengqondo. Umehluko omkhulu phakathi kwezimo wukuthi izingane ezine-Rett syndrome zikhula ngokujwayelekile ezinyangeni ezingu-6 kuya kwezingu-12, bese zibonisa ukuncipha komsebenzi, kuyilapho izingane ezine-cerebral palsy zingakutholi izinyathelo zokuthuthukiswa.
I-Autism Spectrum Disorder
Isiyaluyalu esinkimbinkimbi esinamabonakaliso angabonakalisa njengokwehluleka kokuqonda nokuziphatha, ezinye izingane ku-autism spectrum zingabonisa ukulahlekelwa kwezimoto noma izinkulumo ngezimpawu ezingahle ziphuthelwe ukukhubazeka kwesibindi noma enye indlela.
Ama-Syndromes Ametabolic
Izimo eziphazamisa umzimba noma ukukhiqizwa kwamaprotheni ezifana ne-Tay Sacks isifo, i- Noonan Syndrome , i-Lesch-Nyan syndrome, ne- Neimann-Pick isifo sonke singaba nezici zobuthakathaka bomzimba kanye nokulahlekelwa kwengqondo okungase kube iphutha ngenxa yokukhubazeka kwesifo sofuba kanye nokuphefumula komzimba phosa ngalezi zimo.
Ngaphezu kokunye okuphawulekayo okuphawulekayo, uphawu lwe-metabolic syndromes luvame ukubonisa ukungavamile kokuhlolwa kwegazi okukhethekile, okungasiza ekuhlukaniseni nomunye nomunye kusukela ekuphelelweni kwe-cerebral palsy.
Encephalitis
I-encephalitis, okuwukuvuvukala kobuchopho, ingabangela izimpawu ezijulile ezivela ekugubheni ukukhubazeka ukungaphenduli. Kunezinhlobo ezimbili eziyinhloko ze-encephalitis, ezithathelwanayo nokuvuvukala.
- Izifo ezithathelwanayo: I-encephalitis esithathelwanayo igxila ngokushesha, futhi njengobufakazi bokutheleleka nokuvuvukala ekuhlolweni kwegazi, ebuchosheni be-CT, ebuchosheni be-MRI noma e-lumbar fluid.
- Ukuvuvukala: I- encephalitis yokuvuvukala ingaba yingozi ngaphandle kokuntuleka kwesibindi esithathelwanayo. Kungenzeka kube nemfiva ehambisanayo futhi ngokuvamile kuvame ukuhlolwa kwegazi, ubuchopho be-CT, ubuchopho be-MRI kanye ne-lumbar fluid bubonisa ubufakazi bokuvuvukala.
I-Atrophy yama-spinal muscular
Isifo esingaqala ngesikhathi sokusana, ebuntwaneni, noma somuntu omdala, uhlobo lwe-atrophy yomgogodla oluqala emsana lungaba yingozi, kubangele ukukhubazeka noma eduze nokukhubazeka. Ukunqongophala kwezimoto zokuqala kokuqala komzimba we-spinal muscular atrophy, okuvame ukubhekwa ngokuthi yi-SMA hlobo 0, kunzima kakhulu kunokwesikhumba sokuphefumula. Ukugula kulindeleke ukuthi kuqhubekele phambili ngokushesha ekupheleni kokulimala, okungafani nokukhubazeka kwengqondo.
I-Cerebral Adrenoleukodystrophy
Isifo esingavamile esichazwe ngokulahlekelwa okubonakalayo nokuncipha kwengqondo, i-cerebral adrenoleukodystrophy ithinta kakhulu abafana. Ukuhlukana okubalulekile phakathi kwe-adrenoleukodystrophy kanye ne-cerebral palsy ukuthi izingane ezine-cerebral adrenoleukodystrophy zinomqondo omhlophe okungeyona engavamile ebuchosheni babo be-MRI kanti isimo sibangela ukwehla kwemisebenzi yokuqonda nokusebenza, hhayi ukungabi namakhono okuthuthukiswa kwamakhono njenge-cerebral palsy.
Dystrophy yamaMuscular
Kunezinhlobo eziningana ze-dystrophy yama-muscular, konke ebonakala ngobuthakathaka nokuntuleka kwezwi lomzimba. Umehluko phakathi kwe-cerebral palsy kanye ne-muscular dystrophy yilokho i-muscular dystrophy ngokuvamile ayihlotshaniswa nokulahlekelwa kwengqondo, futhi ubuthakathaka obubuthakathaka be-muscular dystrophy bungabonakala ngokuthi bubangelwa isifo se-muscle ngokusebenzisa ukuhlolwa ngokomzimba kanye nezifundo ze-EMG / NCV.
> Umthombo:
> Novak I, Morgan C, Adde L, et al. Ukutholwa Kokuqala, Ukuqonda Ngokuqondile Nokungenelela Kwangaphambili Ekuphefumuleni Kwezibilini: Ukuthuthuka Ekuqaphelweni Nokunakekelwa. I-JAMA Pediatr. 2017; 171 (9): 897-907.