Ukuphatha Izimpawu Ze-Amyotrophic Lateral Sclerosis

by UPeter Pressman, MD; Kubukezwe nguClaudia Chaves, MD

Thuthukisa izinga lokuphila

I-Amyotrophic lateral sclerosis (ALS) isifo esilimazayo kakhulu. Njengoba abantu abane-ALS bebuthakathaka, izinguquko eziningi ezingathí sina, ezisongela ukuphila ezidinga ukubhekana neqembu labachwepheshe bezokwelapha. Ngaphezu kwalokho, kunezinguquko ezingezisongela ukuphila, kepha noma kunjalo, zinomthelela ekuphileni kwansuku zonke kwalabo abane-ALS. Ukukhuluma ngalezi zingxenye ze-ALS kungasiza ekuthuthukiseni ikhwalithi yokuphila kulabo ababhekene nalesi sifo esibulalayo sezinzwa.

Ubuhlungu nokugubha

Ngokubangela i-neurons uphondo lwangaphakathi lomgogodla ukuze lube lukhulu, i-ALS ihlukanisa izibonakaliso ezithunyelwe kusuka ebuchosheni ziya emisipha. Ngaphezu kokubuthakathaka, imisipha ingase izwe inzwa yokucindezeleka. Ngaphezu kwalokho, abantu abane-ALS bangase babe buthakathaka kakhulu ukuze benze izinguquko ezincane ezingenakulinganiswa esimweni abantu abaningi abazenza njalo ukuze bahlale bekhululekile, okungabangela ukunganaki okukhulu nobuhlungu.

Akucaci ukuthi kungcono kanjani ukukhulula ukungahambi kahle okungahlanganiswa ne-ALS. Ucwaningo lubonise ukuthi ukuzivocavoca kunenzuzo ethile. Ukwelula okulula kanye nokwelapha ngokomzimba kungasiza ekunciphiseni ukuphazamiseka okuhambisana nalesi sifo. Eminye imithi eye yaboniswa ukusiza ifaka i-baclofen, i-dantrolene, ne-tizanidine yama- spasms we- muscle . Ubuhlungu obuhlobene ne-ALS bungaphathwa ngemithi efanayo ejwayelekile esetshenziselwa ukuphatha kabi, njenge-ibuprofen noma i-acetaminophen, njengoba iqondiswa udokotela.

Njengoba lesi sifo siphuthuka, imithi enamandla e-opiate ingase idingeke kodwa kufanele isetshenziswe ngokuqapha ngenxa yobungozi bokucindezeleka ukuphefumula, ikakhulukazi kumuntu osevele elele amandla ngenxa yokugula kwakhe.

Ukuqonda

I-Amyotrophic lateral sclerosis ngezinye izikhathi ihlangana nomqondo wokushada komqondo . Amaphesenti angu-41 kuya kwangu-41 wezilwane ze-ALS anezinguquko ezingqondweni, kuye ngokuthi lezi zinguquko zivivinywa kanjani.

Uhlobo oluvame kakhulu lwe-dementia oluhambisana ne-ALS yi- dementia ye-frontotemporal , nezinguquko zomuntu nokulawulwa okuncane kokucindezela. Kukhona ukuvumelana okuncane mayelana nokuthi lezi zidakamizwa zingase ziphathwe kahle kanjani, kodwa ngokuqinisekile akulona ukwelashwa okulula. Ngezinye izikhathi, ukubonakala komqondo komqondo kungase kubangelwe ukulala ngokwanele noma ukucindezeleka, ngakho-ke kubalulekile ukuqinisekisa ukuthi lezi zici ziyaphathwa. Ngaphandle kwalokho, ukuphathwa kwale dementias kuncike ekusebenzeni neqembu elingabandakanya isisebenzi sezenhlalakahle, isazi sezinzwa zegazi kanye nesifo sengqondo sokuphatha ukuziphatha kwesiguli. Njengoba njalo, ukuhlela phambili kuyisihluthulelo.

Imodi

Ngayo yonke inguquko engalungile efika ngokuxilongwa kwe-ALS, ukucindezeleka nokukhathazeka kufanele kulindeleke. Okumangalisa ukuthi le mizwa ivame ukungavamile phakathi kwalabo abane-ALS kunezinye izifo, njenge- epilepsy . Uma le mizwa ikhona, ilawulwa kangcono ngenhlanganisela yokweluleka, ukwelapha, kanye nemithi, njengezidakamizwa zokucindezeleka.

I-ALS ingabangela ezinye izinguquko ezilingisa ukucindezeleka nokukhathazeka. Isibonelo, lokho okungase kube nomuzwa wokuthi ukucindezeleka kungaba empeleni ukukhathala ngenxa yomzamo we-muscular nokulala okuncane. Ngaphezu kwalokho, ngenxa yezinguquko zezinzwa ze-ALS, iziguli zingase zithinteke nge-pseudobulbar zithinteka, futhi ziyaziwa ngokuthi yi-IEED yokuziphendulela ngokomzwelo ngokomzwelo, noma i-IEED.

Lokhu kusho ukuthi imizwelo yabo ayizinzile, futhi bangase bazithole behleka noma bekhala ezimweni ezingafanelekile. Inhlanganisela ye-dextromethorphan ne-quinidine iboniswe ukuthi iyasebenza ekusizeni lesi siginci.

Ukulala

Ukungaboni ku-ALS kungalimaza ukukhathala, imizwa, nokuhlushwa. E-ALS, ikhono elinciphile lokuwa noma ukulala lingabangela ukukhubazeka kokuqala kokuphefumula, ukukhathazeka, ukucindezeleka noma ubuhlungu. Indlela engcono kakhulu ukuzama ukuphatha inkinga engaphansi. Isibonelo, ukwelapha okwanele kokuphefumula kuboniswe ukuthi kuvame ukuzuzisa iziguli ze-ALS ezihlupheka ngezinkinga zokulala.

Uma kunokwenzeka, imithi yokudambisa noma yokwehliswa kufanele igwenywe ngaphandle kokusetshenziswa kokugcina, ngoba lokhu kuvame ukunciphisa umshini wokuphefumula.

Ukuxhumana

Esinye sezici ezicindezelayo ze-ALS ukulahlekelwa ikhono lokuxhumana ngokujwayelekile. Njengoba imisipha yobuso ne-larynx iyancipha, izindlela ezintsha zokuxhumana kuzodingeka zihlolwe. Ngenhlanhla, kunezinhlobo eziningi zamadivaysi okukhulumisana ahlukene atholakalayo, kufaka phakathi amabhodi alfabhethi, izinhlelo zekhompyutha, ikhodi ye-Morse, ukusetshenziswa kwe-sphincter yesilwane, nokunyakaza kwamehlo we-infrared, kuye ngezinga lesidingo somuntu. Ukusebenza nodokotela wezinkulumo kungaqinisekisa ukuthi ikhono lokukhulumisana lihlala lingaguquki isikhathi eside ngangokunokwenzeka.

Ukusebenzisa Ukunakekelwa Kwe-Palliative ye-ALS

Ochwepheshe ekunakekelweni ngokucophelela ngokukhethekile ukugcina iziguli zikhululekile. Lokhu akuyona into efanayo ne- hospice , okuyindlela yokunakekelwa kokunakekelwa okulondolozwe iziguli ezinyangeni eziyisithupha zokugcina zokuphila. Njengoba izimpawu ze-ALS zithuthuka, abantu abaningi bayazuza ngokusebenza nongcweti ekunakekelweni ngokucophelela nase-hospice ukuqinisekisa ukuthi induduzo nesithunzi sabo kugcinwa ngendlela efanele.

Ukubaluleka kokuHlelwa okuPhambili

Ingxenye yokunethezeka namhlanje ukwazi ukuthi uhlelo lukhona kusasa. I-ALS yisifo esibulalayo , ngokuvamile esiholela ekufeni eminyakeni emihlanu. Ngesikhathi abanye abantu abane-ALS bephila isikhathi eside, kubalulekile ukuhlela phambili. Ngaphezu kwalokho, ukulahlekelwa okungenakugwema kwezinqubo ezijwayelekile zokuxhumana kwenza izinhlelo ezicacile zokunakekelwa kwezempilo esikhathini esizayo kubaluleke kakhulu. Ngokuqondile ukuthi yiziphi izinhlobo zokwelapha ezizofisa ngaphansi kwezimo ezithile, ezifana nokukhubazeka okuphelele kanye nomqondo ongase ube nokuwohloka komqondo , kudingeka ukuthi ucatshangelwe futhi uxoxe ngazo. Lezi izinqumo zomuntu siqu, futhi kubalulekile ukuthi izifiso zakho zihlonishwe. Ukuhlelwa ngenhloso yokuphila noma kummeli kungasiza ukuqinisekisa ukuthi izifiso zakho ziyahlonishwa.

I-ALS Resources kanye Nokusekela

Uma usanda kutholakala ukuthi unesifo se-ALS noma esinye isifo se-neuron, awuyedwa. Abanye baye bahlangabezana nakho okuhlangenwe nakho, futhi kunezincwadi eziningi nezinye izinsiza ezitholakalayo kuwe. Ukusebenza emtholampilo we-neurological multi-disciplinary mhlawumbe kungcono kakhulu ekuthuthukiseni ikhwalithi yokuphila nokuthuthukisa ukulethwa kwezempilo. Uzodinga usizo oluvela kubangani, emndenini, kanye nabanakekeli abanakekele njengoba isimo sakho siqhubeka. Unganqikazi ukufinyelela kulabo abafuna ukukusekela.

_Imithombo:

_{RG Miller, MD, FAAN, CE Jackson, MD, FAAN, EJ Kasarskis, MD, PhD, FAAN, JD England, MD, FAAN, D. Forshew, RN, et al.} _{Ukuzivocavoca Ukubuyekezwa kweParametha: Ukunakekelwa kwesiguli nge-amyotrophic lateral sclerosis: Imishanguzo, imithi, kanye nokuphefumula (ukubuyekezwa okusekelwe ebufakazini).} _{Umbiko weKomidi Eliphansi Lezilinganiso Ze-American Academy of Neurology, Neurology, Okthoba 13, 2009 vol.} _{73 cha.} _{15 1218-1226}

_{RG Miller, MD, FAAN, CE Jackson, MD, FAAN, EJ Kasarskis, MD, PhD, FAAN, JD England, MD, FAAN, D. Forshew, RN, et al.} _{Ukuzivocavoca Ukubuyekezwa kweParametha: Ukunakekelwa kwesiguli nge-amyotrophic lateral sclerosis: Ukunakekelwa kweminyango eminingi, ukuphathwa kwezimpawu, nokukhubazeka kwengqondo / ukuziphatha (ukubuyekezwa okusekelwe ebufakazini).} _{Umbiko weKomidi Eliphansi Lezilinganiso Ze-American Academy of Neurology, Neurology Ngo-Okthoba 13, 2009 vol.} _{73 cha.} _{15 1227-1233}