Uhlobo olungavamile lwe-MS olungathatha isikhathi eside ukuxilonga
Ukuxilongwa kwe-primary swelling multiple sclerosis (PPMS) kunezinselele ezikhethekile, njengoba abantu abane-PPMS behlehliswa kancane kancane emsebenzini ngaphezu kwezinyanga ukuya eminyakeni. Lokhu kuqhathaniswa nokubuyiswa kabusha kwe-MS, lapho umuntu angase alulame umsebenzi wezinzwa ngemuva kokubuyela emuva.
Ukungafani phakathi kwalezi zinhlobo ezimbili ze-MS kunokwenza okungafani ne-biology ehlukile ngemva kwabo.
Ucwaningo lubonisa ukuthi ukubuyiswa kabusha kwe-MS kuyindlela yokuvuvukala (isimiso sokuzivikela emzimbeni esihlasela ama-fibre nervous) kanti i-MS eyinhloko eqhubekayo iyinkqubo eguquguqukayo kakhulu, lapho izintambo ze-nerve zinciphisa khona kancane. Kungani umuntu oyedwa ekhula i-PPMS ngokuphambene nokubuyiselwa kabusha kwe-MS akucaci, kodwa ochwepheshe bakholelwa ukuthi izakhi zofuzo zingadlala indima, nakuba ubufakazi bezesayensi buyikhipha lokhu.
Ukuxilongwa kwe-Primary Primary Pro MS
I-Definite PPMS ingatholakala uma izimo ezilandelayo zifinyelelwa:
- Umuntu okungenani unyaka owodwa wokuthuthukiswa komtholampilo (okusho ukuwohloka kwezimpawu zakhe ze- MS ).
- Okungenani kokubili kokulandelayo:
- I- MRI lesion yengqondo ejwayelekile ye-MS
- Izilonda ezimbili noma ngaphezulu ku-intambo yomgogodla
- Ukukhishwa kwesibindi, okusho ukuthi kukhona ubufakazi bezinhlobo ze-oligoclonal noma i-IgG ephakeme ye-anti-level level (lawa amaprotheni abonisa ukuvuvukala okwenzeka emzimbeni)
Iningi labantu abane-PPMS liqala ngesibonakaliso sokuthi kube nzima ukuhamba kancane kancane ngokuhamba, okubizwa ngokuthi "i-paraparesis epastic eqhubekayo."
Kodwa-ke, abanye abantu banezinto ezibizwa ngokuthi "i-cerebellar syndrome," ebonakala nge- ataxia enzima nezinkinga ngokulinganisela. Kungakhathaliseki ukuthi yiziphi izinhlobo zezimpawu, kufanele kuboniswe ukuthi ukuqhubekela phambili kuye kwaqhubeka isikhathi esingaphezu konyaka, kungabuyiselwa emuva, ukuthola i-PPMS.
I-MRI ekutholeni i-PPMS
Ukuxilongwa kwe-multiple sclerosis kudinga ukusabalalisa (ukukhuphuka) kwezimpawu nezilonda emkhathini nesikhathi. "Ukusabalalisa ngesikhathi" kunakekelwa yizimpawu eziqhubekayo okungenani ngonyaka owodwa (njengoba kucatshangwe ngenhla). Izilinganiso ze-MRI zisetshenziselwa ukunquma "ukusakazwa kwezilonda emkhathini."
Lokhu kusho ukuthi ukusebenzisa i-MRI ukuhlola ukuthi i-PPMS inezinselele zayo. Enye inselele enkulu ukuthi imiphumela ye-MRI scan ye-brains yabantu abane-PPMS ingase ibe "engacabangi" kuneyabantu abane-RRMS, enezilonda ezincane kakhulu zokugadolinium (ezisebenzayo) .
Noma kunjalo, i-MRI yomgogodla wabantu abane-PPMS izobonisa ngokujwayelekile i- atrophy . Njengoba umgogodla uthinteka kakhulu ku-PPMS, abantu bavame ukuba nezinkinga ngokuhamba, kanye nesisindo somzimba nesibindi.
I-Lumbar Ukuvala Isikhathi Ekuboneni i-PPMS
Okunye okubhekwa njengompompo womgogodla, i-punctures lumbar ingaba usizo kakhulu ekwenzeni ukuxilongwa kwe-PPMS nokulawula ezinye izimo.
Ukuthola okubili kubalulekile ekuqinisekiseni ukuxilongwa kwe-PPMS:
- Ubukhona bama-Oligoclonal Bands: Lokhu kusho ukuthi "amaqembu" ezinamaprotheni athile (ama-immunoglobulins) aboniswa lapho i-spinal fluid ihlaziywa. Ubufakazi bezinhlaka ze-oligoclonal kwi-CSF zingabonakala ezingaphezu kwamaphesenti angu-90 abantu abane-MS kepha zingatholakala kwezinye izifo, futhi.
- I-Intrathecal IgG Antibody Production: Lokhu kusho ukuthi i-IgG ikhiqizwa ngaphakathi kwendawo yomgogodla-lokhu kuyisibonakaliso sokuthi kunempendulo yesistimu yomzimba.
I-VEP Yokusiza Ukuqinisekisa Ukuxilongwa kwe-PPMS
Ukubukwa okubonakalayo okuvezwayo kuyisivivinyo esibandakanya ukugqoka ama-EEG (electroencephalogram) izinzwa esibukweni ngenkathi ubukela iphethini elimnyama nomhlophe elibukeka esikrinini. Izindlela ze-EEG zanciphisa izimpendulo ezenzakalweni ezibukwayo, ezibonisa ukungasebenzi komqondo. I-VEPs nayo isize ekuqiniseni ukuxilongwa kwe-PPMS, ikakhulukazi uma ezinye izinqubo zingagcwaliseki ngokuqondile.
I-MS-Progressive-Relapsing MS
Kubalulekile ukuphawula ukuthi abanye abantu abaqala ukuxilongwa nge-PPMS bangase baphinde baphinde baphinde baxilongwe.
Lapho lokho kuqala kwenzeka, ukuxilongwa kwalowo muntu kuguqulwa kube yi-MS eqhubekayo-ephindaphindiwe (i-PRMS). Kodwa-ke, wonke umuntu onenqubomgomo ye-PRMS uqala ngokuxilongwa kwe-PPMS. I-MS ehamba phambili-i-MS iyindlela ehlukumezayo ye-MS, ne-5% kuphela yabantu abane-MS abathintekile.
Izwi elivela
Ekugcineni, izifo eziningi ze-neurological zilinganisa i-MS , umthwalo omkhulu wokuhlola noma yiluphi uhlobo lwe-MS luqeda ukuthi kungenzeka ukuthi kungenye into. Ezinye izifo ezidingeke zikhishwe ngaphandle zihlanganisa: Ukuntuleka kweVithamini B12, isifo se-Lyme, ukucindezela komgogodla, ukucindezela kwe-neurosyphilis noma isifo se-neuron, ukubiza amagama ambalwa nje.
Yingakho kubalulekile ukubona udokotela ukuthola ukuxilongwa okufanele uma uhlangabezana nezimpawu zezinzwa. Ngenkathi inqubo yokuxilongwa ingase ibe yinkimbinkimbi, qhubeka ubekezela futhi usebenza kahle ekunakekelweni kwezempilo.
> Imithombo:
> Coyle, Patricia K. noHaper, ngoJuni. Ukuphila ne-Progressive Multiple Sclerosis: Ukunqoba Izinselele (2 ku-ed.). I-New York: I-Demos Publishing. 2008.
> I-Cree BA. I-genetics ye-primary progressive multiple sclerosis. I-Handb Clin Neurol. 2014; 122: 211-30.
> National MS Society. Ukuthola i-PPMS.