I-Dyskinesia uhlobo lwe-disorder disorder elibhekene neziqephu zokuzibandakanya zokuphikisana noma ukugubha umzimba. Ukunyakaza ngokuvamile kuhilela izingalo noma imilenze, kodwa kungabandakanya i-torso, ikhanda noma ubuso. Iziqephu zomuntu ngamunye zingase zihlale kumasekhondi ambalwa kuze kube ngu-15 imizuzu noma ngaphezulu futhi zixazulula ngokuzodwa zodwa. Ngokuhamba kwesikhathi, lezi ziqephu zivame ukwanda emvamisa futhi zibe nzima kakhulu.
Ukuphila Ne-Dyskinesia
Ama-Dyskinesias awaphazamisi ukuqonda, futhi azikho nganoma iyiphi indlela ehlotshaniswa nokuhlukunyezwa noma ukuxubana , nakuba kungase kuqala kubonakale kufana nalabo ababhekene nazo.
Uma uhlangabezana nama-dyskinesias, ungalindela ukuhlala uqaphile ngokugcwele futhi uqaphele ukunyakaza, futhi ngezinye izikhathi ungase ukwazi ukutshela ukuthi uzoqala ukuqala. Esikhathini esiningi, abantu abane-dyskinesia abanalo ukulawula noma ukulawula okuncane kakhulu ukunyakaza.
Kunezici eziningi ezinzima ze-dyskinesia ezithinta impilo yansuku zonke. Zijwayele ukubukeka futhi zingase zenze ukunakwa okungadingeki kwabanye. Lokhu kuhamba okungavunyelwe kungaba ukuphazanyiswa okuphazamisayo kuwe ngisho nalapho uwedwa. Ama-dyskinesias angakwenzeka kungazelelwe futhi angalindelekile, evimbela ikhono lakho lokulawula umzimba wakho ngendlela ofuna ngayo. Bangaphazamisa imisebenzi yakho kanye nokunyakaza kwakho okunenjongo. Ngezinye izikhathi, ama-dyskinesias angase angakhululekile ngokomzimba, futhi angaba nobuhlungu, nakuba lokho akuvamile.
Izimbangela zeDyskinesia
Kunezimbangela ezimbalwa ze-dyskinesia; lezi zihlanganisa ukushaywa yisifo sofuba, ukukhubazeka kwengqondo , i- multiple sclerosis , kanye nemithi yokwelapha. Isizathu esivame kakhulu se-dyskinesia sibizwa ngokuthi i-dyskinesia (i-IDID) ye-levodopa (IDID.) I-LID ichaza i-dyskinesias eyenzeka njengomthelela ohlangothini wemithi esetshenziselwa ukwelashwa kwezimpawu zika- Parkinson's disease .
Kungani i-Dyskinesia iqala njengomphumela weMithi yokwelapha kaParkinson
Isifo sikaParkinson yisifo sokunyakaza esitholakala ngokuphumula ukuqina kwesibindi nokuqina kwemisipha. Imithi esetshenziselwa isifo sikaParkinson ingenye yezimbangela ezizwakalayo ze-dyskinesia. Imithi esetshenziselwa ukulawula izimpawu zesifo sikaParkinson ibizwa ngokuthi imithi ye-dopaminergic. Njengoba le mithi ye-dopaminergic ikwandisa inani le-dopamine ebuchosheni, iyanciphisa ngokuphumelelayo izimpawu zesifo sikaParkinson.
I-Dyskinesia ayitholakali njengomphumela wamanani ambalwa kuphela wemithi ye-dopaminergic noma uma usebenzisa le mithi isikhathi esifushane. Ngenxa yokuthi isifo sikaPasinson sinesimo sompilo, abantu abanesifo banesidingo sokuthatha imithi ye-dopaminergic iminyaka. Emva kweminyaka eminingana yokuthatha le mithi, abantu abanesifo sikaParkinson bangase bahlakulele umphumela ovame ukulibala ohlangothini lwe-dyskinesia.
Kube nokuphenyisisa okukhulu ukuthi kungenzeka yini ukuvimbela ama-dyskinesias ekuthuthukiseni nokuthi ngabe ukuxoshwa kwezidakamizwa ze-dopaminergic kungabambezela noma kunciphise ukuthuthukiswa noma ubunzima be-dyskinesia. Kodwa abukho ubufakazi bokubonisa ukuthi ukuphuza imithi ye-dopaminergic kungavimbela lo mphumela ohlangothini kusukela ekugcineni ukuthuthukisa noma ukwenza kube nzima kakhulu ngokuhamba kwesikhathi.
Iningi labantu abanesifo sikaParkinson linikezwa izincazelo ezicacile mayelana nokukwazi ukuthuthukisa ukusebenza komphumela we-dyskinesia kusengaphambili kusengaphambili. Ngokuvamile, ngoba imishanguzo ye-dopaminergic iphumelela kakhulu ekunciphiseni izimpawu eziphawulekayo zesifo sikaParkinson, abantu abanesifo sikaParkinson bacabanga ukuthi izinga lokuphila liphuthumayo okufanele libhekele umphumela we-dyskinesia emgwaqeni.
Ukwelashwa Kwe-Dyskinesias
Ngokuvamile, uma uqala ukuzwa ama-dyskinesias ngemuva kweminyaka yokuthatha imithi kaParkinson, odokotela bakho bangase baphathe lo mphumela ohlangothini ngokulungisa imithi yakho .
Izinguquko zingase zihilele ukuthatha imithi yokwenza isikhathi eside noma ukuhlela isimiso sakho semithi nsuku zonke. Odokotela bakho banganezela imishanguzo ehlukahlukene emithamo ephansi esebenza ndawonye esikhundleni sokusebenzisa umthamo ophezulu, imithi yokwenza umphumela ohlangene. Lezi zinguquko ezilungiselelwe zingalinganisa isidingo sokunciphisa izimpawu zakho ze-Parkinson ngenkathi futhi unciphisa i-dyskinesia yakho.
Lezi zindlela zisebenza kwabanye abantu abane-LID, kodwa abasebenza kuwo wonke umuntu. Uma ukulungiswa kwemithi okwanele kungakalungi ukuhlehlisa ukulinganisela phakathi kokunciphisa izimpawu nokunciphisa imiphumela emibi, kunezindlela zokuhlinza ezinganciphisa ama-dyskinesias athuthuka ngokuthatha imithi ye-dopaminergic.
Ukukhushulwa Kwengqondo Ejulile (DBS) ye-Dyskinesia
I-DBS yindlela yokuhlinzwa esetshenziselwa ukulawula i-dyskinesia ephumela ekwelapheni kwesifo sikaParkinson. Le nqubo ihilela ukubeka isishusha kagesi esifundeni sobuchopho.
Kunezindawo ezimbalwa ezibhekwa njengendlela efanele yokubekwa kwedivayisi ye-DBS, futhi ukuhlolwa kokuqala kwangaphambi kokuhlinzwa kungasiza ukukhomba indawo ekahle esimweni sakho esithile. Lezi zindawo zihlanganisa i-globus pallidus internus kanye ne-nucleus ye-subthalamic, zombili zazo ziyizifunda ezincane ezikude ebuchosheni.
Amadivaysi e-DBS afaka ama-electrode, afakwe kunoma iyiphi eyodwa noma zombili izinhlangothi ze-globus pallidus noma i-nucleus ye-subthalamic. I-generator, ehlelwe ukulawula ukuvuselela kagesi okufanele, ifakwe esifundeni esingaphezulu kwesifuba. Idivayisi ifakwe ibhethri yokusebenza okuqhubekayo, futhi leli bhethri lidinga ukushintshwa njalo eminyakeni embalwa.
Indlela i-DBS eyasiza ngayo i-Dyskinesia
Indlela eyenziwe ngayo i-DBS kusiza ukunciphisa i-dyskinesia ihileleke kahle. Le divayisi ikhuthaza ukuvuselela ubuchopho, okungajabulisa noma ukucindezela umsebenzi wobuchopho. Kuye ngokuthi indawo ye-electrodes, ukuvuselela kagesi kunganciphisa kanjani i-dyskinesia ngokusebenza ngokuqondile ebuchosheni, noma kunganciphisa ngokungaqondile i-dyskinesia ngokunciphisa isidingo semithi ye-dopaminergic, okwenza lokho kunciphise umphumela we-dopaminergic wemibala ye-dyskinesia.
Ama-stimulator afakwe ku-globus pallidus ahlasela ngqo ama-dyskinesias, kuyilapho ama-stimulators abekwe enqamuzaneni ye-subthalamic anganciphisa isidingo semithi ye-dopaminergic, ekwehliseni umphumela ohlangothini lwe-dyskinesia.
Ukuphepha kwe-DBS
Ngokuvamile, inqubo iphephile, kodwa njengenqubo yonke, kungaba nezinkinga. Izinkinga ezihlobene ne-DBS zifaka ukutheleleka nokuphuma kwegazi.
Izifo zingase zikhiphe ikhanda, ubuhlungu, ukudideka, nemifudu. Ukukhipha isisu kungaveza ikhanda elibuhlungu, izinguquko zombono, noma ukulahlekelwa ukwazi. Uma uhlelwe ukuthi ube nokuhlinzwa kwe-DBS, ithimba lakho lezokwelapha lizokuqapha eduze ngemva kwenqubo. Kunezizathu ezihlukahlukene zokuqapha kwakho okuthunyelwe, okufaka phakathi ukuhlolwa komsebenzi we-stimulator, nokubamba noma yiziphi izinkinga ngaphambi kokuba kubangele izinkinga ezihlala njalo.
Ezinye izindlela zokuhlinza zeDyskinesia e-Parkinson-Associated-Associated
Kunezinye izinqubo ezimbalwa zokuhlinzwa ezingase zithathwe futhi njengokuphathwa kwe-IDID. Lezi zinqubo azibandakanyi ukufakwa kwe-stimulator; zibandakanya ukwakhiwa kwesinye sezifunda zobuchopho obangela izimpawu zikaParkinson noma ama-dyskinesias.
Ngokuvamile, ukuhlinzeka ngokweqile kuhloswe futhi kuhloswe i-globus pallidus noma i-nucleus ye-subthalamic, futhi kungabandakanya izinhlangothi zombili uma kunesidingo. Lezi zinqubo, njenge-DBS, zibhekwa njengeziphephile futhi zisebenza. Uma ungumuntu obhekene nokuhlinzwa kwe-DBS, cishe kungenzeka ukuthi ithimba lakho lezokwelapha lizoxoxa nawe ngezinketho eziningana zokuhlinzwa, ngaphezu kwe-DBS.
Izwi elivela
Isifo sikaParkinson yisifo esivamile kakhulu sokunyakaza. Kuyinto isimo sokuphila okulindeleke ukuba sibi kakhulu eminyakeni. Ngenxa yezibonakaliso ezimbi kakhulu, abantu abanesifo sikaPasinson badinga ukulungiswa kwemithi njengoba lesi sifo sisebenza futhi njengoba nemiphumela emibi ikhula.
Okumangalisa ukuthi umphumela ohlangothini wemithi esetshenziselwa isifo sikaParkinson ungenye inkinga yokunyakaza, i-dyskinesia. Kwabanye abantu abanesifo sikaPasinson, kufika iphuzu lapho imithi ingasakwazi ukubekezelela khona, futhi izindlela zokuhlinzwa zingabhekwa njengendlela engcono kakhulu.
Nokho, izindaba ezinhle ukuthi isifo sikaPasinson noma i-dyskinesias asiyingozi noma sisongela ukuphila. Ukuhlinzwa kwe-DBS kuyindlela ekhethiwe iminyaka eminingi, iqondakala kahle, futhi ibhekwa njengokuphephile nokubekezeleleka kahle. Kule minyaka edlule, kuye kwaba nezinkulungwane zabantu abanezifo zikaPasinson abaye bahlinzwa ngokuhlinzeka nge-LID, futhi imiphumela yaba kuhle. Uma ungumuntu ozobhapathizwa we-DBS, lindela ukuthi uhlinzekwe ngokucophelela nokuhlinzwa okulandelayo ngokulandela inqubo yakho, njengoba lokhu kuzokwandisa amathuba akho wokuthola imiphumela engcono kakhulu nokuthola kabusha.
> Umthombo:
> Tan ZG, Zhou Q, Huang T, Jiang Y. Ukusebenza kwe-globus pallidus ukugqugquzela nokuvuselela kwe-nucleus ye-subthalamic yesifo esiphakeme se-Parkinson: ukuhlaziywa kwe-meta-analysis of randomzed controlled trials, Clin Interv Aging. 2016 Jun 21; 11: 777-86.