I-HD ineempawu ezininzi ezinokuthi ziphuhliswe, ezinye zazo zilawulwe ngempumelelo ngemichiza kunye neendlela ezingekho kweziyobisi. Ngaphambi kokuba uhlalutye unyango, iimpawu zokuqonda njengenxalenye yesifo zinganceda ukunxulumana nazo kwaye uthathe indima echaphazelekayo kwilungu lakho okanye ilungu lentsapho.
Iintlobo zeMpawu
Njengengxaki ye-neurological, i-Huntington ibangela izibonakaliso eziqhelekileyo kwiintlobo zintathu: ukuguqulwa komzimba / ukunyakaza, utshintsho lweenkqubela, kunye neenguqu zengqondo / zokuziphatha.
I-HD yenye yeemeko ezininzi ezibangela ukuguga komqondo ukukhula.
Iimpawu zivame ukukhula phakathi kweminyaka engama-30 no-50 ubudala. Nangona kunjalo, abanye abantu abangaphantsi kweminyaka engama-20 bahlakulela uhlobo lwesifo sikaHuntington esibizwa ngokuba sisifo sesantya saseHuntington.
Iinguqu zenyama
Enye yeempawu eziphawulekayo ze-HD yi-chorea. I-Chorea ibhekisela ekulahlekelweni kwamandla okulawula ukunyakaza komzimba. Ivelisa ukunyakaza okungazibandakanyeki, okwenyukayo, kwaye ngokukhawuleza. Ezi ntshukumo zivame ukuvela emzimbeni ophezulu kwaye zibandakanye iingalo ezingaphezulu, i-trunk, intloko, intamo kunye nobuso. Ziyakwenzeka kwakhona kwimilenze. I-Chorea ikhona malunga neepesenti ezingama-90 zabantu abane-HD kwaye enye yeempawu zihlala zijoliswe ngamachiza.
Ezinye iimpawu ze-HD ziquka ukuncipha kokuhamba nokuthetha, ukungabikho kokulungelelanisa, ukuphazamiseka ekugwityeni ukutya kunye notywala kwaye, ngoko ke, ukulahleka komzimba. Ngenxa yezi zimpawu, ingozi yokuwa iphezulu kubantu abane-HD, kodwa ukusebenza kunye neengcali kunokunceda ukunciphisa umngcipheko.
Utshintsho lweCognitive
I-HD yiphumo lokutshintsha kwengqondo, ngoko kuyaqondakala ukuba amandla okuqonda achaphazelekayo. Nangona imemori ingathinteka, ezinye iindawo zokunakwa kwengqalelo zichaphazelekayo ngokunjalo. Ezi zibandakanya ukusebenza kakubi kokulawula (njengokwazi ukucwangcisa nokwenza izigqibo), ukugxininiswa kakubi, ukungabikho kokugxila, ingcamango engalunganga kunye nokungabikho kokuqonda kwimiqathango yakho.
Ukungabikho kwemimiselo kunokuhlakulela. Ngokomzekelo, ukuba unayo i-HD, unokwenza into ongeke uyiva ukuba iyona efanelekile ngenxa yokuba ulawulo lwakho lokunyanzelisa luyancipha.
Ukutshintsha kwemizwelo kunye nokuziphatha
Izimpawu ze-HD ziquka iinguqu ezininzi kunye nokuziphatha. Unokuziva uzive ukhululekile kunye nentukuthelo, kunye neengxaki ezingapheliyo. Ulwaphulo lomlomo nolusenokuthi luphuhlise. Enyanisweni, uphando luphetha ukuba ama-22 ekhulwini ukuya kuma-66 ekhulwini abantu abane-HD baya kubonisa ubugwenxa, kaninzi kwizigaba zokuqala zesifo.
Njengokuba kunjalo nezinye iintlobo zemeko yokugula komzimba , ukunganakwa kuyinto eqhelekileyo kwi-HD. Ukudandatheka (okufana nokunganakwa kodwa ngokuqhelekileyo kuquka ukuvakalelwa kunye nokuphelelwa lithemba) kunokubaluleka ngokukhethekileyo kwaye kukuqhelanise ukucinga okanye ukucinga ukuzibulala. Uphando lubonisa ukuba kukho ingozi ephezulu yokucinga ngokuzibulala kulabo abahlala ne-HD, kunye nezifundo ezithile ezibonisa ubungqina bokuzibulala ngenxa ye-19 ekhulwini yabathathi-nxaxheba.
Imiba yokuxhalabisa idla ngokukhawuleza. Uphando lwezophando lubonisa ukuba naphakathi kwimizuzu engama-34 ukuya kuma-61 kwalabo abanenkxalabo yokuxhalaba kwe-HD.
Ukunyamezela , apho "uzinamathele" kwigama, ucinga okanye isenzo, akuqhelekanga.
Oku kunokudibanisa kunye nokunyanzeliswa kunye nokunyanzeliswa kwaye kwenze kube nzima ukuqhubela phambili kumsebenzi omtsha. Kwakhona kunokubangela ukuziphatha okungafanelekanga kwintlalo eyenza kube nzima kwabanye ukuba bakwazi ukusebenzisa ixesha kunye nomntu ono-HD.
Uhlolo oluPhezulu
Nangona kungekho nonyango etholakalayo kwi-HD ngeli xesha, kukho imithi embalwa kunye neendlela ezincedisayo ezinganceda ukukhupha iimpawu ezithile zexesha. Gcina ukhumbule ukuba akufanele usebenzise izinto ezincedisayo okanye ezongezelelweyo ngaphandle kokujonga ngogqirha wakho, njengokuba abanye banokuba nemiphumo emibi engundoqo okanye ukusebenzisana kweziyobisi kunye namanye amayeza.
Ekubeni kungekho nonyango, injongo yonyango kwi-HD kukuphucula umgangatho wobomi kwaye ugcine ukusebenza ngokude kangangoko kunokwenzeka.
Mayeza
Xenazine (tetrabenazine)
I-Xenazine yavunywa ngo-2008 yi-US Food and Drug Administration (FDA) ukuphatha i-chorea kwi-HD. Kuye kwaboniswa ukunceda ukunciphisa ukunyakaza okungazibandakanyeki kwaye ngokuqhelekileyo kuthathwa njengenye yeendlela eziqhelekileyo nezisebenzayo zokuphatha i-HD.
I-Xenazine, kodwa, isenza isilumkiso malunga nokusetyenziswa kubantu abanexinzelelo ngenxa yokuba kubonakala kwandisa ukuxinezeleka kunye neengcinga zokuzibulala. Imiphumo emibi ingabandakanya nokulala nokulala.
Austedo ( deutetrabenazine )
I-Austedo ivunyiwe yi-FDA ngo-2017. Inikwe umyalelo wokunyanga ukunyanzeliswa kokuzibandakanya (chorea) kwisifo sikaHuntington.
U-Austedo ufana ne-Xenazine njengokhemikhali kodwa ukusebenza kwayo kuqhubeka ixesha elide. Ngenxa yoko, i-Austedo idla ngokumiselwa ukuba ithathwe kanye okanye kabini ngemini, ngoxa iXenazine idla ngokumiselwa ukuba ithathwe kathathu ngosuku ngalunye.
I-Austedo ibonise ukuphumelela ekunciphiseni iimpawu ze-chorea, kodwa njenge-Xenazine, eli liyeza liza kunye nesilumkiso esinamandla esichaza ukuba akufanele sisetyenziselwe abantu abane-HD abavakalelwa kukuba bacinezelekile okanye bazivelele, njengoko kunokunyusa loo mvakalelo.
IMicropsychotic Medication
Amayeza a-Antipsychotic, abuye athiwa njenge-neuroleptics, ngamanye amaxesha anikezelwe ukuba aphathe i-chorea. Oku kusetyenziselwa iileyile ngaphandle kweleyile, oko kuthetha ukuba i-FDA ayizange ivume le miyeza ngokukodwa kule njongo; Nangona kunjalo, ezinye zazo ziye zabonisa inzuzo ethile kule ndawo.
Iziphumo zophando ziyahlukahluka, kodwa i-antipsychotics yama-atypical esetyenziswa rhoqo ekuphatheni i-HD iquka iZyprexa (olanzapine), i-Risperdal (risperidone), kunye ne-Seroquel (letiapine). I-antipsychotics ezindala ezifana neHaldol (haloperidol) kunye neClozaril (clozapine) nazo zinqunywe kodwa zineempembelelo ezinobungozi kunye ne-tardive dyskinesia, ezo zombini ezibangela ezinye iintambo ezingenakuzibandakanya kwaye kungenjalo.
Ukongezelela, ezinye iipilisi ze-antipsychotic ezifana ne-Abilify (aripiprazole) zibonise ukuphumelela ekunciphiseni iimpawu zokudakumba kwi-HD, kunye nokuphucula ukuqonda.
I-Antipsychotics isetyenziswe ngamanye amaxesha ngenjongo yokunciphisa ukuziphatha okucelomngeni (njengobundlobongela) obuya kukhula kwi-HD; Nangona kunjalo, kukho iziphumo ezinobungozi ezininzi kunye nokusetyenziswa kwe-antipsychotics, ngoko kuqikelelwa kuqinisekiswe.
Symmetrel
Uphando malunga nokusebenza kwe-Symmetrel (i-amantadine) ibonise iziphumo eziphikisanayo. I-Symmetrel iyinkunkuma ye-anti-virus eyenziwa ukuphatha ukugubungela okungazibandakanyeki ngezinye izihlandlo ezenzekayo kwisifo se- Parkinson , ngoko i-target yayo kwi-HD iyimpawu ye-chorea. Kubonakala kunenzuzo kwabanye abantu abane-HD.
SSRIs
I-serotonin i-reuptake inhibitor (SSRI) ekhethiweyo i-inhibitor (SSRI) i-anti-depressant medication imiselwe ngamanye amaxesha ukuphatha uxinzelelo kunye nokunyanzeliswa kunye nokunyanzeliswa ngamanye amaxesha abo bahlala ne-HD. Nje ngezinye iimichiza, ukuphumelela kusebenza.
Iimpawu zokuzinza
Ukuqiniswa kwemizwa efana neDepakote (divalproex) ingasetyenziselwa ukujongana nohlobo olukhulu kwiimvakalelo ezinokuhamba kunye ne-HD, kunye nobudlova, ukunyaniseka, kunye neempawu eziphosakeleyo.
Amanye amayeza
Ekuphenduleni iimpawu ezahlukahlukeneyo ezigulisa isigulane kwigqirha, ezinye iyeza ziyalelwe ukuba zijongane nale micimbi ethile. Ngokomzekelo, ukuba ukulala nokuxhalaba kukuxhalabisayo kakhulu kwi-HD, ugqirha uya kufaka umyalelo wokuwasebenzisa. Ngaloo ndlela, kubalulekile ukuba uvule iqela lakho lononophelo lwezempilo kwaye ubazise malunga nantoni na ekukukhathazayo. Basenokuba nenketho eya kuphucula imeko yakho.
Iindlela ezingekho phantsi kweziyobisi
Ekubeni iilwimi zingaphelanga ukuzama ukulawula iimpawu ezithile kwi-HD, ezinye iindlela ezingenayo izidakamizwa ziyacetyiswa.
Uthethelo lweelwimi kunye neelwimi
Intetho kunye nolophulo lweelwimi lunokusebenza kunye nawe ukuncedisa ekunxibelelaneni iimfuno zakho kunye nezinto ozikhethayo. Ukuzivocavoca ezithile kunokukunceda uqinise ulwimi lwakho kunye nemisipha yomlomo ukuze ugcine ukusebenza kwakho kangangoko kunokwenzeka.
Iingcali zeengxoxo nazo zingavavanya amandla akho okugwinya kwaye zichonge ukuba zeziphi izixhobo okanye ukungenelela kuya kuba luncedo kuwe. Oku kubalulekile kuba, njengoko eso sifo siyaqhubeka, kunokuba nzima kunzima ukugwinya ukutya okanye amanzi ngaphandle kokukhahlela.
Ulwaphulo lweMpilo kunye neSebenzi
Ulwaphulo lwezonyango kunye neyeza lokuncedisa inokukunceda ngeendlela ezininzi. Kwimigangatho yangaphambili ye-HD, unyango lomzimba lunokunceda ukuphucula nokugcina amandla kunye nokusebenza. Njengoko i-HD iqhubela phambili, izixhobo ziyakunikwa kwaye zilungelelaniswe neemfuno zakho ezithile, kunye neprogram yovavanyo lwekhaya ingaqulunqwa ukukhulisa impilo yomzimba.
Ingcali yomsebenzi ingasebenza nawe ekunqumeni indlela engcono yokuyenza imisebenzi yokuphila kwansuku zonke , njengokwenyuka nokugqoka. Iingcali zengqesho ziyakwazi ukuchonga ukuqeqeshwa kwengqondo , ngenjongo yokugcina ukusebenza kwakho kwengqondo.
Iingcali ziyakwazi ukusebenza kunye nabanononophelo njengoko isifo sithuthuka ukubanceda bazi indlela engcono yokunyamekela ngayo.
Ukuzivocavoca
Ukuzilolonga ngokomzimba kuye kwaxhamla kakhulu kunye nokukwazi ukuphucula ingqondo-okanye nokuphucula ukuqonda kwengqondo kwiintlobo ezininzi ezibangelwa ukugula ngengqondo, kwaye oku kuyenzeka kwi-HD ngokunjalo. Uphando luye lwabonisa ukuba amanqanaba aphezulu okuzilolonga umzimba aqikelele amanqaku angcono kwiimvavanyo zengqondo kunye nokusebenza kwimihla ngemihla.
Psychotherapy / Counseling Counseling
Ukuthetha nomsebenzi wezentlalo okanye isazi seengqondo kunokubaluleka xa ulungelelanisa utshintsho olukhutshwa ngu-HD kwaye ufumanisa izicwangciso zakho zokujamelana. Ukuthetha ngonyango kunokuba luncedo kakhulu kwabatshatileyo okanye amaqabane, kunye nabantwana kunye neentsapho.
I-HD izisa utshintsho oluphawulekayo kwinqanaba lakho lokusebenza, kwaye linokuphakamisa iingxakalo kumalungu entsapho malunga nomngcipheko wokuba i-HD kubeni igqithiselwa ngokwemvelo kubantwana. Ingcali inokukunceda wena kunye nosapho lwakho nisebenze ngeenguqu ezenzekayo, ingozi yomzimba ye-HD, kunye nokuxhuma kunye nezibonelelo kwindawo yakho kunye nekhaya lakho.
ZoPhilo lweMpilo
Ezinye iinkqubo ziza kunceda abo bahlala ne-HD. Umzekelo, umculo , ubugcisa, kunye nelase-drama zonke zisetyenzisiwe. Nangona bengasayi kutshintsha iimpawu ze-HD, bangakwazi ukuchaphazela uluntu jikelele kunye nokuphucula umgangatho wobomi.
IiNkonzo zeDetethi
Ukutya ukutya okunempilo kubalulekile kuthi sonke, nangona kunjalo xa uhlangabezana neHD. Ukuqinisekisa ukuba umzimba wakho ufumana izondlo ezifanelekileyo ozifunayo kunokukunceda ugcine amandla akho. Oku kunokuba nzima, ngokukodwa njengoko i-HD iqhubeka, ngoko unokufumana incedo kwi-dietitian ebhalisiweyo.
ILizwi
Okubaluleke kakhulu, abantu abane-HD kunye neentsapho zabo banomngcipheko wokuzihlukanisa. Yazi ukuba kukho izibonelelo kunye nenkxaso ekhoyo ukukukhuthaza kwaye ikuncede ukuba uqikelele amanyathelo akho alandelayo. Ukuba awuqinisekanga ukuba wenzeni okanye ufuna uncedo, i-Huntington's Disease Society of America inezahluko zendawo kunye namaqela enkxaso ye-intanethi anokukukhuthaza, uphendule imibuzo yakho okanye uhambe nawe okanye nje ube ngumphulaphuli njengoko uhlala HD.
> Imithombo:
> Arora, G. (2015). Ukulawula Ukunyanzelisa kwiZifo zikaHuntington. http://hdsa.org/wp-content/uploads/2015/07/Managing-Aggression-in-HD_Garima-Arora_ver005.pdf
> Coppen, E. kunye noRoos, R. (2016). Iindlela ezikhoyo ze-Pharmacological Approaches zokunciphisa i-Chorea kwiZifo zikaHuntington. Iziyobisi , 77 (1), iphepha 2.9-46. 10.1007 / s40265-016-0670-4
> Dale, M. no van Duijn, E. (2015). Ukukhathazeka kwiZifo zikaHuntington. I-Journal ye-Neuropsychiatry ne-Clinical Neuroscience , 27 (4), iphepha 2.62-271.
> Wallace M, Downing N, uLourens S, et al. Ngaba Kukhona Umbutho Wemisebenzi Yokwenyama Ngomqulu WeBongo, Ukuziphatha, kunye nokuSebenza Kwimihla ngemihla? Umnqophiso oPhezulu lweCandelo loPhulo oluPhambili kunye neNkulumbuso yeHuntington yasekuqaleni. Iingcingo ze-PLoS . 2016; 8.
> Wetzel HH, Gehl CR, Dellefave L, et al. Iinjongo zokuzibulala kwisifo seHuntington: Inxaxheba yecala. Uphando lweengqondo . 2011; 188 (3): 372-376. i-doi: 10.1016 / j.psychres.2011.05.006.