Ukuxilonga i-multiple sclerosis (MS) inzima kwaye inzima, ingakumbi ngenxa yokuba iimpawu ze-MS zihlukile kumntu ngamnye, kwaye ziyakulinganisa ezinye izifo. Ukongezelela, akukho vavanyo lwegazi olulodwa, ukuhlolwa komzimba, okanye ukuvavanya ukuhlolwa kwe-MS.
Namhlanje, i-neurologists isebenzisa iMicdonald Criteria ukuxilonga i-MS. Le setethi yezikhokelo yahlaziywa ngo-2010 ukubandakanya i-MRIs kwinkqubo yokuxilongwa.
Iindaba ezilungileyo malunga nale nto kukuba abantu abane-MS sele bafumanisa ukuvavanywa kwangaphambili-oku kuthetha ukuba abantu bangakwazi ukuqala unyango kwangaphambili kwaye banokuphungula isifo sabo phantsi.
Iimfuno zoMcdonald for the diagnosis of MS
Iimfuno zeMcDonald zijikeleze ukufumaneka kwe- MS kwakhona , eyaziwa nangokuthi ukuhlaselwa, ukutshatyalaliswa, ukunyusa, okanye ukunyuka.
Ukuphindaphinda kwe-MS kubhekisela kwisifo esingaqhelekanga sesifo sengqondo okanye ukungaqheleki kwemvelo okubonakalayo ekuhloleni ngokomzimba. Le ngqondo engavumelekiyo ye-neurolo kufuneka ibe yinto ebonakalayo ye-MS lesion kwinkqubo ye-nervous central, eyona ingqondo, umgogodla kunye ne-optic nererve. Le nto yinto yakho ye-neurologist iya kukwazi.
Ngokomqathango kaMcDonald, ukuze kuhlolwe ukuba ne-MS, kufuneka kubekho ubungqina bokubuyela kwakhona kwe-MS okwenzeke kwiindawo ezimbini ezihlukeneyo zesistim se-nervous. Ukongezelela, le i-MS ibuyela kwakhona kufuneka ihlukaniswe ngexesha leenyanga.
Ukuxilongwa kwe-MS kunokwenziwa ngekliniki, okubhekiselele kwimpawu zeempawu zabantu, nangona ukuphindaphinda kwabo kwenzeka ngaphambili-nangona oku kungenziwa kuphela ukuphindaphinda, enye inokuthi ikhoyo ngoku. Kwakhona, enye yokubuyela kwawo kufuneka iqinisekiswe ngolu hlobo lweemvavanyo ze-neurological, i-visual potential evoked, okanye iMRI.
Ngaphandle koko, ukuxilongwa kungenziwa ngokudibanisa kweziphumo zeklinikhi kunye nobungqina bentsholongwane ye- MS kwi-MRI. Nangona umntu edibana ne-McDonald, i-neurologists iya kwenza ezinye iimvavanyo ezifana nomsebenzi wegazi, ukugqithiswa kwe-lumbar, kunye nokubonwa kwezinto ezibonakalayo ukukhupha ukuxilongwa nokulawula izifo ezingathi zilingane ne-MS .
Ngamanye amazwi, i-neurologist ifuna ukuqiniseka ukuba yenza i-diagnostic eyiyo kwaye akukho nto ichazwayo-inengqiqo, inene? Into yokugqibela ofuna ukuyifumana i-MS xa ungenayo ngempela. Ngoko i-neurologist ifuna ukuqiniseka, kwaye siyavuya ngenxa yoko, nangona kuthetha ukuvavanywa kweemvavanyo ezininzi.
Izinto ezicatshangelwayo kunye neendlela ezisetyenziselwa ukuchonga i-MS
Nanku ukujonga ngokuthe ngqo kwizixhobo ogqirha wakho azakusebenzisa kuzo zombini ukuxilongwa kweMMS nokulawula ezinye iindlela zokuxilonga:
Imbali Yonyango
Ugqirha uya kucela imibuzo emininzi malunga neempawu ozifumanayo kunye nanoma yiyiphi into oye wawafumana ngayo ngaphambili. Ingcamango enhle yokwenza "irekhodi lomqondiso" ngaphambi kokuba ubone ugqirha, ubeke uluhlu lwaluphi na uhlobo lwempawu oye wazenza ngaphambili, ixesha elide lihlala ngayo, kunye nolunye ulwazi malunga nalo. Qinisekisa ukuba uluhlu zonke iimpawu, nokuba ngaba oogqirha bangaphambili bakuxelele ukuba akukho nto iphosakeleyo.
Ukongeza, thabatha zonke iinkcukacha zezokwelapha, kunye neyiphi imithi egqirhayo, kunye naluphina iziphumo zovavanyo lwezonyango oye wazenza ngaphambili.
Uyakucelwa kwakhona imibuzo emininzi ngembali yonyango yezihlobo, ukusetyenziswa kweziyobisi kunye nokusetyenziswa kotywala, kunye nezinye izinto eziphambili zezempilo. Yonke le ngcaciso iza kuncedisa iqela le-neurologist kunye nomfanekiso ukukunceda ukuba ngaba i-MS iyakwazi ukuxilongwa.
Uvavanyo lweeurological
Ugqirha uya kuhlola oku kulandelayo:
- Ukusebenza kweentsholongwane ze- cranial (ezi zilawula iinjongo, kunye nendlela othetha ngayo kwaye ugxininise ngayo)
- Ulungelelaniso
- Amandla
- I-Reflexes
- U kuqonda
Uya kwenza oku ngokuthi wenze imisebenzi (njengokuthinta impumlo yakho, umnwe wakhe ngokulandelelana), ekukuthintela ngezixhobo ezahlukeneyo (kwaye ubika ingxelo okanye ufune impendulo ngokwayo) kwaye wenze uviwo lwamehlo akho. Qiniseka ukuba ezi mvavanyo azilimazi. Uvavanyo olupheleleyo luzakuhlala malunga nemizuzu engama-45 kodwa lunokuhlala ixesha elide kwiiyure ezimbini.
Ukujonga umfanekiso weMagnetic Resonance (MRI)
I-MRIs isebenzisa amagagasi ombane ukuvelisa imifanekiso yengqondo kunye nomgogodla. Ukuba i-MS ikhunjulwa, i-injection ekhethekileyo yezinto (gadolinium) ixhomekeke ngexesha lokuskena, njengoko iphendula kwiindawo zokuvuvukala kwaye "iya kukhanya" xa isilonda sisebenza. Oku kubonisa ukuba ukudemokelwa kuyenzeka ngoku okanye kwiiveki ezidlulileyo.
I-MRI ayibuhlungu, kodwa ingaba ngamava angaqhelekanga. Kunceda ukuba uyazi ukuba ulindele ntoni kule vavanyo. Kukho ezinye izinto onokuzenza ukuze wenze amava akho ngcono .
Njengoko kubonisiwe, oku kuthethwa ngolu vavanyo oluhle kakhulu lokufumanisa i-MS, njengoko izilonda ezingavamile zivela kwi-MRIs ngaphezu kwama-95 ekhulwini labantu abane-MS. Nangona kunjalo, ama-5 eepesenti yabantu abane-MS abanakho ukungaqhelekanga okungafunyanwa kwi-MRI (ukuvelisa umonakalo okhohlakeleyo), kunye nomonakalo onxulumene neminyaka okanye ezinye iimeko, njenge-migraine okanye ingxaki yengqondo, ibonakala njengezilonda ze-MS (ukuvelisa ubuxoki ezintle).
Lumbar Ukuhamba
Kwakhona kuthiwa ngumpompo womthambo , olu vavanyo ludinga ukuba i-cerebrospinal fluid (CSF) isetyenziswe kwisalathini sakho somgudu ngedaliti efakwe phakathi kwe-vertebrae yakho. Ugqirha uzakuthumela umbane ukuhlola, ukukhangela ubukho beendidi ze-oligoclonal (inani elinyukayo lamachiza athile) - isalathisi sokwandisa umsebenzi wokuzivikela ngomzimba emlanjeni.
Olu vavanyo luneempembelelo kuma-90 ekhulwini labantu abane-MS kodwa ayithethi ngqo kwi-MS, ngoko ke umphumo omuhle unokubonisa esinye isifo okanye ingxaki. Ngokuxhomekeka kwiziphumo ezivela kwi-MRI, ukuhlolwa kwegazi, kunye nembali yesiganeko, kunokwenzeka ukuba awufanele ufumane i-lumbar puncture ukuze ufumane ukuxilongwa ngokucacileyo kwe-MS (andizange ndifumane). Nangona kunjalo, iziphumo zokubamba izibilini zingaba luncedo ekulawuleni ezinye izinto ukuba kusekho umbuzo malunga nokuxilongwa.
Ukuvavanywa kwamathuba okuvavanya
Iintlobo ezi-ezintathu eziphambili zeemvavanyo ezikhutshweyo zisetyenziselwa ukuxilongwa kwe-MS. Ngalunye lwale mvavanyo kufuna ukuba i-electrodes ifakwe kwi-scalp yakho kwaye ixhunywe kwi-electroencephalograph (EEG) ukurekhoda i-brainwaves ekuphenduleni imiyalelo eyahlukeneyo. Iimvavanyo ezahlukeneyo zezi:
- I-Brainstem Auditory Evoked Potentials (BAEP): Uchungechunge lweefowuni ludlalwa kwindlebe nganye ngokusebenzisa i-headphones.
- Iimpawu ezibonakalayo ezivuthwayo (VEP): Uchungechunge lwamaphetheni e-checkboard luboniswa kwisikrini.
- Iimpawu ezithintekayo zokuzikhusela (SEP): Ukutshatyalaliswa kwamandla kagesi kusetyenziswa ingalo okanye umlenze.
Ugqirha ukhangela ubukhulu bompendulo kunye nesantya apho ubuchopho bufumana uphawu. I-Weaker okanye i-slower signals ingabonisa ukuba ukunyuswa kwe-demyelination kwenzekile kwaye i-MS inokwenzeka. Nangona kunjalo, olu vavanyo alululwanga ngokucacileyo kwi-MS, oku kuthetha ukungabikho komsebenzi kungabonisa enye ingxaki. Uchungechunge lweemvavanyo ezintathu zingaphatha iiyure ezimbini ukugqiba.
Uvavanyo lweGazi
Okwangoku akukho vavanyo lwegazi lwe-MS. Sekunjalo, uchungechunge lweemvavanyo luya kuqhutywa kwigazi lakho ukulawula ezinye izinto, ezifana nesifo seLyme , i-HIV, ezinye izifo ezingabonakaliyo zofuzo, kunye neqela lezifo ezibizwa ngokuba zizifo ze-collagen-vascular, ezifana ne-lupus.
ILizwi
I-MS ingaba isifo esiyingozi ukuba uhlolisise ngokucacileyo, kwaye inkqubo iya kufuna imonde. Ngaloo nto, kubalulekile ukufumana i-neurologist ukuba uziva ukhululekile kwaye unentembelo osebenza kuyo. Emva koko, ukuba unayo i-MS, lo mntu uya kuba ngumlingani wakho kwimpilo ixesha elide.
Imithombo
National Society of MS. Ukuchonga i-MS.
Polman, CH, et al. (2011). Inkqubo yokuxilonga kwi-multiple sclerosis: ukuhlaziywa kwe-2010 kwimilinganiselo kaMcdonald. Ama-Annal of Neurology , Feb; 69 (2): 292-302.