I-cerebral palsy yimeko ekhoyo ngexesha lokuzalwa okanye kungekudala emva kokuzalwa. Enye yezinto eziphambili ekuxilongweni kukuba abantwana abafikeli iinjongo eziphuhlisayo, kanti, ngezinye iimeko ze-neurological, abantwana bafikelela kwizinto ezibalulekileyo kwaye bancipha ngokuhamba kwexesha.
Ukuxilongwa kwe-cerebral palsy kudinga inkqubo enononophelo neyobuchule exhomekeka kakhulu ekubonweni nasekuhlolweni kweklinikhi.
Ukuba ukrokrela ukuxilongwa, ukuqonda inkqubo kunokunceda ekunciphiseni ukukhathazeka.
Uhlolo lokuSebenza
Abantwana abane-cerebral palsy bangabonisa iimpawu ezahlukahlukeneyo eziphambili ekuxilongeni kwalo mqathango. Iimpawu zibandakanya ubuthakathaka obusweni bobuso, iingalo, izandla, imilenze okanye i-trunk, ukunyakaza okunamandla kunye nama-floppy imisipha, intetho esicacileyo kunye nobunzima ukuyiqonda, iingxaki zokuhlafuna nokugwinya, kunye nokulahleka kwengqondo.
Njengomzali okanye umnakekeli, ukuphawula ezi zimpawu kunokubangela uxinzelelo kunye nokubhekiselele. Ukuqinisekisa ukuba baqwalaselwe ngokufanelekileyo, kunokunceda ukuhlawula ngokuthe ngqo malunga nabo-ixesha, imisebenzi ngaphambi / emva koko, kunye nokunye kunokunceda ugqirha ngexesha lokunxibelelana.
IiLabs kunye novavanyo
Kukho iimvavanyo eziliqela ezixhasa kwaye ziqinisekisa ukuxilongwa kwepheney, okubaluleke kakhulu kuyo imbali yeklinikhi kunye nokuhlolwa komzimba.
Umlando Wezonyango kunye noPhando lweMpilo.
Imbali yekliniki inokukwazi ukubona iziganeko ezifana nokulimala okubuhlungu, ukusulela abantwana kunye nezifo ezifana nokugaya, ukuphefumula kunye neengxaki zentliziyo ezinokubangela iimpawu ezibonakala zifana nezo zentsholongwane, ikakhulukazi kwiintsana ezincinci.
Ukuvavanya kwamakhono omntwana usebenzisa uvavanyo olunzulu lwe-neuroloji luphakathi kwama-90-98 ekhulwini oluchanileyo ekufumaneni ukukhubazeka kwe-cerebral.
Ezinye iindlela ezimbalwa zokuvavanya ubuchule bentwana zibandakanya uvavanyo lwe-Prechtl oluVunyiweyo lweMigudu yokuHlola kunye ne-Hammersmith Iintsana zeNtsholongwane yeeNtsholongwane, zombini ezivandlakanyo kunye nokulinganisa amakhono omzimba kunye nokuqonda kwengqondo kwizinga.
Uvavanyo lweGazi
Iimvavanyo zegazi azilindeleke ukuba zibonise ukungaqhelekanga kwi-cerebral palsy. Ama-syndromes amachiza anokubonakalisa iimpawu ezinjengezo zokukhubazeka kwe-cerebral kulindeleke ukuba zibonise ukungalingani kwegazi, ezinokukunceda ukuhlula iimeko. Ukuhlolwa kwegazi kunokucatshangelwa ukuba umntwana onempawu ze-cerebral palsy eneempawu zokugula, ukuhluleka komzimba okanye isifo.
Uvavanyo lweGenesis
Iimvavanyo ze-Genetic zinokukunceda ekuboneni ukungalingani kwemfuyo ehambelana nokukhubazeka kwe-cerebral palsy. I-cerebral palsy ayiqhathaniswa nxamnye neempembelelo zofuzo eziqinisekisiwe, kwaye ixabiso elikhulu lokuvavanya i-genetic lugxininiso lwezinye iimeko ezikliniki ezifana ne-cerebral palsy kwaye ziyazi iipatheni zofuzo.
Akuyena wonke umntu ovulekileyo wokuba uvavanyo lofuzo. Ukuba unenkxalabo, xela ugqirha wakho. Kwakhona, xubusha kunye neqabane lakho-cwangciso malunga nento oyenzayo xa iziphumo zikulungele zinokukunceda bobabini ukuhlangabezana nokuxhasana.
Electroencephalogram yeEEG
Abanye abantwana abane-cerebral palsy bahlutha. Ezinye iintlobo zokuhluthwa ezingabandakanyiswa ne-cerebral palsy zingaba negalelo elikhulu ekuphuculeni abantwana. Ngolu hlobo lweengxaki zokubamba, ukuqonda ingenakho ukuphazamiseka ngendlela efana neklinikhi efana neengxaki ezingenakucatshulwa ezibonwe ekukhubazekeni kwe-cerebral, kwaye i-EEG inokukunceda ukuchonga i-subclinical (engacacile).
Izifundo Zokuqhuba Amanzi (NCV) kunye ne-Electromyography (EMG)
Ezinye izifo zesisu kunye nezifo zomgulana zingabangela ubuthathaka obuqala ekuqaleni. Imisipha kunye neentlungu ezingaqhelekanga azibonakalisi ngokukhubazeka kwe-cerebral, kwaye ngoko ke iipatheni ezingavamile kule mvavanyo zinokukunceda ukulawula kwezinye iimeko kwaye zilawula ukukhubazeka kwe-cerebral palsy.
Ukucinga
Ubungqina bebongo kaninzi abuqinisekisi ukukhubazeka kwe-cerebral ngokwayo, kodwa luyakwazi ukubona enye yeemeko ezinokuveza iimpawu ezifana nezobuchopho bentliziyo.
Brain CT
Ingqondo yengqondo ye- CT ene-cerebral palsy ingaqhelekanga okanye ingabonisa ubungqina bentsholongwane, okanye i-anatomical impairment. Iipatheni ezibonisa ukuba iimpawu zomntwana azikho ukukhubazeka kwe-cerebral ziquka ukusuleleka, ukuphuka, ukuphuma kwamanzi, i- tumor okanye i- hydrocephalus .
MRI yeBongo
Ingqondo ye-MRI yinkcazo epheleleyo yembono yobuchopho kune-CT scan. Ubukho bezinye iintlobo zeengxaki, kunye nokungaqhelekanga okucebisa phambili kokulimala kwe-ischemic (ukungabikho kokuphuma kwegazi) kumbono omhlophe okanye obomvu wengqondo, kunokuxhasa ukuxilongwa kwepereysi ye-cerebral palsy. Ububungqina bokuvuvukala okusebenzayo kunokubhekisela kwezinye iimeko ezifana ne-cerebral adrenoleukodystrophy.
Kuzo zombini ezi zivivinyo zengqondo, umntwana (kunye nomnakekeli) unokuziva unkwantya. Buza ukuba kukho nayiphi na into enokuyenza ukuze uncede ukuphucula amava kwimisebenzi yabantwana, ukuba nomntu osondeleyo, okanye ukusebenzisa ulwimi oluthile olumntwana lube yinto into ogqirha angayinika yona.
Ukuxilongwa ngokungafani
Unyango, ulawulo, kunye nesifo sokukhubazeka kwe-cerebral palsy kuyahluka kwezinye zeemeko ezifanayo, kwaye le ngenye yezizathu ukuba ukuxilongwa ngokuchanekileyo kubaluleke kakhulu. Ezinye zeemeko zidibene nomngcipheko onobungozi obucacileyo, ngoko ke ukuchongwa kwimeko ngomntwana omnye kunokubanceda abazali ukuba baqaphele ngokusesikweni kunye nokonyango lwabanye abantwana, ngaphandle kokubonelela ngolwazi kwiintsapho zonke ezinokubaluleka ekucwangciseni ukuzala .
Baby Syndrome
Umqathango obangelwa ngumntwana osisigxina esisisigxina-sisifo-unokuchaphazela abantwana abancinci beeminyaka yonke, kwaye iyaqhelekileyo kwiintsana ezindala kunabantwana abatsha. I-babyken syndrome ephazanyiswayo ibonakaliswe yi-skull fractures, i-hemorrhage (ukuphuma kwegazi) kwingqondo, kwaye ihlala ixakeke kwezinye iindawo zomzimba.
Ngokuxhomekeke ekuhlaleni, ukuzuliswa kwe-baby syndrome kungabangela ukulahlekelwa kwezakhono eziqalile ukuvela, ngelixa i-cerebral palsy ibonakala ngokungabikho kwezakhono eziphuhlisayo.
Rett Syndrome
Isimo esingaqhelekanga esichaphazela amantombazana, i-Rett syndrome ingabangela ukungabikho kokulawulwa kwemoto kunye nokulahlekelwa kwengqondo. Ukwahluke kakhulu phakathi kweemeko kukuba abantwana abane-Rett syndrome baqala ngokuqhelekileyo kwiinyanga ezili-6 ukuya kwezi-12, baze babonise ukwehla komsebenzi, ngelixa abantwana abane-cerebral palsy bengayifumani imiphumo ephambili.
I-Autism Spectrum Disorder
Ingxaki eyinkimbinkimbi eneempawu ezingabonakalisa njengengxaki yokuqonda kunye neendlela zokuziphatha, abanye abantwana kwi-autism i-spectism bangabonakalisa ukulahlekelwa kwemoto okanye yokuthetha ngeempawu ezinokuphutha ngenxa yokukhubazeka kwe-cerebral okanye enye indlela.
Syndromes Metabolic
Iimeko eziphazamisana nometabolism okanye ngemveliso yeprotheni efana neT Tay izigulana, i- Noonan Syndrome , i-Lesch-Nyan, kunye ne- Neimann-Pick isifo sinokuthi sibe nezinto ezinobuthakathaka obuthathaka kunye neengxaki ezingacatshangelwayo ezingahle ziphosakele ngenxa yokukhubazeka kwe-cerebral-and cerebral palsy ukuphosakela ngale miqathango.
Ukongezelela kwezinye iimpawu zorhwebo, iimpawu zesifo se-metabolic zivame ukubonisa ukungaqhelekanga kwiimvavanyo ezizodwa zegazi, ezinokukunceda ukuba zihluke phakathi komnye kwaye zisuke zivela kumzimba wokukhubazeka kwe-cerebral.
Encephalitis
I-Encephalitis, ukutshabalala kwengqondo, inokubangela iimpawu ezinzulu ezivela ekuthinjeni ukukhubazeka ukungaphenduli. Kukho iindidi ezibalulekileyo ze-encephalitis, ezithintekayo kwaye zivuthayo.
- Izifo ezithintekayo: Incephalitis echaphazelekayo ibonakala ngokukhawuleza, kwaye njengobungqina bentsholongwane nokuvuvukala kwiimvavanyo zegazi, ingqondo yeCC, i-MRI yengqondo okanye i-lumbar fluid.
- Ukuvuvukala: Incephalitis enobuhlungu ingaba yingozi nangona kungabikho kwesifo esithintekayo. Kukho iimeko ezinxulumene nezifo kunye nokuhlolwa kwegazi, ingqondo ye-CT, ingqondo ye-MRI kunye ne-lumbar fluid ibonisa ubungqina bokuvuvukala.
I-Spinal Muscular Atrophy
Isifo esingaqala xa sisesebuntwaneni, ebuntwaneni, okanye emdala, uhlobo lwe-sprown muscular atrophy oluqala ukususela ebusheni lunokuba lunzima, lubangele ukukhubazeka okanye kufutshane nokukhubazeka. Ubuthakathaka obuthathaka bokuqala kwe-spinal muscular atrophy, kwakhona ebizwa ngokuba ngu-SMA hlobo 0, luyingozi kakhulu kunokuba i-cerebral palsy. Isifo kulindeleke ukuba siphumelele ngokukhawuleza kwisiphumo esibulalayo, esingafanekanga nokukhubazeka kwesiberebhu.
Cerebral Adrenoleukodystrophy
Isifo esingaqhelekanga esibonakaliswe yizinto ezibonakalayo kunye nokuncipha kwengqondo, i-cerebral adrenoleukodystrophy ichaphazela kakhulu abafana. Ulwahlulo olubalulekileyo phakathi kwe-adrenoleukodystrophy kunye ne-cerebral palsy kukuba abantwana abane-cerebral adrenoleukodystrophy banemeko emhlophe engqondweni yabo i-MRI kwaye imeko ibangela ukuncipha kwenkqubela kunye nokusebenza kwemoto, kungekhona ukungaphumeleli kokuphuhlisa izakhono njengengqondo yokukhubazeka kwe-cerebral palsy.
Muscular Dystrophy
Kukho iintlobo ezininzi ze-dystrophic muscular, zonke ezibonakala zibuthathaka kunye nokungabikho kwesimo se-muscle. Ukwahlukana phakathi kwe-cerebral palsy kunye ne-muscular dysstrophy kukuba i-dystrophy ye-muscular ayisoloko ihambelana nokulahlekelwa kwengqondo, kwaye ubuthathaka obunamahlunu obunama-muscular dystrophy bunokubonakala ngokubangela isifo sesisu ngokuhlolwa koqobo kunye ne-EMG / NCV.
> Umthombo:
> Novak I, Morgan C, Adde L, et al. Ekuqaleni, Ukuchonga ngokuchanekileyo kunye nokuPhunyezwa kwangaphambili kwiCerebral Palsy: Intuthuko ekuHongeni nasekuPhileni. JAMA Pediatr. 2017; 171 (9): 897-907.