Izizathu, unyango, kunye nobunzima beSimo Epilepticus
Iimeko zesifo sephepha, okanye 'isimo' siphumo esiphuthumayo sonyango esidinga ukunakekelwa ngokukhawuleza-enyanisweni, ukunonyamekela unyango olukhawulezayo kunokulondoloza ubomi.
Qaphela : Ukuba unenkxalabo yokuba umntu unesimo se-epilepticus u-911
Ukutshatyalaliswa akuqhelekanga, umsebenzi ongenamandla kagesi owenzeka ngaphakathi kwengqondo.
Ukuba umntu unesigxina esipheleleyo, ukuxilongwa kwesifo sokuhluthwa kwenziwa ngokusekelwe kwizifundo zegazi, imbali yonyango epheleleyo, kunye neminye imvavanyo, efana ne-EEG, iphepheni yomgcini okanye izifundo zokucinga. Kule ngxaki apho umboneleli wakho wezempilo uyakukunikezela ngamachiza afanelekileyo aya kulawula imeko yakho.
Ngokuhluthwa, uya kufumana ukuba ininzi yokugaya ingadlulela kwiminithi embalwa . Kwezinye iimeko ezinqabileyo, zingaphila ixesha elide kwaye, ngokwenene, zingabonakali zimele. Oku kubhekiselwa kuyo njenge-static epilepticus. Kulinganiselwa ukuba malunga nama-50 000 ukuya kuma-150,000 abantu baseUnited States bachaphazeleka yimo yesifo se-epilepticus minyaka yonke.
Yintoni Isimo Epilepticus?
Ngethuba loxinzelelo lwe-epilepticus, umntu onesihlunu uya kuba nolwazi olubi kunye nokuphikelela okanye ukuphindaphinda. Ukuqhafaza ngokuqhelekileyo kuya kuthatha imizuzu embalwa nje. Nangona kunjalo, xa ukuxhwaba kuthatha imizuzu emi-5 ukuya kwe-30 ngaphandle kokuba kuqaphele ukuqonda, umntu uya kufumelwa ukuba ene-static epilepticus.
Isimo esiphezulu sisifo sxamnye nexinzelelo lwezonyango olufuna unyango olukhawulezileyo nolunyamekileyo kwaye lunokuba lubulawe ukuba aluyi kukhawuleza. Iingxaki ezinokuvela kwiimeko zesifo sezinto ziquka ukungasebenzi kweentliziyo okanye iimiphunga, utshintsho lwezinto ezinobungakanani, ukunyuka kokushisa komzimba, kwaye ekugqibeleni, ukulimala kwengqondo engapheliyo.
Isimo se-epilepticus sinokuthi sichazwe njenge-convulsive okanye esingenanto. Ukuxhalabisa kuthetha ukuba umntu unobunzima obuqhaqhazelayo (ukugubha nje). I-nonpilebultic epilepticus ibhekisela kwiimeko zokudideka nokungazi kakuhle. Abantu abathile kwimeko engabonakaliyo abayi kubonakala bebanjwe ngokugqithisileyo, kodwa basenokuba nokuthuthwa kombane kwiingqondo ezihambelana nokuthunjwa. Emva kokuqhaqhaqhaqhaqhaqhaqhaba ukuma kunye nomntu engabuyi kubuya emva kwexesha elide, umboneleli wezempilo uya kuqwalasela ukwenza i-EEG ukuqinisekisa ukuba umntu akahlali kwisimo esingenasicatshulwa.
Ziziphi Iimeko Zesiko Epilepticus?
Isimo se-epilepticus sisimo esibalulekileyo kwaye sisongela ubomi esidinga unyango olukhawulezileyo kunye oluphuthumayo ukwenzela ukukhusela ingxaki eninzi kunye nokugcina umsebenzi wengqondo. Isimo sokubamba isisu singathintela nayiphi na ibakala leminyaka, nangona ezinye iimeko zinokubangela ukuba babe ngabantwana nabanye abaqhelekileyo kubantu abadala. Ezi zinto zibandakanya:
- Izifo ezithintekayo (izifo ezithintela iinxalenye ezinkulu zomzimba)
- I-Febrile (izifo ezinxulumene nengqondo)
- Intlungu yentlekele
- Stroke
- Eminye i cancer
- Ukutshatyalaliswa ngokukhawuleza kwe- anticonvulsant (anti-seizure) amayeza
- Ukukhawuleza ukutywala utywala okanye iziyobisi ezingekho mthethweni
- Izifo ze-metabolic (i-sodium ephantsi, i-calcium ephantsi, isishukela esiphantsi okanye ephezulu)
- Uxinzelelo oluphantsi lweziyobisi zokulwa ne-antiepileptic kwigazi
Inkathalo eNgxamisekileyo yeSimo Epilepticus
Uphulo lokuqala luqala ngemithetho ye-ABC: Qinisekisa ukuba indlela yomntu ngamnye icacile, umntu uphefumula kwaye abuyisele umzimba womzimba.
Uvavanyo lwezokwelapha luya kwenziwa kwakhona ukuze lufumanise ukuba kutheni umntu wangena kwi-static epilepticus kwindawo yokuqala.
Ukuze kulawulwe ukuxhwala, imithi ethile iya kusetyenziswa. Izikhokelo ezintsha zafakwa ngo-2016 yi-American Epilepsy Society.
Imithi yokuqala kunye nekhethiweyo esetyenziswayo yi-IV benzodiazepines, equka i diazepam, lorazepam, kunye nemidazolam. ILorazepam isetyenziswa rhoqo ngenxa yokusebenza kwayo ngokukhawuleza. Abantu abangama-55% baya kuphendula kule ndlela yokuqala. Ukuba ayisebenzanga, enye yezi ziyobisi zingaphindwa, kodwa ukuba ihluleka ukusebenza emva kwesazi yesibini, lixesha lokutshintsha kumayeza ahlukeneyo.
Okukhethwa kukho ukwenziwa kweyeza lesibini kunyango lubandakanya i-IV fosphenytoin, i-valproic acid, okanye i-levetiracetam. Ukuba le nto ayisebenzi enye yilezi ziyobisi ingasetyenziswa, okanye i-phenobarbital inganikwa.
Ukuba ezi zixhobo zesigaba sesibini azisebenzi, sekuyisikhathi sokungena kwisigaba esinobudlova ngokusetyenziswa kohlolo lwe-EEG oluqhubekayo . Isicatshulwa sesibini sonyango singaphindwa okanye isiguli singaphathwa nge-anesthetic dose thiopental, midazolam, pentobarbital, okanye propofol.
Ukubaluleka kunye nokuxhamla kwimeko ye-Epilepticus
Isimo se-epilepticus sinokufa kwaye akufanele sithathwe kalula. Olunye uphando lubonise ukuba izinga lokufa kwabantu abafumene ukuhluthwa liphezulu njengama-22%, kunye nezinga lokufa eli-3% kwabantwana kunye nama-26% kubantu abadala. Ngoko ke, isenzo esheshayo sibaluleke kakhulu.
Ukukhusela Isimo Epilepticus
Ukuze kunqande isimo se-epilepticus, abantu kufuneka bahambisane nemithi yabo yokulwa ne-antiepileptic. Ukongezwa koko, ukutyelela rhoqo kwiinkonzo zonyango kufuneka kwenziwe ukwenzela ukuba isiqinisekiso sokuthi imishanguzo isebenza ngokufanelekileyo, akukho zonyango ezongeziweyo ezinokunciphisa ukuphumelela kwemithi yazo yokulwa ne-antiepileptic, kunye nokuvavanya naziphi na ezinye iimeko (ezifana notywala, isifo sikashukela esingalawulwayo , ukuphazamiseka kwemizimba) okungaziphazamisa ukulawula ukuthatha.
Imithombo:
Betjemann, J., noD. Lowenstein. Isimo sohlwayo. ILancet Neurology . 2015. 14 (6): 615-624.
UDrislane, F. Iimeko ezixhamlayo kwi-epilepticus kubantu abadala: Ukwahlula, iimpawu zekliniki kunye nokuxilongwa. Isemgangathweno. Updated 11/20/15. http://www.uptodate.com/contents/convulsive-status-epilepticus-in-adults-classification-clinical-features-and-diagnosis
Glauser, T., Shinnar, S., Gloss, D. Isikhokelo esisekelwe kwiNkcazo: Ukonyangwa kweNkcazo ye-Convulsive Epilepticus kwabantwana nakwaBantu abadala: Ingxelo yeKomiti yeKhokelo ye-American Epilepsy Society. Iintlupheko zeSpilepsy . 2016. 16 (1): 48-61.
I-Trinka, E., Cock, H., Hesdorffer. Okqhubekayo. Inkcazo kunye nokwahlula kwe-status epilepticus-Ingxelo ye-ILAE Task Force kwiSigaba se-Epilepticus. Epilepsia . 2015. 56 (10): 1515-23.