Uhlobo oluqhelekileyo lwe-MS olungathatha ixesha elide ukuxilonga
Ukuxilongwa kwe-primary- sclerosis multiple sclerosis (PPMS) ineengxaki ezikhethekileyo, njengoko abantu abanePPMS banokuphulukana ngokukhawuleza kokusebenza kwinyanga ukuya kwiminyaka. Oku kuhambelani nokubuyiswa kwakhona kwe-MS, apho umntu angakwazi ukufumana umsebenzi we-neurological emva kokubuya kwakhona.
Ukwahluke phakathi kwezi zimbini ze-MS kunokwenza ntoni ne-biology ehlukile emva kwabo.
Uphando lubonisa ukuba kwakhona ukubuyisela-MS ukubuyisela inkqubo (ukuzivikela komzimba ukuhlasela ama-nerf fibers) kanti i-MS eyimpumelelo ephambili iyinkqubo yokuguga, apho i-nerve fibers iyahlahlaka. Kutheni umntu omnye ephakamisa i-PPMS ngokuchasene ne-MS-reing MS engacacile, kodwa iingcali zikholelwa ukuba izakhi zengqungquthela zingadlala indima, nangona ubungqina benzululwazi obuya kubuyiselwa oku lukhuni.
Ukuxilongwa kwe-MS yePrayimari ePhambili
I-Definite PPMS iyakwazi ukufunyanwa xa ezi zilandelayo zihambelana:
- Umntu unomnyaka owodwa unyuselo lwekliniki (olubhekiselele ekudakaleni kweempawu zakhe ze- MS ).
- Ubuncinane ezimbini kwezi zinto zilandelayo:
- Ingqondo ye- MRI lesion efana ne-MS
- Izilonda ezimbini okanye ngaphezulu ze-MS kumgca wesipelini
- Ukugqithisa okulungileyo, oku kuthetha ukuba kukho ubungqina bee-oligoclonal bands okanye i-anti-IgG ye-anti-level level (ezi iiprotheni ezibonisa ukuvuvukala kwenzeka emzimbeni)
Uninzi lwabantu abanePPMS luqala ngesibonakaliso sokunyuka kwengxaki ngokuhamba, okubizwa ngokuba yi "paraparesis epastic".
Nangona kunjalo, abanye abantu banezinto ezibizwa ngokuthi "i-cerebellar syndrome," ebonakaliswa yi- ataxia enzima kunye neengxaki ngokulinganisela. Kungakhathaliseki ukuba zeziphi iimpawu zeempawu, kufuneka kuboniswe ukuba ukunyuka kwenkqubela kuye kwaqhubeka ngaphezu konyaka, kungabikho kwakhona, ukuxilonga i-PPMS.
I-MRI ekuchongwa kwe-PPMS
Ukuxilongwa kwe-multiple sclerosis kufuna ukusabalalisa (ukugqithisa) kweempawu kunye nezilonda kwithuba kunye nexesha. "Ukusasazwa ngexesha" lunyamekelwa ngokunyuka kweempawu ubuncinane bonyaka omnye (njengoko kuchaziwe ngentla). Iimpawu ze-MRI zisetyenziselwa ukuchonga "ukusabalalisa izilonda kwindawo."
Okokuthi, ukusebenzisa iMRI ukuhlola ukuba i-PPMS ineengxaki. Enye ingxaki enkulu kukuba iziphumo ze-MRI scan of the brain of people with PPMS inokuba "yinto efihlakeleyo" kunokuba abantu abane-RRMS, kunye nezilonda ezincinci zokuphucula i-gadolinium .
Nangona kunjalo, umthambo womnyobo we-MRI wabantu abanePPMS uya kubonisa ngokuqhelekileyo i- atrophy . Ekubeni intambo yomgudu ichaphazeleka kakhulu kwi-PPMS, abantu banamathuba okuba neengxaki zokuhamba, kunye ne-bladder and bwel function.
I-Lumbar Ixesha lokuPhonononga iPMS
Kwakhona kubhekiswe njengempompo yomthambo, i-punctures i-lumbar ingaba luncedo kakhulu ekwenzeni ukuxilongwa kwe-PPMS kunye nokulawula ezinye iimeko.
Iziphumo ezimbini zibalulekile ekuqinisekiseni ukuxilongwa kwe-PPMS:
- Ubuninzi bee-Oligoclonal Bands: Oku kuthetha ukuba "iinqununu" zeeprotheni ezithile (i-immunoglobulins) zibonisa xa uhlalutyo lomgcobhozi luhlalutyiweyo. Ubu bungqina bee-oligoclonal bands kwi-CSF bubonakala kwi-90 ekhulwini labantu abane-MS kodwa banokufumaneka nakweminye ingxaki.
- Ukuveliswa kwe-Anti-IgG ye-Intrathecal: Oku kuthetha ukuba i-IgG ikhiqizwa ngaphakathi kwegumbi lomgcini-mkhuhlane-oku kuyimpawu yokuba kukho ukuphendula komzimba wamagciwane.
I-VEP yoNcedo ekuqinisekiseni ukuxilongwa kwe-PPMS
Ukubonwa kwezinto ezibonakalayo ukuvavanya kukuvavanya okubandakanya ukugqoka i-EEG (electroencephalogram) iisenzi kwi-scalp ngelixa ukhangele umzekelo omnyama nomhlophe onobhenkco. Amanyathelo e-EEG anciphise iimpendulo kwiimvelaphi ezibonakalayo, ezibonisa ukungasebenzi komzimba. Ii-VEP ziye zanceda ekuqiniseni ukuxilongwa kwe-PPMS, ngakumbi xa ezinye iinkqubo zingagqibekanga.
I-MS eqhubela phambili
Kubalulekile ukuba uqaphele ukuba abanye abantu abaqala ngokuxilongwa kwe-PPMS banokubuyiselwa emva kokuxilongwa.
Xa okokuqala kuqala, ukuxilongwa kwaloo mntu kuguqulwa kube yi-MS ekuqhubekeni phambili (i-PRMS). Nangona kunjalo, bonke abantu abane-PRMS baqala ngokuxilongwa kwe-PPMS. Inkqubo yokuhlaziya i-MS yiyona ndlela ye-MS, kwaye i-5% kuphela yabantu abane-MS abachaphazelekayo.
ILizwi
Ekugqibeleni, ezininzi izifo zengqondo zilinganisa i-MS , umthwalo omkhulu wokufumanisa naluphi na uhlobo lwe-MS luphelisa ukuba kungenzeka ukuba yinto enye. Ezinye iziphazamiso ezifuneka ukuba zilawulwe ngaphandle zibandakanya: Ubuthakathaka be-Vitamin B12, isifo seLyme, ukunyanzeliswa kwentambo yomthambo, i-neurosyphilis okanye isifo se-neuron, nje kuthiwa ezimbalwa.
Yingakho kubalulekile ukubona ugqirha ukuba uxilongwe ngokufanelekileyo xa ufumana iimpawu ze-neurological. Nangona inkqubo yokuxilongwa ingaba yinkathazo, qhubeka unomonde kwaye uphumelele ekunakekeleni kwezempilo.
> Imithombo:
> Coyle, uPatricia K. kunye neHaper, ngoJuni. Ukuphila kunye neProgress Multiple Sclerosis: Ukulwa neengxaki (i-2nd ed.). INew York: Ukushicilelwa kweMfuno. 2008.
> I-Cree BA. I-Genetics ye-primary sclerosis. I-Handb Clin Neurol. 2014; 122: 211-30.
> I-MS Society Society. Ukuchonga iPMS.