I-Dyskinesia yintlobo yesifo sokuphazamiseka esichazwe ziziganeko ezingabandakanyekanga zokutshintshisa okanye ukunciphisa umzimba. Ukunyakaza ngokuqhelekileyo kubandakanye iingalo okanye imilenze, kodwa kunokubandakanya i-torso, intloko okanye ubuso. Iziqephu zomntu ngamnye zingadlulela kumasekhondi ambalwa ukuya kwi-15 imizuzu okanye ngaphezulu kwaye zivame ukuzisombulula ngokwabo. Ngokuhamba kwexesha, iziqwenga zivame ukunyuka kwixesha kwaye ziba nzima kakhulu.
Ukuphila NgeDyskinesia
I-Dyskinesias ayinakuphazamisa ukuqonda, kwaye ayikho nayiphi na inxulumene noxinzelelo okanye ukuxinwa , nangona kungenokwenzeka ukuba baqale babonakale befana nabadlali.
Ukuba ufumana ama-dyskinesias, unokulindela ukuhlala uqaphele kwaye uqaphele ukunyakaza, ngamanye amaxesha unokukwazi ukuxelela ukuba baya kuqalisa. Uninzi lwexesha, abantu abane-dyskinesia abanakho ukulawula okanye ukulawulwa okuncinci kokuhamba.
Kukho iinkalo ezininzi ezinengxaki ze-dyskinesia ezichaphazela ubomi bemihla ngemihla. Ziqhelekileyo ekubonakaleni kwaye zinokubangela ingqalelo engafanelekanga kwabanye. Ezi ntshukumo ezingavumiyo zingakuphazanyiswa kukuphazamiseka kwakho xa uwedwa. I-Dyskinesias iyakwenzeka ngokukhawuleza kwaye ingalindelekanga, inqanda amandla akho okulawula umzimba wakho ngendlela ofuna ngayo. Bangakwazi ukuphazamisa imisebenzi yakho kunye nokuhamba kwakho okunenjongo. Ngamanye amaxesha, i-dyskinesias inokuthi ingakhathazeki ngokwenyama, kwaye inokuba yintlungu, nangona oko akuqhelekanga.
Izizathu zeDyskinesia
Kukho izimbalwa ezimbalwa ze-dyskinesia; Ezi ziquka ukubetha, ukukhubazeka kwe-cerebral , i- multiple sclerosis , kunye neyeza-antipsychotic. Isizathu esiqhelekileyo se-dyskinesia sibizwa ngokuba yi-levodopa-induced dyskinesia (i-LID.) I-LID ichaza i-dyskinesias eyenzeka njengempembelelo ecaleni yamachiza asetyenziswa unyango lwezonyango ze- Parkinson .
Kutheni i-Dyskinesia ikhula njengeSiphumo seMigudu ye-Parkinson's Medicine
Isifo se-Parkinson sisifo sokunyakaza esicatshulwa ngokuphumla ukunyaniseka nokuxinwa kwemisipha. Imithi esetyenziselwa isifo sika-Parkinson ziphakathi kwezona zizathu ezibalulekileyo ze-dyskinesia. Amachiza asetyenziswa ukulawula iimpawu zesifo se-Parkinson zibizwa ngokuba yimithi ye-dopaminergic. Njengoko le miyeza ye-dopaminergic yandisa inani le-dopamine kwingqondo, iyanciphisa kakuhle iimpawu zesifo se-Parkinson.
I-Dyskinesia ayifuni ngokuqhelekileyo njengemiphumo yamanyathelo ambalwa nje enemithi ye-dopaminergic okanye xa usebenzisa la mayeza ngexesha elifutshane. Ngenxa yokuba isifo sika-Parkinson sisimo sempilo yonke, abantu abanesi sifo kufuneka bathathe imithi ye-dopaminergic iminyaka. Emva kweminyaka emininzi yokuthabatha la mayeza, abantu abane-Parkinson isifo sinokuphuhlisa isiphumo esicacile sokubambezeleka kwe-dyskinesia.
Kukho uphando oluninzi malunga nokuba kunokwenzeka ukuthintela i-dyskinesias ekuphuhliseni kwaye ukuba ukuxilisa i-dopaminergic imithi kunokulibazisa okanye ukunciphisa ukuphuhliswa okanye ubunzima be-dyskinesia. Kodwa abukho ubungqina obubonisa ukuba ukulibaziseka iyeza ze-dopaminergic kunokuthintela lo mphumela olungasecaleni ekugqibeleni ukuphuhlisa okanye ukwenza kube nzima kakhulu ekuhambeni kwexesha.
Uninzi lwabantu abanesifo sikaParkinson banikezwa iinkcazo ezicacileyo malunga nokuphuhliswa kwesiphumo sokubambezeleka kwe-dyskinesia kwangaphambili. Ngokubanzi, ngenxa yokuba imishanguzo ye-dopaminergic iphumelele ekunciphiseni iimpawu eziphawulekayo zesifo se-Parkinson, abantu abanesifo sika-Parkinson bacinga ukuba uphuculo lomgangatho wokuphila lufanelekile ukubeka ingozi kwimpembelelo yecyskinesia phantsi kwendlela.
Unyango lweeDyskinesias
Ngokuqhelekileyo, ukuba uqala ukufumana ama-dyskinesias emva kweminyaka yokuthatha amayeza e-Parkinson, oogqirha bakho bangakwazi ukulawula le mpahla ngokuguqula amayeza akho .
Ukulungiswa kunokubandakanya ukuthatha imishanguzo yokwenza ixesha elide okanye ukulungelelanisa ishedyuli yakho yamayeza emini. Oogqirha bakho bangongeza amayeza amaninzi ahlukeneyo kumayeza aphantsi asebenza kunye endaweni yokusebenzisa i-dose ephezulu, ukuvelisa iziphumo zonyango. Ezi zihlengahlengiso zilungelelanisa isidingo sokunciphisa iimpawu ze-Parkinson kunye nokunciphisa i-dyskinesia yakho.
Ezi ndlela zisebenza kwabanye abantu abane-LID, kodwa asebenzelanga wonke umntu. Xa ukuguqulwa kwamachiza akwanele ukuba kulungelelanise ukulinganisela phakathi kokunciphisa iimpawu nokunciphisa imiphumo emibi, kukho iindlela zokugada ezinokunciphisa i-dyskinesias eziphuhliswayo ngokuthatha imithi ye-dopaminergic.
Ubungqiqo obunzulu beBrain (DBS) kwiDyskinesia
I-DBS yindlela yokucwangcisa esetyenziselwa ukulawula i-dyskinesia ephumela kwizifo zonyango lika-Parkinson. Le nkqubo ibandakanya ukubeka umqhubi wombane kwingingqi yengqondo.
Kukho iindawo ezimbalwa ezibhekwa njengezilungelelaniso kwi-DBS yokubeka idivaysi, kwaye uvavanyo oluphambi kokuvuthwa lunokukunceda ukuchonga indawo efanelekileyo kwindawo ethile. Ezi ndawo zibandakanya i-globus pallidus internus kunye ne-nucleus ye-subthalam, ezo zombini ziindawo ezincinci ziphantsi kwengqondo.
Izixhobo ze-DBS ziquka i-electrodes, ezibekwe kwindawo enye okanye zombini kwi-globus pallidus okanye i-nucleus ye-subthalam. Ijeneretha, eyenzelwe ukulawula ukulungiswa kombane okuchanekileyo, ifakwe kwisithili esiphezulu. Ifowuni ifakwe ibhetri yokusebenza okuqhubekayo, kwaye le bhetri idinga ukutshintshwa yonke iminyaka embalwa.
Indlela iDBS inceda ngayo iDyskinesia
Indlela esebenzisa ngayo i-DBS inceda ekunciphiseni i-dyskinesia inxaxheba ngokufanelekileyo. Ifowuni inciphisa ubuchopho bobuchopho, obu novuyo okanye ukukhusela umsebenzi wengqondo. Ngokuxhomekeka kwendawo yokuhlala ye-electrodes, ukuvuselelwa kombane kunokunciphisa i-dyskinesia ngokusebenza ngokuthe ngqo kwingqondo, okanye kunokunciphisa ngokuchanekileyo i-dyskinesia ngokunciphisa imfuno yonyango lwe-dopaminergic, nto leyo eyenza iyanciphisa i-dysamineric effect effect ye-dyskinesia.
Izishukumisi ezifakwe kwi-globus pallidus zichaphazela ngqo i-dyskinesias, ngelixa ama-stimulator afakwe kwi-nucleus ye-subthalam inokunciphisa imfuno yemithi ye-dopaminergic, ukunciphisa umphumo we-dyskinesia.
Khu seleko lweDBS
Ngokubanzi, le nkqubo ikhuselekile, kodwa njengazo zonke iinkqubo, kunokukho iingxaki. Iingxaki ezinxulumene neDBS ziquka ukusuleleka kunye nokuphuma kwegazi.
Izifo ziyakwazi ukuvelisa intloko, ukunyaniseka, ukudideka kunye neentsholongwane. Ukuhlamba kunokuvelisa i-headaches, iinguqu zenguqu, okanye ukulahleka kwengqondo. Ukuba uhleliwe ukuba ube ne-DBS yokuhlinzwa, iqela lakho lezonyango liyakukujonga ngokukhawuleza emva kwenkqubo. Kukho izizathu ezahlukeneyo zokubeka iliso emva kokusebenza, kubandakanya ukuhlolwa komsebenzi we-stimulator, nokubamba nayiphi na ingxaki ngaphambi kokubangela iingxaki ezihlala zihlala njalo.
Ezinye iindlela zokuPhepha ze-Dyskinesia e-Parkinson-Associated-Dyskinesia
Kukho ezinye iindlela ezimbalwa zokucwangcisa ezinokuqwalaselwa ngokulawulwa kwe-LID. Ezi nkqubo azibandakanyi ukufakwa kwe-stimulator; zibandakanya ukudala esinye isiqhelo semimandla yengqondo ejongene neempawu zeParkinson okanye i-dyskinesias.
Ngokuqhelekileyo, utyando lwe-lesional lujolise kwi-globus pallidus okanye i-nucleus ye-subthalam, kwaye inokubandakanya amacala omabini xa kuyimfuneko. Le nkqubo ifana ne-DBS, ithathwa njengekhuselekile kwaye isebenzayo. Ukuba ungumgqatswa we-DBS, ke kunokwenzeka ukuba iqela lakho lezonyango liza kuxoxa ngeendlela ezininzi zokunyanga kunye nawe, ngaphezu kweDBS.
ILizwi
Isifo se-Parkinson sisona sisifo esiqhelekileyo sentshukumo. Yimpilo yobomi ekulindeleke ukuba ibe nzima ngakumbi kwiminyaka. Ngenxa yeempawu ezibuhlungu, abantu abanesifo sika-Parkinson bahlala befuna ukulungiswa kwemithi njengoko isifo sisenza kunye neziphumo ezichaphazelekayo.
Okumangalisa kukuba, impembelelo yecala lezonyango ezisetyenziselwa isifo sikaChinsinson enye ingxaki yokunyakaza, i-dyskinesia. Kwabanye abantu abanesifo sika-Parkinson, kuza iqondo apho amayeza angasayi kuba nako ukunyamezela, kwaye iindlela zokugonywa zingabonwa njengona khetho.
Iindaba ezilungileyo, nokuba kunjalo, kukuba isifo sikaParkinson okanye i-dyskinesias ayingozi okanye sisongela ubomi. Utyando lwe-DBS lukhetho oluye lwadlulayo iminyaka emininzi, luqondwa kakuhle, kwaye lubonwa ukuba lukhuselekile kwaye lunyamezeleke. Kule minyaka edluleyo, kuye kwaba namawaka abantu abane-Parkinson yesifo abaye baqhwala i-LID, kwaye iziphumo ziye zalungile. Ukuba ungumgqatswa we-DBS, lindela ukuba uqulunqwe ngokucwangcisekileyo kunye nokulandelelana okufutshane emva kwenkqubo yakho, njengoko oku kuya kwandisa amathuba akho kwisiphumo esiphumeleleyo kunye nokubuyiselwa.
> Umthombo:
> I-Tan ZG, i-Zhou Q, i-Huang T, i-Jiang Y. Iingcambu ze-globus pallidus ukuvuselela kunye nokuvuselela kwe-nucleus yesifo sePasinson yesifo esiphambili: uhlalutyo lwe-meta-analysis of randomized controls, i-Clin Interv Aging. 2016 Juni 21; 11: 777-86.