Uhlobo Oluthile Lokwenyuka Okumangalisa
Uninzi lwabantu lukholelwa ukuba bayazi ukuba kuthathwa njani ukubetha . Umntu onokubamba uqala ukugubha ngokungaqondakaliyo, uwa phantsi, aze alahleke. Kodwa oku akunjalo ngaso sonke isikhathi. Ukuxhamla kungabonakala ngendlela engavamile, ngamanye amaxesha kunokuchaphazela enye inxalenye yomzimba, ngamanye amaxesha kuthintela inxalenye yengqondo ngaphandle kokuxubana ngokugqithiseleyo.
Isimo se-epilepticus sisona sihlobo esinzima kakhulu sokuthatha-ukuthatha inkunkuma engayi kuyeka. Ukongeza kokubeka ngokufanelekileyo isigulane singene kwi- coma , isimo se-epilepticus sinokubulala kwaye sikhowule kumonakalo wengqondo esisigxina. Isimo se-epilepticus yimeko engxamisekileyo yonyango.
Phantse kwiminyaka elishumi edlulileyo, abaphandi base-Columbia University e-New York badala inzululwazi kuluntu lwezonyango xa bevavanya izigulane kwi-ICU nge- electroencephalography . Nangona kwakungekho sikrokreko sokuba ezi zigulane zithintela, yiloo nto abaphandi abayifumeneyo. Phantse iipesenti ezilishumi zezigulane ezingaphenduliyo kwi-ICU empeleni zisesimo esingaxhamliyo nesifo se-epilepticus, i-NCSE.
Yintoni engeyona iNgconvulsive Status Epilepticus?
Ngesimo esingaxhamliyo, isifo sengqondo sihlala sithatha, okanye sithatha ngokuphindaphindiweyo kangangokuthi isigulane asinakho ithuba lokubuyiselwa kwixesha elide lokudideka ngokuqhelekileyo elilandela ukutshatyalaliswa.
Eli xesha lokubuyisela libizwa ngokuba yi- post-ictal state .
Ngona-nxalenye, abantu abanesimo esingenasimangalo se-epilepticus kubonakala ngathi ezinye izigulane ze-ICU ezingaphenduliyo ngenxa yokungaboni kakuhle okanye naliphi na ezinye iziphazamiso zengqondo . Nangona kunjalo, ukuba kuhlolwa nge-EEG, sinokubona ukuba ngokwenene, isigulane sisesimo se-epilepticus.
Ukwahlukana kubalulekile, kuba isimo se-epilepticus singaphendula kumachiza. Ngokuqhelekileyo, kuya kuba yingcamango eyingozi ukunika isigulane se-encephalopathic i-benzodiazepine efana ne-Ativan (lorazepam), kuba la mayeza anciphisa umsebenzi wengqondo. Kwisigulane esele singacingi kakuhle, i-benzodiazepines ingenza ingxaki ibe nzima.
Ngakolunye uhlangothi, ukuxhatshazwa kubangelwa yimisebenzi engqondweni engavamile. Kule meko, imishanguzo yokulwa ne-epileptic, njenge-benzodiazepine, inokunceda ngokwenene isigulane siphinde siqaphele emva kokuba isimo se-epilepticus siphazamisekile.
Ukuxilongwa kweNkcazo engeyiyo Inqabana Epilepticus
Enyanisweni, ukwenzela ukuba unyamekele isimo esingaxubulanga nesifo se-epilepticus, kufuneka uqale ugqibe ukuba isigulane sithatha. Ngokubanzi, isimo esingaxhamliyo nesifo se-epilus sichazwa, esichazela ukuba izigulane ezininzi aziphilwanga. Ingxenye yesizathu kukuba i-NCSE yinto echazwe ngokutsha, kwaye ngohlobo lwalo, alubonakali ngokuphawulekayo njengendlela yokuxhamla kwesimo se-epilepticus.
Esinye isizathu sokuba i-NCSE ye-undersiagnosis yinto yokuba ivela kwiindlela ezininzi ezahlukeneyo, ezininzi zazo zidla ngokubangela into eqhelekileyo. Ngokomzekelo, malunga nesiqingatha sezigulane esibhedlele zihlupheke kwi- delirium , ezinokubonakala zifana ne-NCSE kodwa zixhaphake kakhulu.
Kwezinye iindawo eziphambili zezemfundo ze-neurology, kuba yinto eqhelekileyo yokuqhagamshela i-EEG ikhokelela kuzo zonke izigulane ze-ICU. Nangona kunjalo, kwizibhedlele ezininzi, ugqirha kufuneka aqwalasele ngononophelo isigulane esifanele senze uvavanyo olusondeleyo kunye ne-EEG.
Unyango lweNkcazo engeyiyo Inqabana Epilepticus
Indlela yokuphatha kakuhle i-NCSE yindawo ekhulayo yeyeza. Indlela eyona ndlela ibhetele ishiywe yimiba yesigulane, ezinye izifo kunye nezinye iinkalo zokubamba. Ngokomzekelo, i-NCSE ngamanye amaxesha ilandela isimo esicacileyo se-epilepticus. Kule meko, kukho ingozi ecacileyo kwi-NCSE, kwaye unyango olukhuselekileyo kwiyunithi yonyango enzulu (ICU) iyabizwa.
Nangona kunjalo, kwezinye iimeko apho i-NCSE ingekhe ilandelwe ukuxubusha, kungenokuba ngcono ukuba izigulane zingabonakali kwi-ICU, ngakumbi ukuba izigulane zikhulile. Oku kungenzeka kukuba imithi ye-anticonbulsant ibuye ineempembelelo, kwaye ngenxa yemingcipheko eyongeziweyo yokuhlala kwi-ICU.
Ubudala buba nemicimbi xa unyanga i-NCSE kumncinci kakhulu, njengoko izibangela zokubanjelwa ngokuqhelekileyo zihluke kakhulu kunezigulane ezinde. Abantwana kaninzi banokugunjwa ngenxa yeengxaki ze-genetic, kanti izigulana ezithe zahlala zikhulile zingabanjwa ngenxa yenkinga efumanekayo, njengesihlungu.
Kwiimeko apho i-static epilepticus ihambelana nezinye iingxaki zonyango, enye yezona zinto zonyango zonyango ukujongana neengxaki ezisisiseko. Ukuxhatshazwa kwenziwa kakubi xa umzimba ungalingani nentsholongwane okanye ezinye iingxaki zonyango. Umzekelo, ukuba isigulane sinomonakalo omkhulu weentso kunye nesibindi, ukongeza ii-anticonbulsants zenza imeko ibe yimbi. Nje ngokuba kunjalo, unyango lwe-NCSE kufuneka lulungelelaniswe neemfuno zesigulane ngasinye njengomntu ngamnye.
Imithombo:
J Claassen, iMeer SA, iKowalski RG, uEmerson RG, uHirsch LJ. Ukufumanisa ukutshatyalaliswa kwe-electrographic ne-Monitoring EEG eqhubekayo kwizigulane ezigulayo. Neurology. 2004 Meyi 25; 62 (10): 1743-8.
UFrank W. Drislane, u-MD1Umboniso, uVavanyo, kunye noTyango lweNkcazo engeyiyo yonqabileyo Epilepticus Ukuxilwa nokuziphatha 1, 301-314 (2000)
USimon Shorvon Yintoni engeyona inxubileyo ye-eppilepticus, kwaye yiyiphi i-subtypes yayo? I-Epilepsia, 48 (iSiza 8): 35-38, 2007
ULitt B, uWityk RJ, uHertz SH, uMnnel PD, u-Weiss H, uRyan uRD, uHenry TR. Epilepsia. Isimo esingaxhamliyo nesifo se-epilus kwisigulane esigula kakhulu. NgoNovemba ka-1998; 39 (11): 1194-202.