I-Cervical Dystonia

Uke wavuka usunentamo eqinile enganyakazi? Kulabo abane-dystonia yomlomo wesibeletho, lokhu kungahambi kahle kuyiqiniso lansuku zonke. I-Cervical dystonia yisimo se-neurological esibangela ukugoqa okungenangqondo emisipha yentamo, okuholela ekumisekeni kwekhanda okungavamile nokunyakaza. Lesi sifo singathinta kakhulu izinga lempilo yomuntu, senze imisebenzi elula ibe inselele futhi ngokuvamile ibangele ubuhlungu nokuphoxeka.

Ukuqonda isifo se-cervical dystonia kubalulekile ekuphatheni ngempumelelo nasekulashweni. Ake sihlole izimpawu, izimbangela, kanye nezimpawu zokuqala ze-dystonia yomlomo wesibeletho, kanye nezinketho zokwelashwa ezihlukahlukene ezitholakalayo. 

Iyini i-Cervical Dystonia?

I-Cervical dystonia (i-spasmodic torticollis) yisifo sezinzwa esithinta ubuchopho nezinzwa, okubangela ukufingqa kwemisipha okuzenzakalelayo entanyeni. Lesi sifo esingavamile singenzeka kubantu banoma yibuphi ubudala kodwa ngokuvamile sithinta abantu abaneminyaka ephakathi nendawo, abesifazane yibona abangenwa kalula kunabesilisa.

Lesi simo siphoqa imisipha yentamo ukuthi ifinyele ngokuzenzakalelayo, okuholela ekumeni kwekhanda okungavamile nokunyakaza. Lokhu kufinyela kungaholela ekumeni kwekhanda okuhlukahlukene, okuhlanganisa kodwa kungagcini kulokhu:

• Isilevu siqonde phezulu
• Isilevu ngasehlombe
• Isilevu siqonde phansi
• Indlebe ibheke ehlombe

Uhlobo oluvame kakhulu lokusonteka okuhambisana ne-dystonia yomlomo wesibeletho lubandakanya isilevu sidonselwa ngasehlombe. Abanye abantu bangase babe nenhlanganisela yalokhu kumiswa kwekhanda okungavamile, futhi ukunyakaza kwekhanda kungase kwenzeke.

Isifo se-Cervical dystonia sihlukaniswa ngezinhlobo ezimbili ngokuya ngembangela yaso:

• Okuyinhloko
• Secondary

Izimpawu ngokuvamile ziqala kancane kancane futhi ekugcineni zifinyelele ithafa lapho zingabi zimbi kakhulu.

Izimpawu ze-Cervical Dystonia

I-Dystonia yomlomo wesibeletho ibangela ukunyakaza okuzihambelayo okuthinta intamo nekhanda. Izimpawu zokuqala zihlanganisa:

• I-Spasms: Imisipha yentamo yentamo ingase ibangele ukunyakaza okungazelelwe noma ukuxubha.
• Ukuthuthumela: Ukuzamazama okungalawuleki kungenzeka ezingxenyeni ezithile zomzimba, ikakhulukazi ezingalweni.
• Izinguquko zokuma: Isimo sithinta ukuma komuntu, okuholela ezindaweni ezihlukahlukene zekhanda:
  • Ukuzungezisa: Ikhanda liphendukela ohlangothini olulodwa.
  • I-Tilting: Ikhanda liya phambili, emuva, noma uhlangothi ukuya ohlangothini nge-engeli encane.
  • Ukugoba: Intamo nekhanda kugobela phambili, emuva, noma emaceleni.
• Ubuhlungu: Abantu abaningi bazwa ubuhlungu noma ukuzwa okushisayo emahlombe abo nasentanyeni. Lobu buhlungu bungaphuma, bubangele ukungakhululeki ngaphandle kwendawo eseduze.
• Ukuphathwa yikhanda: Lokhu kuvame ukuhambisana nokufinyela kwemisipha nokushintsha kokuma.

Izimbangela ze-Cervical Dystonia

Isizathu esiqondile se-dystonia yomlomo wesibeletho asaziwa kubantu abaningi. Odokotela abakahlonzi inhlamvu ethile yazo zonke izimo. Nokho, ucwaningo lusikisela ukuthi i-basal ganglia, ingxenye yobuchopho enesibopho sokulawula ukunyakaza kwemisipha, ingase ingasebenzi ngendlela efanele kubantu abanalesi simo.

Kwezinye izimo, i-dystonia yomlomo wesibeletho inengxenye yofuzo (ukuguqulwa kofuzo kuzakhi zofuzo ze-GNAL, THAP1, CIZ1, kanye ne-ANO3).

Izici ezithile zingandisa ingozi yokuthuthukisa i-dystonia yomlomo wesibeletho:

• Ukuba namalungu omndeni wemvelo analesi simo
• Ubhekene nokulimala kwengqondo
• Isifo sikaParkinson
• Kwezinye izimo, ukulimala kwekhanda, intamo, noma ihlombe. 

Ukuxilongwa kweCervical Dystonia

Odokotela baxilonga i-dystonia yomlomo wesibeletho ngokusebenzisa ukuhlolwa okuphelele kokubonakaliswa kwemitholampilo. 

• Umlando Wezokwelapha Nokuhlola Umzimba: Odokotela benza ukuhlolwa ngokomzimba ukuze babuyekeze izimpawu futhi babuze ngomlando wezokwelapha wesiguli, kuhlanganise nanoma yimuphi umlando womndeni walesi simo. Ngesikhathi sokubonisana, odokotela bangase bakubuze ngezimpawu zakho, izimbangela, izici zokudambisa, kanye nemithi eqhubekayo.
• Ukuhlola Okwengeziwe: Odokotela bangase batuse ukuhlolwa okwengeziwe ukuze kukhishwe izimo ezikhona. Lokhu kungase kuhlanganise:
  • Ukuhlolwa kwegazi
  • Magnetic resonance imaging (MRI)
  • I-Neuroimaging iyasiza ku-hemidystonia noma i-dystonia evamile kubantu abadala ngenxa yamathuba aphezulu okuveza izimbangela zesakhiwo.
  • Odokotela bangase batuse ukuhlolwa kofuzo kuma-dystonia ahlukanisiwe aqala ekuqaleni.

Lapho i-dystonia yomlomo wesibeletho ihlangana nezinye izici zemizwa noma zesistimu, ukusebenza okwengeziwe kuyadingeka. Ukuhlolwa kwaselabhorethri okukhethekile kuncike ezicini ezihambisanayo neminyaka yokuqala. 

Ukwelashwa kwe-cervical dystonia

Nakuba lingekho ikhambi eliqondile le-dystonia yomlomo wesibeletho, izinketho ezihlukahlukene zokwelapha zingasiza ukuphatha izimpawu nokuthuthukisa izinga lokuphila. Izindlela zokwelapha i-dystonia yomlomo wesibeletho zihloselwe ukunciphisa ubuhlungu bentamo, ukuthuthukisa ukuqondanisa kwentamo nokunciphisa ukunyakaza okungavamile. 

• Imithi:
  • Imijovo yobuthi be-botulinum iphakathi kwezinketho eziphumelela kakhulu zokwelashwa kwe-cervical dystonia, ngokuvamile ephindaphindwa njalo ezinyangeni ezintathu kuya kwezine. 
  • Imithi ephuzwayo enemiphumela ephumuza imisipha ingase ihambisane nokwelashwa kwe-botulinum toxin. Lokhu kungathuthukisa imiphumela noma kusize ukunciphisa umthamo kanye nemvamisa yemijovo.
• Izindlela okungezona ezokwelashwa: 
  • Amaqhinga Enzwa: Ukuthinta izindawo ezithile, njengohlangothi oluphambene lobuso, kungase kumise okwesikhashana izinhlungu.
  • Amaphakethe Okushisa Nokubhucunga: Lokhu kungasiza ukuphumula imisipha yentamo nehlombe.
  • Exercises: Imisebenzi ethuthukisa amandla entamo nokuvumelana nezimo ingase ibonakale inenzuzo.
  • Ukulawula Ukucindezeleka: Ukufunda amasu okuphumula kubalulekile njengoba ukucindezeleka kuvame ukwenza izimpawu zibe zimbi kakhulu.
• Ukuhlinzwa:
  • Ezimweni ezimbi kakhulu ezingaphenduli kwezinye izindlela zokwelapha, kukhona izinketho zokuhlinzwa. Lokhu kuhlanganisa ukushukunyiswa kobuchopho obujulile, lapho ama-pulses kagesi aphazamisa izimpawu zemizwa eziyinkinga, kanye nokuncishana okukhethekile, okubandakanya ukusika imizwa ethile ethwala izimpawu zokufinyela emisipha ethintekile.

Izingozi ze-Cervical Dystonia

I-Dystonia yomlomo wesibeletho ingathinta noma ubani, kodwa izici ezithile zingase zandise amathuba okuba lesi simo, kuhlanganise:

• Ubudala: Nakuba kungenzeka kunoma iyiphi iminyaka yobudala, lesi sifo ngokuvamile siqala ngemva kweminyaka engu-30. Iqembu elisengozini enkulu liphakathi kweminyaka engama-30 nengama-60.
• Ubulili: Abesifazane yibona abathinteka kakhulu kulesi simo kunabesilisa.
• Imithi ethile: Abantu abasebenzisa i-dopamine antagonists noma i-antipsychotics bangase babe nengozi enkulu yokuthuthukisa i-dystonia yomlomo wesibeletho.
• Ukulimala Kobuchopho: Labo abaye babhekana nokulimala kwengqondo basengozini enkulu yokuthuthukisa lesi simo.

Izinkinga zeCervical Dystonia

I-Cervical dystonia ingaholela ezinkingeni ezihlukahlukene ezithinta impilo yomuntu yansuku zonke kanye nenhlalakahle jikelele. 

• Ubuhlungu obukhulu kanye nokungakhululeki kwemisipha emisipha esebenza ngokweqile
• Imisebenzi elula efana nokukama izinwele noma ukuxubha amazinyo ingase ibe inselele ngenxa yokundindizela, ama-spasms, nokunyakaza kwentamo okulinganiselwe. 
• Ukucindezelwa kwezimpande zezinzwa kungase kubangele ukushotshozela, ukuba ndikindiki, noma ukuncipha kokuzwa ebuthakathakeni ezingalweni, ezandleni, ekhanda, nasehlombe.
• Inkulumo, ukugwinya, nokuxhumana ngokomzimba nakho kungahlupheka, okungase kuthinte ukusebenza komsebenzi kanye nezinga lempilo.
• Uma ishiywe ingalashwa, i-dystonia yomlomo wesibeletho ingase isakaze ezindaweni eziseduze ezifana nobuso, umhlathi, izingalo, ne-trunk. 
• Izinkinga zesibili zingavela ku-dystonia yomlomo wesibeletho, njengomgogodla wesibeletho sokuqaqamba kwamalunga kanye ne-stenosis yomlomo wesibeletho (ukuncipha komgogodla entanyeni).
• Kwezinye izimo, i-bone spurs ingase ithuthuke, inciphise isikhala emgodini womgogodla. Lokhu kungaholela ekulimazeni, ukuba ndikindiki, kanye nokuba buthakathaka ezingalweni, ezandleni, emilenzeni, noma ezinyaweni, kube nomthelela omkhulu ekuhambeni nokunethezeka.

Uzoyibona Nini Udokotela

• Abantu ngabanye kufanele bavakashele udokotela uma bebona ama-muscle spasms noma ukuqina kwentamo yabo. 
• Uma izimpawu ze-cervical dystonia ziphazamisa imisebenzi yansuku zonke
• Uma abantu bethola imiphumela emibi yokwelashwa noma izimpawu eziba zimbi kakhulu
• Uma abantu bezwa ukuntweza, ukuba ndikindiki, noma ubuthakathaka ezingalweni, ezandleni, emilenzeni, noma ezinyaweni

Prevention

Nakuba ukuvimbela kusenzima, ukutholakala kusenesikhathi nokuphatha kungasiza ukulawula izimpawu futhi kuthuthukise izinga lempilo. Abantu ngabanye kufanele banake noma yikuphi ukugoqa kwemisipha okungenakuzithandela endaweni yentamo, njengoba lokhu kungase kubonise ukuqala kwe-dystonia yomlomo wesibeletho. Lesi simo ngokuvamile siqala kancane kancane, izimpawu zifike ethafeni ngokuhamba kwesikhathi.

Kubalulekile ukubonana nodokotela uma kuvela izimpawu ze-cervical dystonia. Ukungenelela kusenesikhathi kungasiza ukuphatha izimpawu ngokuphumelelayo futhi kuvimbele izinkinga ezingaba khona, njengokusabalalisa ukufinyela kwemisipha ezindaweni eziseduze noma ukuthuthukisa i-bone spurs.

Isiphetho

Ukuphatha i-dystonia yomlomo wesibeletho kudinga indlela ebanzi ehlanganisa ukwelashwa kwezokwelapha nokulungiswa kwendlela yokuphila. Kusukela emijovweni yobuthi be-botulinum kuya kumasu okulawula ukucindezeleka, kunamasu ahlukahlukene okusiza ekudambiseni izimpawu nokuthuthukisa izinga lempilo. Ukuxilongwa kusenesikhathi nokungenelela kuthinta kakhulu imiphumela yokwelashwa, okugqamisa ukubaluleka kokufuna iseluleko sezokwelapha lapho izimpawu ziqala ukuvela. Le ndlela ivumela abantu abane-dystonia yomlomo wesibeletho ukuthi babhekane kangcono nezimpawu futhi balondoloze ukuphila okwanelisayo naphezu kwezinselele ezibangelwa yilesi sifo sezinzwa.

FAQ sika

1. Ingabe i-dystonia yomlomo wesibeletho iyahamba?

I-Cervical dystonia yisimo sempilo yonke esingenalo ikhambi elaziwayo. Ezimweni ezingavamile, abantu bangase bathole ukukhululwa okuzenzakalelayo, ngokuvamile okwesikhashana. Bangaphansi kuka-1% abantu abathintekile baxolelwe unomphela. Nakuba lesi simo singasithinti isikhathi sokuphila, izimpawu zingase zibe zimbi kakhulu noma zibe yithafa ngokuhamba kwesikhathi.

2. Ingabe ukucindezeleka kungabangela i-dystonia yomlomo wesibeletho?

Ukucindezeleka akubangeli i-dystonia yomlomo wesibeletho, kodwa kungandisa izimpawu. Ukucindezeleka kwengqondo kukhonjwe njengento engase ibe yimbangela. Ezinye iziguli zibika ukucindezeleka ngokweqile ngaphambi kokuqala kwe-dystonia yomlomo wesibeletho ngezinyanga ezimbalwa. Ukufunda amasu okulawula ukucindezeleka kubalulekile ekulawuleni izimpawu ngempumelelo.

3. Yikuphi ukudla okufanele ngikugweme nge-dystonia yomlomo wesibeletho?

Nakuba kungekho ukudla okuqondile kwe-cervical dystonia, ezinye izinguquko zokudla zingasiza ukuphatha izimpawu. Ukugwema ushukela oweqile, ama-carbohydrate alula, i-caffeine, notshwala kungavimbela ukushintshashintsha kukashukela egazini okungase kuthinte ukusebenza kobuchopho. Abanye abantu bathola impumuzo ngokususa i-gluten nobisi, nakuba lokhu kuhluka kumuntu nomuntu. Ukudla okunomsoco okunothiswe izithelo, imifino, inyama engenawo amandla, namantongomane aluhlaza kungaba nomthelela enhlalakahleni yonke.

4. Iyini imbangela ye-dystonia yomlomo wesibeletho?

Isizathu esiqondile se-dystonia yomlomo wesibeletho asaziwa ezimweni eziningi. Ucwaningo lusikisela ukuthi i-basal ganglia, ingxenye yobuchopho elawula ukunyakaza kwemisipha, ingase ingasebenzi kahle. Ezinye izenzakalo zinezixhumanisi zofuzo, okukhonjwe ukuguqulwa kofuzo njenge-GNAL, THAP1, CIZ1, ne-ANO3. Izimbangela zesibili zingabandakanya izinkinga ezivela emithini yengqondo, ukulimala kobuchopho okubuhlungu, noma isifo sikaParkinson.

5. Hlobo luni lukadokotela oluphatha i-dystonia yomlomo wesibeletho?

Odokotela bezinzwa ngokuvamile baxilonga futhi belaphe i-dystonia yomlomo wesibeletho. Laba chwepheshe banolwazi lwezifo ezithinta isimiso sezinzwa. Ukwelashwa kuvame ukuhlanganisa indlela ehlukahlukene, engase ihlanganise abelaphi bomzimba ukuze bazivocavoce nokulawula izinhlungu futhi, kwezinye izimo, izinqubo zokuhlinza ezinjengokushukumisa ubuchopho obujulile.

UDkt. Prof. Umesh T

MBBS, MD (General Medicine), DM (Neurology), DNB (Neurology)
CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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