I-Guillain-Barre Syndrome

I-Guillain-Barre syndrome ithinta abantu abangaba ngu-100,000 emhlabeni wonke unyaka ngamunye. Lokhu kuphazamiseka kwe-autoimmune okungajwayelekile kodwa okuthena amandla kungahlasela ngaphandle kwesixwayiso. Abantu abaphakathi kweminyaka engama-30 no-50 ubudala baba nezimpawu zesifo sika-Guillain Barre ngokushesha phakathi nezinsuku noma amasonto. Umbono wokululama uletha ithemba njengoba iningi leziguli lilulama phakathi nezinyanga eziyisithupha ngemuva kokuvela kwezimpawu. Ukululama okuphelele ngezinye izikhathi kungase kuthathe iminyaka eminingana. Kule bhulogi enemininingwane, ake sihlole ukuthi iyini i-GBS, izimbangela zayo, ukuxilongwa, kanye nezindlela zokwelashwa ezihlukene.

Iyini i-Guillain-Barre syndrome (GBS)?

I-GBS idala inselele eyingqayizivele yesistimu yezinzwa ezungezile elawula ukunyakaza kwemisipha nalezo ezikusiza ukuthi uzwe ubuhlungu, izinga lokushisa, kanye nokuthintwa. Owomzimba izivikeli mzimba ihlasela imizwa yayo ngephutha. Lokhu akuvamile ukuphazamiseka kwemizwa iyimbangela ehamba phambili yokukhubazeka kwe-acute flaccid ezingxenyeni eziningi zomhlaba.

Abantu abane-GBS baqala babone ubuthakathaka nokuluma ezandleni nasezinyaweni. Noma ubani obonisa izimpawu ze-GBS udinga usizo lwezokwelapha ngokushesha ngoba izimpawu zingaba zimbi ngokushesha. Nakhu okumele umuntu akwazi nge-GBS:

• Izimpawu zingavela phakathi nezinsuku noma zithathe amaviki ambalwa ukuthi zivele
• Amadoda athola i-GBS kaningi kunabesifazane, ngesilinganiso esingu-1.5:1
• Lesi simo sithinta abantu bayo yonke iminyaka, kodwa kaningi emadodeni aphakathi kweminyaka engama-30-50
• Izimo eziningi ziqala ngemva kokutheleleka ngegciwane noma amagciwane

Ucwaningo lubonisa ukuthi cishe izingxenye ezimbili kwezintathu zeziguli zibona izimpawu emasontweni ayisithupha ngaphambi kokuqala kwe-GBS. Lezi zifo zisukela ezinkingeni zokuphefumula ziye ezinkingeni zesisu. Iziguli eziningi zibona ukuthuthuka okukhulu phakathi nezinyanga eziyisithupha ngemuva kokuqala kwezimpawu. Abanye abantu bangase bazizwe bebuthakathaka, bendikindiki, noma bekhathele ngemva kokululama.

Izinhlobo ze-Guillain-Barre Syndrome

Ucwaningo lwembule izinhlobo eziningana ezihlukene ze-Guillain-Barre syndrome (GBS) ezithinta isimiso sezinzwa ngezindlela ezahlukene. 

• I-Acute Inflammatory Demyelinating Polyneuropathy (AIDP): Lokhu okuhlukile kuthinta imigoqo ye-myelin yezinzwa, futhi ubuthakathaka buqala emzimbeni ophansi ngaphambi kokuhambela phezulu.
• I-Acute Motor Axonal Neuropathy (AMAN): Lolu hlobo luthinta kuphela izinzwa ezixhumene nokunyakaza, ezivame ukuxhunyaniswa nezifo ezifana neCampylobacter jejuni.
• I-Acute Motor-Sensory Axonal Neuropathy (AMSAN): Lokhu kuhlukahluka okunzima kuthinta kokubili ukunyakaza kanye nezinzwa zezinzwa, okubangela ukukhubazeka okusabalele kanye nokuphazamiseka kwezinzwa ngesikhathi sokutakula isikhathi eside.
• I-Miller-Fisher syndrome (MFS): Lolu hlobo lubonakala nge-ophthalmoplegia, i-ataxia, ne-areflexia, ngokuvamile ngaphandle kobuthakathaka obubalulekile bezitho.

Izimpawu ze-Guillain-Barre Syndrome

Uphawu oluyinhloko lwe-Guillain-Barre syndrome ukuntweza kanye nokuba buthakathaka ezinyaweni nasemilenzeni. Le mizwa ihambela phezulu emzimbeni futhi ithinte umzimba ongaphezulu nezingalo. 
Izimpawu ziqhubeka ngokulandelana okucacile:

• Ukuzwa kwamaphini nezinaliti ezinzwaneni, eminweni, emaqakaleni noma ezihlakaleni
• Ubuthakathaka bemisipha obusakazeka ukusuka emilenzeni kuya emzimbeni ongaphezulu
• Ubunzima bokuhamba noma ukugibela izitebhisi
• Izinkinga zokunyakaza kobuso, okuhlanganisa ukukhuluma nokugwinya
• Izinkinga zombono, kufaka phakathi umbono kabili
• Ubuhlungu obukhulu obunamandla ebusuku
• Ukulahlekelwa Isinye kanye nokulawula amathumbu 
• Izinguquko ekushayeni kwenhliziyo kanye ukushaya kwegazi
• Izinkinga zokuphuza

Iziguli zifinyelela ubuthakathaka obuphezulu phakathi namasonto amabili ngemva kwezimpawu zazo zokuqala. Cishe u-90% weziguli ufinyelela esigabeni sazo esinzima kakhulu ngesonto lesithathu.

Izinkinga ze-GBS Disease

Ucwaningo luthole ukuthi i-Guillain-Barre syndrome iqala ngemva kokuba ukutheleleka kususe impendulo engavamile emasosheni omzimba. Cishe u-70% weziguli ubonisa izimpawu phakathi kwesonto elilodwa kuya kwayisithupha ngemva kokugula. Amasosha omzimba ahlasela imizwa eseceleni ngephutha kulesi simo. Izindlela zokuzivikela zomzimba zingalimaza i-myelin, isivikelo sezinzwa. Lokhu kuvimbela ukuxhumana okubalulekile phakathi kobuchopho nemisipha.

Izingozi Zezingozi

Abantu bangahlakulela i-Guillain-Barre syndrome ngenxa yezizathu eziningana. Lokhu kubandakanya:

• Ukutheleleka kwamagciwane, ikakhulukazi i-Campylobacter jejuni 
• Ukutheleleka ngegciwane njenge-cytomegalovirus, i-Epstein-Barr virus, ne-Zika virus
• Izinqubo zokuhlinzwa zakamuva 
• Izifo zokuphefumula noma zesisu ngaphakathi 
• amasonto ayisithupha edlule
• Iminyaka yobudala, ikakhulukazi kulabo abangaphezu kweminyaka engama-50
• Ubulili besilisa, obunamazinga okwenzeka aphezulu kancane
• Izifo zamaphaphu zakamuva noma i-bacterial gastroenteritis

Izinkinga ze-Guillain-Barre Syndrome

I-Guillain-Barre syndrome ingabangela izinkinga ezincane kuya kwezinzima ezithinta isimiso sezinzwa ezizimele. Lesi simo singaholela kwezinye izinkinga eziningana:

• Ukuphefumula ubunzima
• Izigqi zenhliziyo ezingajwayelekile
• Inkinga yokugaya nokulawula isinye
• Ama-clots egazi ekunganyakazini ngokwanele
• Izilonda zombhede ngenxa yokulala isikhathi eside
• Ubuhlungu bezinzwa obuqhubekayo kwesinye seziguli ezintathu
• Ukuba ndikindiki okuhlala njalo kanye nemizwa elumayo
• Inani elincane leziguli liba nokuphindela emuva

Ukuxilongwa kwe-Guillain-Barre syndrome 

Ukuhlolwa ngokucophelela kwe-Guillain-Barre syndrome kubalulekile ngoba izimpawu zayo zifana nezinye izimo zemizwa. 

Inqubo yokuxilonga iqala ngokubuyekezwa komlando wezokwelapha wesiguli kanye nezifo zakamuva. I-GBS ivame ukuvela ngemva kokutheleleka, ngakho odokotela bafuna ubufakazi bokugula kwangaphambilini emasontweni ayisithupha edlule. Iphethini yokuxilonga yakudala ibonisa ubuthakathaka obuqhubekayo, obulinganayo, phakathi kwezinye izimpawu ezifana nokukhalipha okunciphile noma okungekho. Bahlola amandla emisipha nama-reflexes ngesikhathi sokuhlolwa ngokomzimba.

Ukuhlolwa okuningana okubalulekile kusiza odokotela baqinisekise ukuxilongwa:

• I-Spinal Tap (I-Lumbar Puncture): Lokhu kuhlola kubonisa amazinga amaprotheni anyukile ku-cerebrospinal fluid
• Izifundo Zokuqhuba Imizwa: Ukuhlola ukusebenza kwezinzwa 
• I-Electromyography (EMG): Ama-electrode enaliti encane afakwe emisipha asiza ukuhlola ukusebenza kwemisipha nezinzwa.

Odokotela balandelela ukuqhubeka kwesimo ngokuhlolwa okuphindaphindiwe kwezinzwa.

Ukwelashwa kwe-GBS Syndrome

Iziguli ezine-Guillain-Barre syndrome zidinga ukwamukelwa esibhedlela ngokushesha ukuze zithole ukwelashwa nokuqapha. Ithimba lezokwelapha lisebenza ezicini ezimbili: ukumisa amasosha omzimba ekuhlaseleni izinzwa futhi unikeze ukunakekelwa okusekelayo kuze kube yilapho isiguli siqala ukululama.

Okulandelayo izindlela ezijwayelekile zokwelapha isifo se-GBS:

• I-Plasma Exchange (Plasmapheresis): Umshini uhlukanisa i-plasma kumangqamuzana egazi, uhlunge amasosha omzimba ayingozi, futhi ubuyisele igazi elakhiwe emzimbeni
• I-Immunoglobulin Therapy (IVIG): Amasosha omzimba anempilo avela kwabanikela ngegazi avimba amasosha omzimba adala i-GBS
• Imithi: Imithi yokulawula ubuhlungu obukhulu nokuvimbela amahlule egazi 
• Ukwelashwa Kwemvelo: Ukuthuthukisa ukunyakaza kwezingalo nemilenze
• Ukwelashwa kwenkulumo nokugwinya: Isiza labo abanenkinga yokugwinya

Uzoyibona Nini Udokotela

Kufanele ufune usizo oluphuthumayo lwezokwelapha uma uhlangabezana:

• Ukuluma okuqala ezinyaweni noma ezinzwaneni futhi kukhuphukele phezulu emzimbeni
• Ubuthakathaka obusakazeka ngokushesha
• Ukuphefumula kanzima, ikakhulukazi lapho ulele phansi
• Izinkinga zokugwinya noma ukuminyanisa amathe
• Ubuthakathaka obungazelelwe bemisipha oba bubi kakhulu phakathi namahora noma izinsuku

Iziguli ze-GBS zidinga ukunakekelwa ngokushesha esibhedlela ngoba izimpawu zingaba zimbi ngokushesha. 

Prevention

Isayensi yezokwelapha ayikwazi ukuqinisekisa ukuvinjelwa okuphelele kwe-Guillain-Barre syndrome. Ungathatha izinyathelo ezimbalwa zokuhlanzeka eziyisisekelo ukuze unciphise ingozi yokuba nalesi simo. Amasosha omzimba aqinile ayisivikelo sakho sokuqala ezintweni ezingase zibangele.

Lezi zinyathelo ezilula zokuvimbela ziyasiza:

• Ukugeza izandla njalo ngensipho ethambile namanzi, ikakhulukazi ngemva kokuvakasha endlini yangasese nangaphambi kokuphatha ukudla
• Ukupheka kahle inyama ukugwema izifo zeCampylobacter jejuni
• Ukuhlala kude nabantu abanezifo ezithathelwanayo zokuphefumula noma zesisu
• Ukugcina izindawo ezivamile zihlanzekile futhi zifakwe amagciwane, okuhlanganisa amatafula, izibambo zeminyango, namafoni
• Ukugcina amarekhodi okugoma asesikhathini samanje
• Ukulandela imikhuba emihle yokuphepha kokudla ukuze kuvinjelwe ukungcoliswa kwezifo ezihlukahlukene
• Amasosha akho omzimba azuza ekudleni okunomsoco okucebile izithelo, imifino, amaprotheni mafutha, kanye nezinhlamvu. 
• Umsebenzi womzimba nokulala okwanele kudlala indima ebalulekile ekugcineni impilo yonke. 
• Izivikeli ezingokwemvelo zomzimba wakho ziba namandla uma ulawula amazinga okucindezeleka ngokuphumula okufanele nokuzivocavoca umzimba.
• Thola usizo lwezempilo ngokushesha uma kuvela izimpawu ezifana nomkhuhlane, isifo sohudo, noma izinkinga zokuphefumula. 
• Ukuqwashisa umphakathi okungcono ngezimpawu eziyisixwayiso kusenesikhathi kuholela ekuxilongweni nasekulawuleni ngokushesha, okunciphisa ithuba lemiphumela emibi.

Isiphetho

I-Guillain-Barre syndrome yisimo esingavamile sezinzwa esidinga ukungenelela kwezokwelapha ngokushesha. Ukwelashwa kwesimanje kuye kwathuthukisa kakhulu imiphumela yesiguli ngokushintshaniswa kwe-plasma kanye nokwelashwa kwe-immunoglobulin. Iziguli eziningi zingaphinda zihambe phakathi nezinyanga eziyisithupha zokwelashwa, nakuba izikhathi zokululama ziyehluka.

Ukululama kudinga kokubili ukubekezela nokusekelwa okufanele kwezokwelapha. Amathemba okululama kwesiguli ayathuthuka ngosizo lwezokwelapha ngokushesha ngemva kokuvela kwezimpawu zokuqala. Inhlanganisela yokwelashwa ngokomzimba kanye nokwelashwa okufanele kusiza iziguli zibuyisele amandla azo futhi zizimele.

Imibuzo Evame Ukubuzwa

1. Ingabe i-GBS iyisifo esiyingozi?

Yebo, i-GBS ingaba yingozi futhi ibe yingozi empilweni. Nokho, ngokwelashwa okufanele, abantu abaningi balulama ngokugcwele.

2. I-GBS ihlala isikhathi esingakanani?

Isigaba esibucayi se-GBS ngokuvamile sithatha amaviki ambalwa, kodwa ukululama kungathatha izinyanga kuya eminyakeni. Abantu abaningi babonisa ukuthuthuka okuphawulekayo phakathi nezinyanga ezingu-6-12.

3. Iyini imbangela ye-GBS?

Isizathu esiqondile asaziwa, kodwa odokotela bakholelwa ukuthi impendulo yokuzivikela komzimba ebangelwa izifo noma, kuyaqabukela, ezinye izici ezifana nokutheleleka, ukuhlinzwa noma ukugoma.

4. Ungakwazi yini ukululama ngokugcwele ku-Guillain-Barre syndrome?

Iningi labantu lilulama ngokugcwele ku-GBS, ngisho nasezimeni ezinzima. Kodwa-ke, cishe amaphesenti angama-30 abantu abadala angaba nobuthakathaka obuthile ngemva kweminyaka emithathu.

5. Ingabe kubi ukuba ne-GBS-positive?

Ukuba ne-Guillain-Barre syndrome (GBS) kusho ukuthi amasosha akho omzimba ahlasela imizwa yakho, abangele ubuthakathaka futhi ukukhubazeka. Nakuba kubi, ukwelashwa kusenesikhathi kungathuthukisa ukululama, nakuba okunye kungase kube nemiphumela ehlala njalo.

6. Yimuphi umuthi obulala i-GBS?

Ama-antibiotic awasetshenziselwa ukwelapha i-Guillain-Barre syndrome njengoba amagciwane engayibangeli. Ukwelashwa kugxile kakhulu ekulawuleni izimpawu ze-GBS nokusekela amasosha omzimba.

7. Ubani osengozini enkulu ye-GBS?

Abantu abadala abaphakathi kweminyaka engama-30 kuya kwengama-50 nabesilisa basengozini ethe xaxa, kodwa i-GBS ingathinta abantu babo bonke ubudala nobulili.

8. Ungakwazi yini ukuphila impilo evamile nge-Guillain-Barre syndrome?

Abantu abaningi babuyela emisebenzini evamile ngemva kokululama ku-GBS. Abanye bangase babe nemiphumela ehlala njalo, kodwa abaningi bathola ukululama okuphelele ngokuhamba kwesikhathi nokuvuselelwa.

9. Idluliselwa kanjani i-GBS?

I-GBS ayitheleleki noma idluliselwe komunye umuntu. Kuyimpendulo ye-autoimmune, evame ukubangelwa ukutheleleka.

10. Yikuphi ukudla okulungele i-GBS?

Nakuba kungekho ukudla okuqondile okuqinisekisiwe ukuthi kwelapha i-GBS, a ukudla okulinganiselayo, okunomsoco ingasekela impilo yonke ngesikhathi sokululama. Xhumana nodokotela ukuze uthole iseluleko esiqondene nawe ngokudla.

11. Yikuphi ukudla okufanele ukugweme nge-Guillain-Barre syndrome?

Akukho ukudla okuqondile okwaziwayo ukuthi kwenza i-GBS ibe nzima kakhulu. Kodwa-ke, ukulondoloza umkhuba wokudla okunempilo nokuhlala u-hydrated kubalulekile ngesikhathi sokululama.

12. Kungenzekani uma i-GBS ingelashwa?

I-GBS engelashiwe ingaholela ezinkingeni ezinzima, okuhlanganisa ukwehluleka ukuphefumula, izinkinga zenhliziyo, nokulimala kwemizwa yesikhathi eside. Ukwelashwa ngokushesha kubalulekile ukuze kube nemiphumela engcono kakhulu.

CARE Medical Team

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