Ukuhlinzwa Kwe-Epilepsy

Ukuhlinzwa Kwe-Epilepsy

Ukuhlinzwa kwesithuthwane kuyinqubo yokususa indawo ethile ebuchosheni ebangela ukuquleka. Lokhu kuhlinzwa kwenziwa lapho ukuquleka kwenzeka endaweni ethile noma endaweni eyodwa yobuchopho. Ukuhlinzwa kwesifo sokuwa kusikiselwa lapho imithi emibili elwa nesithuthwane yehlulekile ukwelapha ukuquleka ebuchosheni. Lokhu kuhlinzwa kuhloswe ngakho ukwelapha ukuphazamiseka kobuchopho ngaphandle kokuphazamisa ukusebenza kobuchopho. Ngaphambi kokuhlinzwa kwesifo sokuwa, kuphakanyiswa ukuhlolwa okuhlukahlukene kokuhlinzwa ukuze kubhekwe ukuthi umuntu uyakufanelekela yini lokhu kuhlinzwa.

Ukuquleka kuhilela ukuqubuka okungazelelwe, okungalawuleki komsebenzi kagesi phakathi kwamangqamuzana ezinzwa ebuchosheni, okuholela ekuguqulweni koku:

• Ukuqwashisa.
• Ukulawula imisipha (okuholela ekudikizeni noma ukudlikiza).
• Izinzwa.
• Imizwelo.
• Ukuziphatha.

Ukungenelela kokuhlinzwa kokulawulwa kokubanjwa kuhlanganisa:

• Ukukhipha ingxenye yobuchopho lapho ukuquleka kuqala khona.
• Ukuphazamisa ukuxhumana phakathi kwamangqamuzana ezinzwa zobuchopho ukuze kuvinjelwe ukuquleka ukuthi kungasakazeki.
• Ukusebenzisa ubuchwepheshe be-laser ukushisa nokuqeda amaseli ezinzwa abangela ukuquleka.
• Ukufaka idivayisi efana ne-pacemaker ngama-electrode ukuze kukhishwe amasignali kagesi, ukuvimba noma ukuphazamisa umsebenzi wokudlidliza.
• Ukubeka izintambo zikagesi ezinhle (eziqondiswa amarobhothi) ukuze urekhode umsebenzi wokudlikiza ekujuleni kobuchopho.

Ukuhlukaniswa Kokuhlinzwa Kwesithuthwane

Ukuquleka kwe-Epileptic kwenzeka ngenxa yokusebenza okungavamile kwama-neurons akhona ebuchosheni. Kunezinhlobo ezahlukene zokuhlinzwa kwesithuthwane. Uhlobo Lokuhlinzwa Kwesithuthwane e-Hyderabad luncike kulezi zinto ezilandelayo:

• Iminyaka yesiguli

• Indawo yokuthunjwa

Izinhlobo Zokuhlinzwa Kwesithuthwane

• Ukuhlinzwa Okususa Umzimba - Kulolu hlobo lokuhlinzwa, indawo encane yobuchopho iyasuswa. Udokotela ohlinzayo ususa izicubu zobuchopho zengxenye lapho ukuquleka kwenzeka khona. Le ndawo ngokuvamile iyindawo yokukhubazeka, isimila noma ukulimala kobuchopho. Ingxenye yobuchopho okwenziwa kuyo ukuhlinzwa kwe-resective yaziwa ngokuthi ama-temporal lobes alawula imizwa, inkumbulo ebonakalayo kanye nokuqonda ulimi.

• I-LITT (I-Laser Interstitial Thermal Therapy) - Lolu hlobo lokuhlinza alunangozi kangako noma alubuhlungu kangako lapho kusetshenziswa i-laser ukukhomba nokususa izicubu zobuchopho lapho ukubanjwa kwenzeka khona. I-laser esetshenziswa odokotela abahlinzayo iholwa yi-MRI (Magnetic Resonance Imaging).

• Ukukhushulwa kobuchopho obujulile - Kuyinqubo lapho kusetshenziswa idivayisi eyethulwa ekujuleni kobuchopho. Le divayisi ithumela amasignali kagesi ngezikhathi ezithile eziphazamisa umsebenzi wokudlidliza. Ijeneretha ekhipha lezi zimpawu zikagesi ifakwa esifubeni. Yonke le nqubo iqondiswa yi-MRI.

• I-Corpus Callosotomy - Ingxenye yobuchopho ehlanganisa izinzwa ze-corpus callosum (izinhlangothi kwesokunxele nakwesokudla zobuchopho) ikhishwa kulolu hlobo lokuhlinzwa. Lokhu kuhlinzwa okwalezo zingane ezithola ukusebenza kobuchopho okungavamile okusabalele ukusuka kolunye uhlangothi kuya kolunye uhlangothi lobuchopho.

• I-Hemispherectomy - Le nqubo isetshenziselwa ukususa i-hemisphere (uhlangothi olulodwa) lwe-cerebral cortex (indaba empunga egoqiwe yobuchopho). Ukuhlinzwa kwenziwa kulezo zingane eziquleka ezisuka ezindaweni eziningi ohlangothini olulodwa lobuchopho (i-hemisphere). Le nkinga ezinganeni yenzeka ngesikhathi sokuzalwa noma lapho zisanda kuzalwa.

• I-Hemispherectomy esebenzayo - Kuyinqubo yokukhipha izinzwa ezixhumayo ngaphandle kokukhipha izingxenye zangempela zobuchopho. Ukuhlinzwa kwenziwa ikakhulukazi izingane. 

Ukufaneleka Kokuhlinzwa Kwesithuthwane

Ukuhlinzwa Kwesithuthwane e-Hyderabad inketho lapho imithi ingakwazi ukulawula ukuquleka. Ukuhlinzwa kusebenza kulabo bantu:

• ukuquleka okungalawuleki noma kube nemiphumela emibi yemithi elwa nokuquleka.

• ukubanjwa okugxilisiwe okukhiqizwa ekugxileni kokuthinjwa kwendawo (indawo eyodwa noma ingxenye yobuchopho).

• ukuquleka okubangelwa i-AVM (i-arteriovenous malformation), ukukhubazeka kokuzalwa, izicubu ezibomvu noma isimila sobuchopho.

• ukuquleka okuthinta izinga lempilo.

• i-secondary generalization (ukuquleka kusakazekela ebuchosheni bonke).

Ukuhlolwa Kokuhlinzwa Kokuhlinzwa Kwesithuthwane

Ithimba lezokwelapha lenza ukuhlola okuhlukahlukene kokuhlinza ukuze lithole ukuthi umuntu udinga ukuhlinzwa isithuthwane noma cha, ukuze lithole indawo yobuchopho ethintekile ekubanjweni nasekuqondeni imisebenzi yobuchopho. 

Lezi zivivinyo zichazwe ngezansi:

• Ukuhlolwa kokuthola indawo yokuhlinzwa

• I-EEG (Baseline electroencephalogram) - Ngalokhu kuhlolwa, izindawo ezithintekile zobuchopho zinqunywa. Kulokhu kuhlolwa, ukusebenza kukagesi kobuchopho kukalwa ngokubeka ama-electrode ekhanda.

• I-Video EEG - Lokhu kuhlolwa kwenziwa lapho isiguli singeniswe esibhedlela. Ividiyo ye-EEG isiza ukuqapha nokuqopha ukuquleka. Izinguquko ze-EEG zihlolwa ngokunyakaza komzimba ukuze kutholwe indawo yobuchopho lapho kukhula khona ukuquleka.

• I-MRI (i-Magnetic resonance imaging) - Kulokhu kuhlolwa, amaza omsakazo nezizibuthe zisetshenziswa ukuze kutholwe izithombe ezinemininingwane yezimila, amangqamuzana alimele kanye nezinye izici ezingabangela ukuquleka.

• Ukuhlolwa kokuthola uhlobo lomsebenzi ongajwayelekile kanye nokwenza kube okwasendaweni umthombo wokuquleka

• Ukuqapha kwe-EEG Ehlaselayo - Uma i-EEG evamile inganikezi imiphumela efanele, odokotela abahlinzayo bahamba bayohlola ukuqapha kwe-EEG. Kulokhu kuhlolwa, odokotela babeka imicu noma amagridi ama-electrode endaweni yobuchopho noma afakwe ekujuleni kobuchopho. 

• I-Video EEG isebenzisa ama-electrode ahlaselayo - Ama-electrode afakwe ngokuhlinzwa nawo ayadingeka ngenqubo ye-EEG yevidiyo. Idatha ye-EEG nevidiyo irekhodwa ngemva kokuhlinzwa. Kodwa isiguli asinikezwa imithi ngesikhathi sokuhlala kwezokwelapha.

• I-PET (Positron emission tomography) - Iwumshini wokuthwebula izithombe osetshenziswa ukukala imisebenzi yobuchopho. Izithombe zingahlaziywa zodwa noma zingahlanganiswa nedatha ye-MRI ukuthola umthombo wamaphutha.

• I-SPECT (Single-photon emission computerized tomography) - Lokhu kuhlola kusetshenziselwa ukukala ukugeleza kwegazi ngesikhathi sokudlikiza. Kuyabonakala ukuthi ukugeleza kwegazi kuphezulu engxenyeni yobuchopho lapho kwenzeka khona ukuquleka.

• Ukuhlola ukuqonda imisebenzi yobuchopho

• I-MRI esebenzayo - Lokhu kuhlola kusiza odokotela abahlinzayo ukuthi babone izifunda zobuchopho ezilawula umsebenzi othile.

• Ukuhlolwa kwe-Wada - Kulokhu kuhlolwa, ukulamula kuyajovwa ukuze kubekwe uhlangothi olulodwa lobuchopho ukuthi lulale. Ngemva kwalokhu, kwenziwa ukuhlolwa kwenkumbulo nokusebenza kolimi. Ukuhlola kuyasiza ekutholeni uhlangothi lobuchopho oluhamba phambili ekusetshenzisweni kolimi. 

• Imephu Yobuchopho - Kulokhu kuhlolwa kokuhlinzwa, ama-electrode afakwa ngokuhlinzwa endaweni yobuchopho. Isiguli sicelwa ukuba senze imisebenzi ethile ehambisana nedatha yomsebenzi kagesi wobuchopho.

• I-Neuropsychological Izivivinyo - Lezi zivivinyo ezengeziwe zinconywa ukuze kutholwe umsebenzi wenkumbulo kanye namakhono okufunda okungakhulumi noma okushiwo. Futhi, izindawo ezithintekile zobuchopho zibonakala ngalezi zivivinyo.

Izinkinga Ekuhlinzweni Kwesithuthwane

Ukuhlinzwa ngakunye kunezingozi ezithile. Izingozi zokuhlinzwa kwesithuthwane zincike ohlotsheni lokuhlinzwa nendawo okuhlinzelwa kuyo. Nazi ezinye zezinkinga kulokhu kuhlinzwa:

• Ihluli

• Izifo

• Ukuphuma ngokweqile

• bekhanda 

• Stroke

• Ukusabela ku-anesthesia

• Izinkinga zolimi nenkumbulo

• Ukungaboni kahle

• Ukushintshashintsha kwemizwa noma ukucindezeleka

• Ukukhubazeka ohlangothini olulodwa

Yiziphi izingozi zokuhlinzwa kwesithuthwane?

Konke ukuhlinzwa kuza nezingozi ezingokwemvelo, futhi ezivamile zihlanganisa:

• Ukusabela kwe-anesthesia
• ukopha
• Izifo
• Ukulimala kwezicubu, ikakhulukazi ebuchosheni ukuze kuhlinzwe ubuchopho
• Ukuphulukiswa kubambezelekile endaweni yokuhlinza

Ekuhlinzweni kobuchopho, kunokukhathazeka okwengeziwe njengoba kungase kube nomthelela emisebenzini ebalulekile njengenkumbulo, inkulumo, ukubona, nokunyakaza, ngakunye kubuswa izindawo ezahlukene zobuchopho. Ukuze kuncishiswe lezi zingozi, abahlinzeki bezempilo benza ukuhlola okuphelele kwangaphambi kokuhlinzwa kanye nemephu yobuchopho ukukhomba umsuka wokuquleka, baqinisekise ukuthi ukuhlinzwa kugwema izindawo ezibucayi ezithinta le misebenzi ebalulekile.

Inqubo Yokuhlinzwa Kwesithuthwane

Amazinga omoya-mpilo, izinga lokushaya kwenhliziyo kanye nomfutho wegazi wesiguli kubhekwa ngeso lokhozi ngesikhathi sokuhlinzwa. Imonitha ye-EEG isetshenziselwa ukurekhoda amaza obuchopho ngesikhathi sokuhlinzwa ukuze kutholakale indawo yobuchopho ethintekile ekubanjweni.

Isiguli siyanikezwa i-anesthesia ngakho angase ahlale equlekile ngesikhathi ehlinzwa. Kwezinye izimo, isiguli siyaphaphama ukuze odokotela abahlinzayo banqume ingxenye yobuchopho elawula ukunyakaza nolimi. Kulezi zimo, iziguli zinikezwa imithi ethile yokuthwala izinhlungu.

Kuye ngohlobo lokuhlinzwa, odokotela abahlinzayo benza iwindi elincane noma imbobo ogebhezini. Ngemva kokuphothulwa kokuhlinzwa, iwindi lethambo liyashintshwa futhi ugebhezi olusele luvalwa ukuze luphole.

Ngemva kokuhlinzwa

Lapho ukuhlinzwa sekuqediwe, isiguli sishintshelwa e-ICU (igumbi labagula kakhulu) lapho sihlolwa khona odokotela. Ukuhlala esibhedlela ukuze kuhlinzwe isifo sokuwa cishe izinsuku ezi-3 kuya kwezi-4. 

Lapho isiguli sivuswa, ikhanda laso liyoba buhlungu futhi livuvuke. Banikezwa ama-narcotic njengamaphilisi ezinhlungu. Isikhwama seqhwa siyasiza futhi ekunciphiseni ubuhlungu. Iningi lokuvuvukala nobuhlungu buyaphela emavikini ambalwa.

Iziguli zelulekwa ukuthi ziphumule ngokuphelele embhedeni amasonto athile ngemva kokuhlinzwa futhi kancane kancane zandise imisebenzi yazo yansuku zonke. 

Imiphumela Yokuhlinzwa Kwesithuthwane

Umphumela wokuhlinzwa kwesithuthwane uncike ohlotsheni lokuhlinzwa. Umphumela olindeleke kakhulu futhi ovamile ukuhlinzwa ngempumelelo (ukulawula ukubanjwa) ngemithi elwa nesithuthwane.

Uma isiguli singenakho ukuquleka okungenani unyaka owodwa ngaleso sikhathi, udokotela ucabangela ukuyiyeka imithi. Uma bezwa ukuquleka ngemva kokuthatha imishanguzo, ukulawula kwabo ukubanjwa kuqalwa kabusha ngemithi elwa nokuquleka.

Izibhedlela ze-CARE zingasiza kanjani?  

At CARE Izibhedlela, sihlinzeka ngokuhlinzwa okuhamba phambili kwesithuthwane e-Hyderabad ngokunakekela okuphelele kanye nokwelashwa komuntu siqu kwesithuthwane. Ithimba lethu elinolwazi lwemikhakha eminingi lihlinzeka ngosizo olufanele ngesikhathi sokululama kwesiguli. Izinqubo zethu ezithuthukisiwe zokuhlasela kancane zingasiza abantu bathuthukise izinga labo lempilo.