Rudzi Rwakasiyana Rwenheyo Rungashamisika Iwe
Vanhu vazhinji vanotenda kuti vanoziva kuti kutora kunoratidzika sei. Mumwe munhu ane kurohwa anotanga kuzunungusa asingadzori, anowira pasi, uye anoshayiwa zivo. Asi izvi hazvisi nguva dzose. Kushungurudza kunogona kupa nenzira dzisingawanzoiti, dzimwe nguva kungoita chimwe chikamu chemuviri, uye dzimwe nguva kungoita chimwe chikamu cheuropi pasina chekugadzirisa chinokanganisa zvachose.
Mamiriro epilepticus ndiyo yakanyanya kukanganisa kubatwa-ndiko kubatwa kusingaregi. Mukuwedzera pakuita kuti murwere apinde mu coma , maitiro epilepticus anogona kuuraya uye kutungamirira kukuvadza kwehupi zvachose. Mamiriro epilepticus ndeyekukurumidzira kwechiremba.
Anenge makore gumi apfuura, vatsvakurudzi vanobva Columbia University muNew York vakaita kuti vanhu vauye muhutano pavakaongorora varwere muCUU ne electroencephalography . Kunyange zvazvo pakanga pasina kusava nechokwadi kuti varwere ava vakanga vagumburwa, ndizvo chete izvo vatsvakurudzi vakawana. Vanenge gumi kubva muzana yevasingateereri varwere muI ICU vakanga vari mumamiriro ezvinhu asina kukanganisika epilepticus, NCSE.
Chii chinonzi Nonconvulsive Status Epilepticus?
Muhutu husina kuputika epilepticus, uropi huri kuramba huchibata, kana kubata kakawanda zvokuti murwere haambofi ane mukana wekuwanazve kubva panguva yekuvhiringidzika kwakanyanya izvo zvinowanzoita kubatwa.
Iyi nguva yekudzorera inonzi inonzi post-ictal state .
Pamusoro pezvizhinji, vanhu vari mumamiriro ezvinhu asina kukwana epilepticus vanoita sevamwe varwere vakawanda veCUU vasingateereri nekuda kwekudzivirira pfungwa kana chero humwe humwe hutambudzi hwekuziva . Zvisinei, kana kuongororwa neEEG, tinogona kuona kuti chaizvoizvo, murwere ari muhupenyu epilepticus.
Kusiyana kwakakosha, nokuti chiremera chinokanganisa chinogona kupindura mishonga. Kazhinji, ingadai iri pfungwa yakaipa kupa murwere encephalopathic benzodiazepine seAtivan (lorazepam), nokuti mishonga iyi inoderedza uropi hunoita. Mune murwere uyo asati atofunga zvakanaka, benzodiazepines inogona kuita kuti dambudziko riwedzere.
Kukundikana, kune rumwe rutivi, kunokonzerwa nehupenzi husina kunaka hwehuropi. Muzviitiko izvi, mishonga inorwisa-epileptic, yakadai se benzodiazepine, inogona kubatsira chaizvo murwere kuti adzoke zvakare mushure mokunge epilepticus inopesana.
Kuongororwa kweNonconvulsive Status Epilepticus
Ichokwadi kuti, kuitira kuti usapindire mamiriro ekusava nehupombwe epilepticus, unofanira kutanga utarise kuti murwere ari kutora. Kakawanda, chimiro chisina kuputika epilepticus hachina kuongororwa, zvinoreva kuti varwere vazhinji vanoenda vasina kutenderwa. Chikamu chechikonzero ndechokuti NCSE ndiyo inenge ichangobva kutsanangurwa, uye nehupenyu hwayo, haisi pachena sezvinoshushikana nehutachiona.
Chimwe chikonzero chendaneti chinonzi underdiagnosis ndechokuti inogona kuonekwa munzira dzakasiyana-siyana, dzakawanda dzadzo dzinowanzokonzerwa nechimwe chinhu chakajairika. Somuenzaniso, inenge hafu yevarwere vari muchipatara vanotambura kubva ku delirium , iyo inogona kuonekwa yakafanana neCLESE asi yakawanda zvikuru.
Mune zvimwe zvikoro zvepamusoro zvezvenyeredzi, kuve tsika yakajairika yekubatanidza EEG inotungamirira kune vose varwere veCUU. Zvisinei, mune zvipatara zvakawanda, chiremba anoda kunyatsotarisa kuti murwere anorevei ari pedyo nekuongorora neEEG.
Kurapa kweNonconvulsive Status Epilepticus
Nzira yekugadzirisa nayo zvakanakisisa NCSE inzvimbo inoshandiswa yemishonga. Nzira yakanakisisa inopesana nemakore ekutsungirira, mamwe zvirwere, uye zvimwe zvinhu zvekutora. Semuenzaniso, NCSE dzimwe nguva inotevera zvimwe zvakajeka zvisinganzwisisiki zvakagadziriswa epilepticus. Mune zviitiko izvi, kune ngozi yakajeka kuCSESE, uye kushungurudzwa kwechisimba mune imwe nhengo huru yekuchengetedza (ICU) inodanwa.
Zvisinei, pane dzimwe nguva apo NCSE haina kutorwa nekudengenyeka, zvingave zviri nani kune varwere kuti vasaparidzirwa kuI ICU, kunyanya kana varwere vakwegura. Izvi zvinogona kuva nokuti mishonga inoshandiswa neanticonvulsant inewo migumisiro, uye nekuda kwezvimwe zvipingamupinyi zvekugara muI ICU.
Zera rinobatsirawo pakuchengetedza NCSE mudiki, sezvo zvikonzero zvekugumburwa kazhinji kazhinji zvakasiyana nevatana vakwegura. Vana vanowanzotambuka nekuda kwematambudziko ekuberekwa, asi varwere vakwegura vangangodaro vanogumburwa nekuda kwedambudziko rakagadziriswa, sechirwere.
Mune mamiriro ezvinhu apo chiremera chepachifu chinosangana nemamwe matambudziko ezvehutano, imwe yemakona emakona ekurapa ndeyokutarisana nematambudziko epasi. Kukunda kunowedzera kuipa apo muviri unofananidzwa nehutachiona kana zvimwe zvinetso zvezvechiremba. Somuenzaniso, kana murwere ane utachiona hwakakomba uye chiropa chekuropa, kuwedzera anticonvulsants kunogona kuita kuti mamiriro acho ave akaipa. Sezvinowanzoitika, kurapwa kweCSSE kunofanirwa kuenzaniswa nezvinodikanwa nemurwere mumwe nomumwe semunhu.
Sources:
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Frank W. Drislane, MD1Miridzo, Kuongorora, uye Kuchengetedzwa kweNonconvulsive Status Epilepticus Epilepsy & Behavior 1, 301-314 (2000)
Simon Shorvon Chii chisina kukonzera chimiro chekufa, uye chii chinonzi subtypes? Epilepsia, 48 (Suppl. 8): 35-38, 2007
Litt B, Wityk RJ, Hertz SH, Mullen PD, Weiss H, Ryan DD, Henry TR. Epilepsia. Nzira isina kukwana inokonzerwa nehutano muvakwegura vanorwara. 1998; 39 (11): 1194-202.