Khunyu

Khunyu ndi vuto laubongo momwe munthu amabwereranso kugwa pakapita nthawi. Khunyu ndi magawo a kuwombera kosalamulirika komanso kosazolowereka kwama cell amubongo omwe angayambitse chidwi kapena machitidwe.

Khunyu imachitika pamene kusintha kwa ubongo kumapangitsa kuti ikhale yosangalatsa kapena yosakwiya. Zotsatira zake, ubongo umatumiza zikwangwani zosazolowereka. Izi zimabweretsa kugwidwa mobwerezabwereza, kosayembekezereka. (Kugwidwa kamodzi komwe sikuchitikanso si khunyu.)

Khunyu mwina chifukwa cha matenda kapena kuvulala komwe kumakhudza ubongo. Kapena, chifukwa chake sichingadziwike (idiopathic).

Zomwe zimayambitsa khunyu ndi izi:

• Stroke kapena chosakhalitsa ischemic attack (TIA)
• Dementia, monga matenda a Alzheimer
• Zovulala muubongo
• Matenda, kuphatikizapo abscess ya ubongo, meningitis, encephalitis, ndi HIV / AIDS
• Mavuto aubongo omwe amapezeka pakubadwa (kobadwa nako ubongo)
• Kuvulala kwaubongo komwe kumachitika nthawi yobadwa kapena yoyandikira
• Matenda a metabolism amabwera pobadwa (monga phenylketonuria)
• Chotupa chaubongo
• Mitsempha yamagazi yachilendo muubongo
• Matenda ena omwe amawononga kapena kuwononga minofu yaubongo
• Matenda olanda omwe amapezeka m'mabanja (khunyu yakubadwa)

Matenda a khunyu nthawi zambiri amayamba azaka zapakati pa 5 ndi 20. Palinso mwayi waukulu wogwidwa ndi achikulire azaka zopitilira 60. Koma khunyu la khunyu limatha kuchitika msinkhu uliwonse. Pakhoza kukhala mbiri yabanja yokhudza khunyu kapena khunyu.

Zizindikiro zimasiyanasiyana malinga ndi munthu. Anthu ena atha kukhala ndi zovuta zambiri. Ena agwedezeka mwamphamvu ndikusowa tcheru. Mtundu wa kulanda kumatengera gawo laubongo lomwe lakhudzidwa.

Nthawi zambiri, kulanda kumakhala kofanana ndi komwe kunalipo kale. Anthu ena omwe ali ndi khunyu amakhala ndi vuto ladzidzidzi asanagwidwe. Zomverera zitha kukhala zong'ung'uza, kununkhiza fungo lomwe kulibe kwenikweni, kapena kusintha kwamaganizidwe. Izi zimatchedwa aura.

Dokotala wanu akhoza kukuwuzani zambiri zamtundu womwe mungalandire:

• Kulanda (petit mal) kulanda (kuyang'anitsitsa)
• Kugwidwa kwamtundu wa tonic-clonic (grand mal) (kumakhudza thupi lonse, kuphatikiza aura, minofu yolimba, komanso kusazindikira)
• Kulanda pang'ono (kutsogola) (kumatha kuphatikizira zizindikiritso zomwe zafotokozedwa pamwambapa, kutengera komwe kulanda kulanda kumayamba)

Dokotala amupima. Izi ziphatikiza kuyang'ana mwatsatanetsatane ubongo ndi dongosolo lamanjenje.

EEG (electroencephalogram) idzachitika poyang'ana momwe magetsi amagwirira ntchito muubongo. Anthu omwe ali ndi khunyu nthawi zambiri amakhala ndi magetsi azowoneka pama mayeso awa. Nthawi zina, mayeso amawonetsa dera lomwe lili muubongo pomwe khunyu limayambira. Ubongo ukhoza kuwoneka wabwinobwino atagwidwa kapena atagwidwa.

Kuti mupeze khunyu kapena kukonzekera opaleshoni ya khunyu, mungafunike:

• Valani chojambulira cha EEG masiku kapena masabata pamene mukuchita moyo wanu watsiku ndi tsiku.
• Khalani mchipatala chapadera pomwe zochitika zamaubongo zimatha kujambulidwa pomwe makamera amakanema amakupatsani zomwe zimakuchitikirani panthawi yolanda. Izi zimatchedwa kanema EEG.

Mayeso omwe angachitike ndi awa:

• Magazi amadzimadzi
• Shuga wamagazi
• Kuwerengera kwathunthu kwa magazi (CBC)
• Ntchito ya impso
• Kuyesa kwa chiwindi
• Lumbar kuboola (tapampopi)
• Kuyesedwa kwa matenda opatsirana

Kujambula kwa mutu wa CT kapena MRI nthawi zambiri kumachitika kuti mupeze chomwe chimayambitsa vuto muubongo.

Chithandizo cha khunyu chimaphatikizapo kumwa mankhwala, kusintha kwa moyo, ndipo nthawi zina opaleshoni.

Ngati khunyu limayamba chifukwa cha chotupa, mitsempha yachilendo, kapena kutuluka magazi muubongo, kuchitidwa opaleshoni kuthana ndi mavutowa kumatha kupangitsa kuti agwere.

Mankhwala oteteza khunyu, omwe amatchedwa anticonvulsants (kapena antiepileptic mankhwala), amachepetsa kuchuluka kwa kugwa kwamtsogolo:

• Mankhwalawa amatengedwa pakamwa. Mtundu womwe mwalamulidwa umadalira mtundu wa khunyu zomwe muli nazo.
• Mlingo wanu ungafunike kusinthidwa nthawi ndi nthawi. Mungafunike kuyezetsa magazi pafupipafupi kuti muwone ngati ali ndi zotsatirapo zoyipa.
• Nthawi zonse tengani mankhwala anu munthawi yake komanso monga mwawuzidwa. Kuperewera kwa mankhwala kumatha kukupangitsani kuti mugwere. Musasiye kumwa kapena kusintha mankhwala panokha. Lankhulani ndi dokotala wanu poyamba.
• Mankhwala ambiri a khunyu amachititsa kupunduka. Azimayi omwe akukonzekera kutenga pakati ayenera kuuza adokotala pasadakhale kuti asinthe mankhwala.

Mankhwala ambiri a khunyu angakhudze thanzi la mafupa anu. Lankhulani ndi dokotala wanu ngati mukufuna mavitamini ndi zina zowonjezera.

Khunyu komwe sikumakhala bwino pakatha kuyesedwa kwa mankhwala a 2 kapena 3 a anti-khunyu amatchedwa "khunyu yokhudzana ndi zamankhwala." Poterepa, adotolo amalimbikitsa kuchitidwa opaleshoni kuti:

• Chotsani maselo osazolowereka omwe amayambitsa kugwa.
• Ikani vagal nerve stimulator (VNS). Chida ichi chimafanana ndi chopanga mtima. Zitha kuthandiza kuchepetsa kuchuluka kwa kugwidwa.

Ana ena amapatsidwa chakudya chapadera kuti ateteze kugwa. Chodziwika kwambiri ndi zakudya za ketogenic. Zakudya zopanda chakudya, monga zakudya za Atkins, zitha kuthandizanso kwa achikulire ena. Onetsetsani kuti mukukambirana ndi dokotala musanayese.

Moyo kapena kusintha kwachipatala kumatha kuonjezera chiopsezo chogwidwa ndi akulu ndi ana omwe ali ndi khunyu. Lankhulani ndi dokotala za:

• Mankhwala atsopano, mavitamini, kapena zowonjezera mavitamini
• Kupsinjika mtima
• Matenda, makamaka matenda
• Kusowa tulo
• Mimba
• Kudumpha mlingo wa mankhwala a khunyu
• Kumwa mowa kapena mankhwala ena osokoneza bongo
• Kuwonetsedwa ndi magetsi owala kapena zoyeserera
• Kutulutsa mpweya

Mfundo zina:

• Anthu omwe ali ndi khunyu ayenera kuvala zodzikongoletsera zachipatala kuti athandizidwe mwachangu ngati atagwidwa.
• Anthu omwe ali ndi matenda a khunyu sayenera kuyendetsa galimoto. Chongani malamulo aboma lanu okhudza anthu omwe ali ndi mbiri yakukomoka omwe amaloledwa kuyendetsa galimoto.
• Musagwiritse ntchito makina kapena kuchita zinthu zomwe zingawononge chidwi chanu, monga kukwera kumalo okwera, kupalasa njinga, ndikusambira nokha.

Kupsyinjika kokhala ndi khunyu kapena kusamalira munthu wodwala khunyu nthawi zambiri kumathandizidwa kulowa nawo gulu lothandizira. M'maguluwa, mamembala amagawana zokumana nazo zomwe zimawachitikira komanso mavuto.

Anthu ena omwe ali ndi khunyu amatha kuchepetsa kapena kuimitsa mankhwala awo olimbana ndi khunyu atakhala kuti sanagwidwe kwazaka zingapo. Mitundu ina ya khunyu yaubwana imatha kapena kusintha msinkhu, nthawi zambiri kumapeto kwa zaka za m'ma 20 kapena 20.

Kwa anthu ambiri, khunyu ndi vuto la moyo wonse. Zikatero, mankhwala oletsa kulanda amafunika kupitilizidwa. Pali chiopsezo chochepa kwambiri chomwalira mwadzidzidzi ndi khunyu.

Zovuta zingaphatikizepo:

• Kuphunzira kovuta
• Kupumira chakudya kapena malovu m'mapapu panthawi yakugwa, komwe kumatha kuyambitsa chibayo
• Kuvulala chifukwa chakugwa, zophulika, kudzilumikiza, kuyendetsa kapena kugwiritsa ntchito makina panthawi yolanda
• Kuwonongeka kwamuyaya kwa ubongo (sitiroko kapena kuwonongeka kwina)
• Zotsatira zoyipa za mankhwala

Itanani nambala yanu yadzidzidzi (monga 911) ngati:

• Aka ndi koyamba kuti munthu akhale ndi khunyu
• Kugwidwa kumachitika kwa munthu amene savala chibangili chachipatala (chomwe chili ndi malangizo ofotokozera zoyenera kuchita)

Pankhani ya munthu amene adadwalapo kale, itanani 911 pazomwe zingachitike mwadzidzidzi izi:

• Uku ndikulanda kwakanthawi kuposa komwe munthu amakhala nako, kapena kuchuluka kwakanthawi kachilendo kwa munthuyo
• Kugwidwa mobwerezabwereza kwa mphindi zochepa
• Kugwidwa mobwerezabwereza komwe chidziwitso kapena machitidwe abwinobwino sanapezenso pakati pawo (status epilepticus)

Itanani dokotala wanu ngati pali zina zatsopano:

• Kutaya tsitsi
• Nseru kapena kusanza
• Kutupa
• Zotsatira zoyipa zamankhwala, monga kusinza, kupumula, kusokonezeka, kukhazikika
• Kugwedezeka kapena mayendedwe achilendo, kapena mavuto pakugwirizana

Palibe njira yodziwika yopewera khunyu. Kudya moyenera ndi kugona mokwanira, komanso kupewa kumwa mowa ndi mankhwala osokoneza bongo kumachepetsa mwayi wopangitsa kuti anthu omwe ali ndi khunyu ayambe kugwidwa.

Kuchepetsa chiopsezo chovulala kumutu mwa kuvala chisoti pochita zinthu zowopsa. Izi zitha kuchepetsa mwayi wovulala muubongo komwe kumabweretsa khunyu ndi khunyu.

Matenda olanda; Khunyu - khunyu

• Opaleshoni ya ubongo - kutulutsa
• Khunyu akuluakulu - zomwe mungafunse dokotala wanu
• Khunyu ana - kumaliseche
• Khunyu mwa ana - zomwe mungafunse dokotala wanu
• Khunyu kapena khunyu - kumaliseche
• Matenda a febrile - zomwe mungafunse dokotala wanu
• Ma stereosactic radiosurgery - kutulutsa

• Nyumba zamaubongo
• Limbic dongosolo
• Udindo wa mitsempha ya vagus khunyu
• Central dongosolo lamanjenje ndi zotumphukira zamanjenje
• Kugwedezeka - chithandizo choyamba - mndandanda

Pezani nkhaniyi pa intaneti Abou-Khalil BW, Gallagher MJ, Macdonald RL. Khunyu. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 101.

González HFJ, Yengo-Kahn A, Wolemba DJ. Vagus mitsempha yolimbikitsira chithandizo cha khunyu. Chipatala cha Neurosurg N Am. 2019; 30 (2): 219-230 (Pamasamba) PMID: 30898273 www.ncbi.nlm.nih.gov/pubmed/30898273.

Thijs RD, Akukwera R, O'Brien TJ, Sander JW. Khunyu akuluakulu. Lancet. 2019; 393 (10172): 689-701. PMID: 30686584 pubed.ncbi.nlm.nih.gov/30686584/.

Wiebe S. Khunyu. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 375.