Dementia yakutsogolo
Frontotemporal dementia (FTD) ndi mtundu wosowa wamatenda womwe umafanana ndi matenda a Alzheimer, kupatula kuti umangokhudza magawo ena okha amubongo.
Anthu omwe ali ndi FTD ali ndi zinthu zachilendo (zotchedwa zingwe, matupi a Pick, ndi maselo a Pick, ndi tau mapuloteni) mkati mwa maselo amitsempha m'malo owonongeka aubongo.
Zomwe zimayambitsa zinthu zachilendo sizikudziwika. Mitundu yambiri yachilendo yapezeka yomwe ingayambitse FTD. Milandu ina ya FTD imadutsa m'mabanja.
FTD ndiyosowa. Zitha kuchitika kwa anthu azaka zosakwana 20. Koma nthawi zambiri zimayambira pakati pa 40 ndi 60. Zaka zapakati pomwe zimayambira ndi 54.
Matendawa amakula pang'onopang'ono. Minofu m'mbali zina za ubongo imatha nthawi. Zizindikiro monga kusintha kwamakhalidwe, vuto lakulankhula, komanso mavuto amalingaliro zimachitika pang'onopang'ono ndikuipiraipira.
Kusintha kwaumunthu koyambirira kumatha kuthandiza madokotala kuuza FTD kupatula matenda a Alzheimer's. (Nthawi zambiri kukumbukira kukumbukira ndiko kukhala chizindikiro cha matenda a Alzheimer.)
Anthu omwe ali ndi FTD amakonda kuchita zinthu zosayenera m'malo osiyanasiyana. Kusintha kwamakhalidwe kukukulirakulira ndipo nthawi zambiri kumakhala chimodzi mwazizindikiro zosokoneza kwambiri za matendawa. Anthu ena amakhala ndi zovuta zambiri pakupanga zisankho, ntchito zovuta, kapena chilankhulo (kupeza zovuta kapena kumvetsetsa mawu kapena kulemba).
Zizindikiro zambiri zimaphatikizapo:
KUSINTHA KWAMBIRI:
- Osatha kusunga ntchito
- Makhalidwe okakamiza
- Kutengeka kapena zosayenera
- Kulephera kugwira ntchito kapena kuyanjana ndi anzanu kapena zochitika zanu
- Mavuto ndi ukhondo
- Khalidwe lobwerezabwereza
- Kusiya kucheza ndi anthu
KUSINTHA KWA MTIMA
- Kusintha kwadzidzidzi
- Kuchepetsa chidwi pazinthu zatsiku ndi tsiku
- Kulephera kuzindikira kusintha kwamakhalidwe
- Kulephera kuwonetsa kutentha kwa malingaliro, nkhawa, kumvera ena chisoni, chisoni
- Maganizo osayenera
- Osasamala za zochitika kapena chilengedwe
KUSINTHA CHINENERO
- Sangathe kuyankhula (mutism)
- Kuchepetsa kutha kuwerenga kapena kulemba
- Zovuta kupeza mawu
- Kuvuta kulankhula kapena kumvetsetsa mawu (aphasia)
- Kubwereza chilichonse chomwe adayankhula nawo (echolalia)
- Mawu ocheperako
- Mawu ofooka, osagwirizana
MAVUTO A M'NTHAWI YINA
- Kuchuluka kwa minofu (kukhwima)
- Kutaya kukumbukira kumawonjezeka
- Mavuto oyendetsa / kuyenda (apraxia)
- Kufooka
MAVUTO ENA
- Kusadziletsa kwamikodzo
Wothandizira zaumoyo adzafunsa za mbiri yazachipatala ndi zizindikilo zake.
Mayeso atha kulamulidwa kuti athandize kuchotsa zina zomwe zimayambitsa matenda amisala, kuphatikiza matenda amisala chifukwa chazomwe zimapangitsa. FTD imapezeka potengera zizindikilo ndi zotsatira za mayeso, kuphatikiza:
- Kuunika kwamalingaliro ndi machitidwe (kuwunika kwa neuropsychological)
- MRI yaubongo
- Electroencephalogram (EEG)
- Kuyesedwa kwa ubongo ndi zamanjenje (mayeso amitsempha)
- Kuyesa kwamadzimadzi kozungulira chapakati wamanjenje (cerebrospinal fluid) pambuyo pobowola lumbar
- Mutu wa CT
- Kuyesedwa kwa kutengeka, kulingalira ndi kulingalira (kuzindikira ntchito), ndi magwiridwe antchito
- Njira zatsopano zomwe zimayesa kagayidwe kabongo kapenanso kuchuluka kwa mapuloteni zitha kuloleza kuzindikiritsidwa molondola mtsogolo
- Positron emission tomography (PET) sikani yaubongo
Biopsy ya ubongo ndiyeso yokhayo yomwe ingatsimikizire matendawa.
Palibe mankhwala enieni a FTD. Mankhwala amatha kuthandiza kusinthasintha kwamaganizidwe.
Nthawi zina, anthu omwe ali ndi FTD amatenga mankhwala omwewo omwe amachiza mitundu ina ya matenda amisala.
Nthawi zina, kuimitsa kapena kusintha mankhwala omwe amapititsa patsogolo chisokonezo kapena omwe safunika amatha kukonza kulingalira ndi magwiridwe ena amisala. Mankhwala ndi awa:
- Zotsatira
- Wotsutsa
- Central mantha dongosolo depressants
- Cimetidine
- Lidocaine
Ndikofunika kuthana ndi zovuta zilizonse zomwe zingayambitse chisokonezo. Izi zikuphatikiza:
- Kuchepa kwa magazi m'thupi
- Kuchepetsa mpweya wa okosijeni (hypoxia)
- Mtima kulephera
- Mulingo wambiri wa carbon dioxide
- Matenda
- Impso kulephera
- Kulephera kwa chiwindi
- Matenda a zakudya
- Matenda a chithokomiro
- Matenda amisala, monga kukhumudwa
Mankhwala angafunike kuti athane ndi nkhanza, zoopsa, kapena kukwiya.
Kusintha kwamakhalidwe kumatha kuthandiza anthu ena kuwongolera machitidwe osavomerezeka kapena owopsa. Izi zimakhala ndimakhalidwe oyenera kapena abwino ndikunyalanyaza machitidwe osayenera (ngati zili bwino kutero).
Therapy ya kulankhula (psychotherapy) sikugwira ntchito nthawi zonse. Izi ndichifukwa choti zimatha kuyambitsa chisokonezo kapena kusokonezeka.
Zochitika zenizeni, zomwe zimalimbikitsa zachilengedwe ndi zina, zitha kuthandiza kuchepetsa kusokonezeka.
Kutengera ndikukula kwa matendawa, kuwunika ndi kuwathandiza kukhala aukhondo komanso kudzisamalira kungafunike. Potsirizira pake, pangafunike kusamalidwa kwa maola 24 kunyumba kapena malo ena apadera. Upangiri wabanja ukhoza kuthandiza munthuyo kuthana ndi zosintha zofunika pakulera kunyumba.
Chisamaliro chingaphatikizepo:
- Ntchito zoteteza achikulire
- Zothandizira pagulu
- Okonza nyumba
- Anesi oyendera kapena othandizira
- Ntchito zodzipereka
Anthu omwe ali ndi FTD ndi mabanja awo angafunikire kufunsa upangiri wamalamulo koyambirira kwa matendawa. Malangizo a Advance care, mphamvu ya loya, ndi zochitika zina zalamulo zitha kupangitsa kuti zikhale zosavuta kupanga zisankho zokhudzana ndi chisamaliro cha munthu yemwe ali ndi FTD.
Mutha kuchepetsa nkhawa za FTD polowa nawo gulu lothandizira. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha. Zambiri ndi chithandizo kwa anthu omwe ali ndi FTD ndi mabanja awo amapezeka ku:
Association for Frontotemporal Degeneration - www.theaftd.org/get-involve/in-your-region/
Matendawa amafulumira. Munthuyo amakhala wolumala kwathunthu kumayambiriro kwa matendawa.
FTD imayambitsa imfa mkati mwa zaka 8 mpaka 10, nthawi zambiri kuchokera ku matenda, kapena nthawi zina chifukwa machitidwe amthupi amalephera.
Itanani omwe akukuthandizani kapena pitani kuchipinda chadzidzidzi ngati ntchito yamaganizidwe ikukulirakulira.
Palibe njira yodziwika yopewera.
Kusokonezeka maganizo; Dementia - malingaliro; Matenda a frontotemporal; FTD; Matenda a Arnold Pick; Sankhani matenda; 3R matenda opatsirana pogonana
- Central dongosolo lamanjenje ndi zotumphukira zamanjenje
- Ubongo
- Ubongo ndi dongosolo lamanjenje
[Adasankhidwa] Bang J, Spina S, Miller BL. Dementia yakutsogolo. Lancet. 2015; 386 (10004): 1672-1682. PMID: 26595641 pubed.ncbi.nlm.nih.gov/26595641/.
Peterson R, Graff-Radford J. Matenda a Alzheimer ndi matenda ena amisala. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 95.