Kusuntha - kosagwirizana

Kuyenda kosagwirizana kumachitika chifukwa cha vuto la kuwongolera minofu komwe kumayambitsa kulephera kuyendetsa mayendedwe. Zimatsogolera pakuyenda, kusakhazikika, kuyenda uku ndi uku pakati pa thupi (thunthu) ndi njira yosakhazikika (yoyenda). Zingakhudzenso miyendo.

Dzina lachipatala la vutoli ndi ataxia.

Kusuntha kosalala kumafunikira kulinganiza pakati pamagulu osiyanasiyana amisempha. Gawo laubongo lotchedwa cerebellum limayang'anira izi.

Ataxia imatha kusokoneza zochitika zatsiku ndi tsiku.

Matenda omwe amawononga cerebellum, msana, kapena mitsempha yotumphukira imatha kusokoneza kuyenda kwaminyewa. Zotsatira zake ndi zazikulu, zosasunthika, zosagwirizana.

Kuvulala kwaubongo kapena matenda omwe angayambitse mayendedwe osagwirizana ndi awa:

• Kuvulala kwa ubongo kapena kupwetekedwa mutu
• Nkhuku kapena matenda ena a ubongo (encephalitis)
• Zinthu zomwe zimadutsa m'mabanja (monga congenital cerebellar ataxia, Friedreich ataxia, ataxia - telangiectasia, kapena matenda a Wilson)
• Multiple sclerosis (MS)
• Stroke kapena chosakhalitsa ischemic attack (TIA)

Poizoni kapena poyizoni woyambitsa chifukwa cha:

• Mowa
• Mankhwala ena
• Zitsulo zolemera monga mercury, thallium, ndi lead
• Zosungunulira monga toluene kapena carbon tetrachloride
• Mankhwala osokoneza bongo

Zina mwa zifukwa zake ndi izi:

• Khansa ina, momwe zizindikilo zosagwirizana zitha kuwonekera miyezi kapena zaka khansa isanapezeke (yotchedwa paraneoplastic syndrome)
• Mavuto ndi mitsempha ya m'miyendo (neuropathy)
• Kuvulala kwa msana kapena matenda omwe amawononga msana (monga kupindika kwa msana)

Kuwunika kwachitetezo chanyumba ndi wochizira thupi kutha kukhala kothandiza.

Chitani zinthu zokuthandizani kuti zikhale zosavuta komanso zotetezeka poyenda panyumba. Mwachitsanzo, chotsani zodetsa, siyani misewu yayikulu, ndikuchotsa zoponya kapena zinthu zina zomwe zitha kuyambitsa kugwa.

Anthu omwe ali ndi vutoli ayenera kulimbikitsidwa kutenga nawo mbali pazinthu zanthawi zonse. Achibale ayenera kukhala oleza mtima ndi munthu yemwe sagwirizana bwino. Tengani nthawi yosonyeza munthuyo njira zochitira ntchito mosavuta. Gwiritsani ntchito zomwe munthuyo akuchita bwino popewa zofooka zawo.

Funsani wothandizira zaumoyo ngati zothandizira kuyenda, monga ndodo kapena kuyenda, zitha kukhala zothandiza.

Anthu omwe ali ndi ataxia amatha kugwa. Lankhulani ndi wopezayo za njira zopewera kugwa.

Itanani omwe akukuthandizani ngati:

• Munthu ali ndi mavuto osafotokozedwa ndi mgwirizano
• Kuperewera kwa mgwirizano kumatenga nthawi yayitali kuposa mphindi zochepa

Pakachitika zadzidzidzi, muyenera kukhazikika kuti zisonyezo zisakulirakulira.

Wothandizirayo ayesa mayeso, omwe atha kukhala:

• Kuwunika mwatsatanetsatane dongosolo lamanjenje ndi minofu, kuyang'anira mosamala kuyenda, kulimbitsa thupi, komanso kulumikizana koloza ndi zala ndi zala.
• Kukufunsani kuti muyimirire ndi mapazi anu pamodzi maso atatsekedwa. Izi zimatchedwa kuyesa kwa Romberg. Ngati mutayika bwino, ichi ndi chisonyezo chakuti malingaliro anu atayika. Pachifukwa ichi, mayeserowa amawoneka kuti ndi abwino.

Mafunso a mbiri yakale azachipatala atha kuphatikizira:

• Zizindikiro zidayamba liti?
• Kodi mayendedwe osagwirizana amachitika nthawi zonse kapena amangochitika?
• Kodi chikuipiraipira?
• Mumamwa mankhwala ati?
• Kodi mumamwa mowa?
• Mumagwiritsa ntchito mankhwala osokoneza bongo?
• Kodi mwakumana ndi china chake chomwe chingayambitse poizoni?
• Ndi zisonyezo zina ziti zomwe muli nazo? Mwachitsanzo: kufooka kapena kufooka, dzanzi, kumva kulasalasa, kapena kutaya mphamvu, kusokonezeka kapena kusokonezeka, kugwidwa.

Mayeso omwe atha kulamulidwa ndi awa:

• Kuyesera kwa antibody kuti muwone ngati pali paraneoplastic syndromes
• Mayeso amwazi (monga CBC kapena kusiyanasiyana kwamagazi)
• Kujambula kwa CT pamutu
• Kuyesedwa kwachibadwa
• MRI ya mutu

Mungafunike kutumizidwa kwa katswiri kuti akuthandizeni. Ngati vuto linalake likuyambitsa ataxia, vutoli lidzachiritsidwa. Mwachitsanzo, ngati mankhwala akuyambitsa mavuto ogwirizana, mankhwalawo amatha kusintha kapena kuimitsa. Zifukwa zina sizingachiritsidwe. Woperekayo angakuuzeni zambiri.

Kusagwirizana; Kutaya kwa mgwirizano; Kuwonongeka kwa mgwirizano; Ataxia; Kusasamala; Kusagwirizana kosagwirizana

• Kulephera kwa minofu

Chilankhulo AE. Zovuta zina zoyenda. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 410.

Subramony SH, Xia G. Zovuta za cerebellum, kuphatikiza ma ataxias osachiritsika. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 97.