Zomwe Muyenera Kudziwa Zokhudza Catatonia

Zamkati

• Kodi mitundu yosiyanasiyana ya catatonia ndi iti?
• Kodi chimayambitsa catatonia ndi chiyani?
• Mankhwala
• Zomwe zimayambitsa chilengedwe
• Kodi ndi chiani chomwe chimayambitsa katatoniya?
• Zizindikiro za catatonia ndi ziti?
• Katatonia wokondwa
• Katatoni woyipa
• Kufanana ndi zikhalidwe zina
• Kodi catatonia imapezeka bwanji?
• Kodi catatonia imathandizidwa bwanji?
• Mankhwala
• Mankhwala a electroconvulsive (ECT)
• Kodi catatonia ili ndi chiyembekezo chotani?
• Kodi katatoniya ingapewe?

Catatonia ndi chiyani?

Catatonia ndi vuto la psychomotor, kutanthauza kuti limakhudza kulumikizana kwamaganizidwe ndi kuyenda. Catatonia imakhudza kuthekera kwa munthu kusuntha mwanjira yabwinobwino.

Anthu omwe ali ndi catatonia amatha kukhala ndi zizindikilo zosiyanasiyana. Chizindikiro chofala kwambiri ndi kugona, zomwe zikutanthauza kuti munthuyo samatha kusuntha, kuyankhula, kapena kuyankha pazomwe zimayambitsa. Komabe, anthu ena omwe ali ndi catatonia amatha kuwonetsa mayendedwe azinthu zambiri komanso kusokonezeka.

Catatonia imatha kukhalapo kulikonse kuyambira maola ochepa mpaka masabata, miyezi, kapena zaka. Itha kubwereranso pafupipafupi kwa milungu mpaka zaka pambuyo pachigawo choyambacho.

Ngati katatoniya ndi chizindikiro cha chifukwa chodziwika, amatchedwa extrinsic. Ngati palibe chifukwa chomwe chingadziwike, chimawerengedwa kuti ndichachidziwikire.

Kodi mitundu yosiyanasiyana ya catatonia ndi iti?

Kutulutsa kwaposachedwa kwa Diagnostic and Statistical Manual of Mental Disways (DSM-5) sikugawilanso katatoni kukhala mitundu. Komabe, akatswiri ambiri azaumoyo amatha kupatula katatoni kukhala mitundu itatu: ofooka, osangalala, komanso oyipa.

Catatonia yotayika ndi mawonekedwe ofala kwambiri a catatonia. Zimayambitsa kuyenda pang'onopang'ono. Munthu yemwe ali ndi catatonia yofooka amatha kuyang'anitsitsa mumlengalenga ndipo nthawi zambiri samayankhula. Izi zimatchedwanso akinetic catatonia.

Anthu omwe ali ndi catatonia yosangalala amaoneka ngati "athamangitsidwa," osakhazikika, komanso asokonezeka. Nthawi zina amachita zovulaza. Fomuyi imadziwikanso kuti hyperkinetic catatonia.

Anthu omwe ali ndi catatonia yoyipa atha kukhala ndi delirium. Nthawi zambiri amakhala ndi malungo. Amathanso kugunda kwamtima komanso kuthamanga kwa magazi.

Kodi chimayambitsa catatonia ndi chiyani?

Malinga ndi DSM-5, zinthu zingapo zimatha kuyambitsa catatonia. Zikuphatikizapo:

• Matenda a neurodevelopmental (zovuta zomwe zimakhudza chitukuko cha ubongo)
• Matenda a psychotic
• matenda ochititsa munthu kusinthasintha zochitika
• Matenda okhumudwitsa
• Matenda ena, monga kuchepa kwa ubongo, matenda osadziwika a autoimmune, ndi matenda osowa paraneoplastic (omwe amakhudzana ndi zotupa za khansa)

Mankhwala

Catatonia ndi zotsatira zoyipa za mankhwala ena omwe amagwiritsidwa ntchito pochiza matenda amisala. Ngati mukuganiza kuti mankhwala akuyambitsa katatoniya, pitani kuchipatala mwachangu. Izi zimaonedwa ngati zachipatala.

Kusiya mankhwala ena, monga clozapine (Clozaril), kumatha kuyambitsa catatonia.

Zomwe zimayambitsa chilengedwe

Kafukufuku wolingalira akuwonetsa kuti anthu ena omwe ali ndi catatonia yanthawi yayitali amatha kukhala ndi zovuta zina muubongo.

Akatswiri ena amakhulupirira kuti kukhala ndi owonjezera kapena kuchepa kwa ma neurotransmitters kumayambitsa catatonia. Ma Neurotransmitters ndi mankhwala amubongo omwe amanyamula mauthenga kuchokera ku neuron imodzi kupita kwina.

Lingaliro lina ndikuti kuchepa kwadzidzidzi kwa dopamine, neurotransmitter, kumayambitsa catatonia. Lingaliro linanso ndikuti kuchepa kwa gamma-aminobutyric acid (GABA), neurotransmitter ina, kumabweretsa vutoli.

Kodi ndi chiani chomwe chimayambitsa katatoniya?

Azimayi ali ndi chiopsezo chachikulu chotenga catatonia. Chiwopsezo chimakulirakulira.

Ngakhale kuti catatonia kale idalumikizidwa ndi schizophrenia, madokotala amisala tsopano amati catatonia ndi vuto lake, lomwe limachitika potengera zovuta zina.

Akuti pafupifupi 10% ya odwala odwala matenda amisala amakumana ndi catatonia. Makumi awiri% a odwala katatoni ali ndi matenda a schizophrenia diagnoses, pomwe 45% ali ndi matenda amisala.

Amayi omwe ali ndi vuto la postpartum (PPD) atha kukhala ndi catatonia.

Zina mwaziwopsezo ndizogwiritsa ntchito cocaine, mchere wambiri m'magazi, komanso kugwiritsa ntchito mankhwala monga ciprofloxacin (Cipro).

Zizindikiro za catatonia ndi ziti?

Catatonia ili ndi zizindikiro zambiri, zomwe ndizofala kwambiri monga:

• kugona, kumene munthu samatha kusuntha, sangathe kuyankhula, ndikuwoneka kuti akuyang'ana mlengalenga
• kukhazikika kapena "kusinthasintha mawonekedwe," komwe munthu amakhala pamalo omwewo kwakanthawi
• kusowa zakudya m'thupi ndi kutaya madzi m'thupi chifukwa chosowa kapena kumwa
• echolalia, pomwe munthu amayankha zokambirana pongobwereza zomwe wamva

Zizindikiro zofala izi zimawoneka mwa anthu omwe ali ndi catatonia yofooka.

Zizindikiro zina za catatonia ndi monga:

• catalepsy, womwe ndi mtundu wa kulimba kwa minofu
• negativism, komwe ndikusowa kuyankha kapena kutsutsa kukondoweza kwakunja
• echopraxia, komwe ndiko kutsanzira mayendedwe a munthu wina
• kusokoneza
• wachisoni

Katatonia wokondwa

Zizindikiro zokhudzana ndi katatoni wokondwa zimaphatikizapo mayendedwe achilendo, osazolowereka. Izi zikuphatikiza:

• kubvutika
• kusakhazikika
• mayendedwe opanda cholinga

Katatoni woyipa

Katatonia woyipa amachititsa zizindikilo zowopsa kwambiri. Zikuphatikizapo:

• delirium
• malungo
• kukhwimitsa
• thukuta

Zizindikiro zofunika monga kuthamanga kwa magazi, kupuma, komanso kugunda kwa mtima zimatha kusinthasintha. Zizindikirozi zimafunikira chithandizo mwachangu.

Kufanana ndi zikhalidwe zina

Zizindikiro za Catatonia zimawonetsa zina mwazinthu zina, kuphatikiza:

• psychosis yovuta
• encephalitis, kapena kutupa mu minofu yaubongo
• matenda oopsa a neuroleptic (NMS), osowa kwambiri komanso osagwirizana ndi mankhwala a antipsychotic
• nonconvulsive status epilepticus, mtundu wa kugwidwa koopsa

Madokotala ayenera kuchotsa izi asanazindikire katatonia. Munthu ayenera kuwonetsa zizindikiro ziwiri zazikulu za catatonia kwa maola 24 dokotala asanadziwe kuti ndi catatonia.

Kodi catatonia imapezeka bwanji?

Palibe mayeso otsimikizika a catatonia omwe alipo. Kuti mupeze matenda a catatonia, kuyezetsa thupi ndikuyezetsa kuyenera kuyambitsa zina.

Mulingo wa Bush-Francis Catatonia Rating Scale (BFCRS) ndi mayeso omwe amagwiritsidwa ntchito pozindikira katatonia. Mulingo uwu uli ndi zinthu 23 zomwe zatulutsidwa kuchokera 0 mpaka 3. Muyeso wa "0" umatanthauza kuti chizindikirocho palibe. Chiwerengero cha "3" chimatanthauza kuti chizindikirocho chilipo.

Kuyezetsa magazi kumatha kuthana ndi kusamvana kwa ma electrolyte. Izi zitha kupangitsa kusintha kwamaganizidwe. Kuphatikizika kwamapapu, kapena magazi m'mapapu, kumatha kubweretsa zizindikiritso za katatoniya.

Kuyezetsa magazi kwa fibrin D-dimer kungathandizenso. Kafukufuku waposachedwa akuwonetsa kuti catatonia imagwirizanitsidwa ndi milingo yayikulu ya D-dimer. Komabe, zikhalidwe zambiri (monga pulmonary embolism) zimatha kukhudza milingo ya D-dimer.

Kujambula kwa CT kapena MRI kumalola madotolo kuwona ubongo. Izi zimathandiza kutulutsa chotupa muubongo kapena kutupa.

Kodi catatonia imathandizidwa bwanji?

Mankhwala kapena electroconvulsive therapy (ECT) atha kugwiritsidwa ntchito pochiza katatonia.

Mankhwala

Mankhwala nthawi zambiri ndiyo njira yoyamba yothandizira catatonia. Mitundu yamankhwala omwe angaperekedwe ndi monga benzodiazepines, zopumulira minofu, ndipo nthawi zina, tricyclic antidepressants. Benzodiazepines nthawi zambiri amakhala mankhwala oyamba omwe amapatsidwa.

Benzodiazepines akuphatikizapo clonazepam (Klonopin), lorazepam (Ativan), ndi diazepam (Valium). Mankhwalawa amachulukitsa GABA muubongo, zomwe zimathandizira lingaliro loti GABA yocheperako imabweretsa ku catatonia. Anthu omwe ali ndi masitepe apamwamba pa BFCRS nthawi zambiri amayankha bwino mankhwala a benzodiazepine.

Mankhwala ena omwe angaperekedwe, kutengera zomwe munthu akuchita, ndi awa:

• amobarbital, wokonda
• bromocriptine (Cycloset, Parlodel)
• carbamazepine (Carbatrol, Epitol, Tegretol)
• lifiyamu carbonate
• mahomoni a chithokomiro
• zolpidem (Ambien)

Pambuyo masiku 5, ngati palibe yankho la mankhwalawo kapena ngati zizindikiro zikukulirakulira, dokotala akhoza kulangiza mankhwala ena.

Mankhwala a electroconvulsive (ECT)

Electroconvulsive therapy (ECT) ndi mankhwala othandiza ku catatonia. Mankhwalawa amachitika mchipatala moyang'aniridwa ndi azachipatala. Ndi njira yopanda ululu.

Munthu atakhala pansi, makina apadera amatulutsa magetsi kuubongo. Izi zimapangitsa kugwidwa muubongo kwakanthawi kwakanthawi.

Kulandidwa kumakhulupirira kuti kumayambitsa kusintha kwa kuchuluka kwa ma neurotransmitters muubongo. Izi zitha kukonza zizindikiro za catatonia.

Malinga ndi kafukufuku wa 2018, ECT ndi benzodiazepines ndiwo mankhwala okhawo omwe atsimikiziridwa kuti amachiza katatoniya.

Kodi catatonia ili ndi chiyembekezo chotani?

Anthu amayankha mwachangu kuchipatala cha catatonia. Ngati munthu sakuyankha mankhwala omwe akupatsidwa, dokotala atha kupereka mankhwala ena mpaka zizindikiro zitatha.

Anthu omwe amadwala ECT ali ndi vuto lobwereranso kwambiri ku catatonia. Zizindikiro zimawonekeranso pasanathe chaka.

Kodi katatoniya ingapewe?

Chifukwa chomwe chimayambitsa catatonia nthawi zambiri sichidziwika, kupewa sikutheka. Komabe, anthu omwe ali ndi catatonia ayenera kupewa kumwa mankhwala osokoneza bongo, monga chlorpromazine. Kugwiritsa ntchito molakwika mankhwala kumatha kukulitsa zizindikiritso za catatonia.