Igicuri ni iki? Ni ibihe bimenyetso byigicuri?

Igicuri ni indwara idakira (igihe kirekire), izwi kandi nka epilepsy. Muri epilepsy, gusohora gutunguranye kandi kutagaragaye bibaho muri neuron mubwonko. Nkigisubizo, kwikuramo kubushake, impinduka zumutima nimpinduka mumitekerereze bibaho kumurwayi. Igicuri ni indwara itera gufatwa. Umurwayi afite ubuzima bwiza hagati yo gufatwa. Umurwayi ufite igicuri kimwe gusa mubuzima bwe ntabwo afatwa nkigicuri.

Ku isi hari abarwayi bagera kuri miliyoni 65 barwaye igicuri. Nubwo kuri ubu nta muti ushobora gutanga ubuvuzi bwuzuye bwigicuri, ni indwara ishobora kugenzurwa hifashishijwe ingamba zo gukumira no gufata imiti.

Kurwara Igicuri ni iki?

Kurwara, bibaho biturutse ku mpinduka zikorwa mubikorwa byamashanyarazi byubwonko kandi bishobora guherekezwa nibimenyetso nko guhinda umushyitsi no guta ubwenge no kugenzura, nikibazo cyingenzi cyubuzima cyabayeho muminsi yambere yubusabane.

Gufata bibaho biturutse ku guhuza imbaraga kwitsinda ryingirabuzimafatizo muri sisitemu yimitsi mugihe runaka. Mu gufata igicuri, kugabanuka kwimitsi birashobora guherekeza gufatwa.

Nubwo igicuri no gufatwa ari amagambo akoreshwa mu buryo bumwe, ntabwo asobanura ikintu kimwe. Itandukaniro riri hagati yo gufatwa nigicuri ni uko igicuri ari indwara irangwa no gufatwa kenshi kandi bidatinze. Amateka imwe yo gufatwa ntabwo yerekana ko umuntu afite igicuri.

Ni izihe mpamvu zitera igicuri?

Uburyo bwinshi butandukanye bushobora kugira uruhare mugutezimbere igicuri. Ubusumbane buri hagati yuburuhukiro no kwishima bwimitsi irashobora kuba ishingiro ryubwonko bushingiye ku gufatwa nigicuri.

Impamvu nyamukuru ntishobora kugenwa neza mubihe byose byigicuri. Ihahamuka ryamavuko, ihahamuka ryumutwe kubera impanuka zabanjirije iyi, amateka yo kuvuka bigoye, imitsi idasanzwe mu mitsi yubwonko mu myaka yubukure, indwara zifite umuriro mwinshi, isukari nke mu maraso, kunywa inzoga, ibibyimba byo mu nda ndetse no gutwika ubwonko ni zimwe mu mpamvu zagaragaye nkaho bifitanye isano nogushaka kugira igicuri. Igicuri kirashobora kubaho igihe icyo aricyo cyose kuva akiri muto kugeza akuze.

Hariho ibintu byinshi bishobora kongera umuntu kwandura igicuri:

• Imyaka

Igicuri kirashobora kugaragara mu kigero cimyaka iyo ari yo yose, ariko amatsinda yimyaka iyi ndwara ikunze kugaragaramo ni abantu bakiri bato na nyuma yimyaka 55.

• Indwara zubwonko

Hariho kwiyongera kwibyago byo kurwara igicuri mu ndwara zigenda zitera hamwe no gutwika, nka meningite (inflammation of the membrane membrane) na encephalitis (inflammation of the tissue tissue).

• Gufata Ubwana

Kurwara bidafitanye isano na epilepsy birashobora kugaragara mubana bato. Indwara ifata cyane cyane mu ndwara ziherekejwe numuriro mwinshi, ubusanzwe zirashira uko umwana akura. Mu bana bamwe, iyi ndwara irashobora kurangirana no gukura igicuri.

• guta umutwe

Hashobora kubaho intandaro yo gukura igicuri mu ndwara nkindwara ya Alzheimer, igenda itera imbere gutakaza imikorere yimikorere.

• Amateka Yumuryango

Abantu bafite abavandimwe ba hafi barwaye igicuri bafatwa nkaho bafite ibyago byinshi byo kwandura iyi ndwara. Hariho hafi 5% yanduye iyi ndwara kubana bafite nyina cyangwa se bafite igicuri.

• Ihahamuka

Igicuri gishobora kugaragara mu bantu nyuma yo guhahamuka mu mutwe nko kugwa ningaruka. Ni ngombwa kurinda umutwe numubiri hamwe nibikoresho bikwiye mugihe cyibikorwa nko gusiganwa ku magare, gusiganwa ku maguru no gutwara moto.

• Indwara yamaraso

Indwara yubwonko, iterwa nibihe nko guhagarika cyangwa kuva amaraso mu mitsi yamaraso ishinzwe umwuka wa ogisijeni no kugaburira imirire ubwonko, bishobora kwangiza ubwonko. Uturemangingo twangiritse mu bwonko turashobora gutera igicuri aho, bigatuma abantu barwara igicuri.

Ni ibihe bimenyetso byigicuri?

Ubwoko bumwebumwe bwigicuri bushobora kubaho icyarimwe cyangwa bikurikiranye, bigatuma ibimenyetso byinshi nibimenyetso bigaragara mubantu. Igihe cyibimenyetso gishobora gutandukana kuva amasegonda make kugeza kuminota 15.

Ibimenyetso bimwe ni ngombwa kuko bibaho mbere yo gufatwa nigicuri:

• Ibintu bitunguranye ubwoba bwinshi no guhangayika
• Isesemi
• Kuzunguruka
• Impinduka zijyanye nicyerekezo
• Kubura igice cyo kugenzura ibirenge namaboko
• Kumva urimo usohoka mumubiri wawe
• Kubabara umutwe

Ibimenyetso bitandukanye bibaho nyuma yibi bihe birashobora kwerekana ko umuntu yarwaye igicuri:

• Urujijo nyuma yo guta ubwenge
• Kugabanuka kwimitsi itagenzuwe
• Ifuro iva mu kanwa
• Kugwa
• Uburyohe budasanzwe mu kanwa
• Kunyoza amenyo
• Kuruma ururimi
• Mu buryo butunguranye, amaso yihuta
• Gukora amajwi adasanzwe kandi adafite ubusobanuro
• Gutakaza ubushobozi bwo munda no mu ruhago
• Umwuka utunguranye

Ni ubuhe bwoko bwo gufatwa?

Hariho ubwoko bwinshi bwo gufatwa bushobora gusobanurwa nkigicuri. Amagambo magufi agenda yitwa kwifata adahari. Niba gufatwa bibaye mu gice kimwe gusa cyumubiri, byitwa gufata neza. Niba kwikuramo bibaye mumubiri mugihe cyo gufatwa, umurwayi atakaza inkari hamwe nifuro kumunwa, ibi byitwa gufatwa muri rusange.

Muri rusange gufatwa, habaho ubwonko bwa neuronal mubice byinshi byubwonko, mugihe mugihe cyo gufatira mukarere, akarere kamwe gusa kubwonko (focal) nako kagira uruhare muri ibyo birori. Mugihe cyo gufatwa, ubwenge burashobora kuba cyangwa kuzimya. Gufata bitangiye kwibanda birashobora kwaguka. Kwifata byibanze bisuzumwa mumatsinda abiri yingenzi. Gufata byoroheje byibanze hamwe no gufata ibintu bigoye (bigoye) bigize ubu bwoko 2 bwubwoko bwibanze.

Ni ngombwa gukomeza ubwenge mu gufata ibintu byoroshye kandi aba barwayi barashobora gusubiza ibibazo namabwiriza mugihe cyo gufatwa. Muri icyo gihe, abantu nyuma yo gufatwa byoroshye barashobora kwibuka inzira yo gufatwa. Mu gufata ibintu bigoye, habaho impinduka mumitekerereze cyangwa guta ubwenge, kubwibyo bantu ntibashobora gusubiza muburyo bukwiye kubibazo namabwiriza mugihe cyo gufatwa.

Gutandukanya ibi byombi byafashwe ni ngombwa kuko abantu bafite ibibazo byibanze ntibagomba kwishora mubikorwa nko gutwara cyangwa gukoresha imashini ziremereye.

Ibimenyetso bimwe nibimenyetso bishobora kugaragara kubarwayi ba epilepsy bahura nibibazo byoroshye:

• Kunyeganyega cyangwa gukurura ibice byumubiri nkamaboko namaguru
• Impinduka zitunguranye zibaho nta mpamvu
• Ibibazo byo kuvuga no gusobanukirwa ibivugwa
• Ibyiyumvo bya deja vu, cyangwa kumva wongeye kwibonera uburambe inshuro nyinshi
• Ibyiyumvo bitoroshye nko kuzamuka mu gifu (epigastric) no gutera umutima byihuse
• Ibyiyumvo bya salusiyo, urumuri rwumucyo, cyangwa ibyiyumvo bikomeye byo gutitira bibaho nta kintu na kimwe kigutera imbaraga nko kumva impumuro, uburyohe, cyangwa kumva

Mu gufata ibintu bigoye, impinduka iba murwego rwumuntu, kandi izi mpinduka mumitekerereze zishobora guherekezwa nibimenyetso byinshi bitandukanye:

• Ibyiyumvo bitandukanye (aura) byerekana iterambere ryigifu
• Witegereze neza werekeza ku ngingo ihamye
• Ingendo zidafite intego, zidafite intego kandi zisubiramo (automatisme)
• Gusubiramo ijambo, gutaka, guseka no kurira
• Kutitabira

Muri rusange gufatwa, ibice byinshi byubwonko bigira uruhare mugukura kwifata. Hariho ubwoko 6 butandukanye bwo gufatwa muri rusange:

• Mu bwoko bwa tonic bwo gufatwa, habaho gukomeza, gukomera no gukomera cyane mubice byanduye byumubiri. Imihindagurikire yimiterere yimitsi irashobora kuviramo gukomera kwimitsi. Imitsi yukuboko, ukuguru ninyuma nitsinda ryimitsi ikunze kwibasirwa nubwoko bwa tonic. Impinduka mumitekerereze ntizigaragara muri ubu bwoko bwo gufatwa.

Gufata Tonic mubisanzwe bibaho mugihe cyo gusinzira kandi igihe cyacyo kiratandukanye hagati yamasegonda 5 na 20.

• Ubwoko bwa clonic gufatwa, gusubiramo injyana ya retmic no kuruhuka bishobora kugaragara mumitsi yanduye. Imitsi yo mu ijosi, mu maso no mu ntoki ni imitsi ikunze kwibasirwa cyane muri ubu bwoko bwo gufatwa. Imyitwarire ibaho mugihe cyo gufatwa ntishobora guhagarikwa kubushake.

• Indwara ya Tonic-clonic nayo yitwa grand mal seisures, bivuze uburwayi bukomeye mu gifaransa. Ubu bwoko bwo gufatwa bukunda kumara hagati yiminota 1-3, kandi niba bumara iminota irenga 5, nibimwe mubyihutirwa byubuvuzi bisaba gutabarwa. Kwirukana umubiri, guhinda umushyitsi, gutakaza ubushobozi bwo munda no mu ruhago, kuruma ururimi no guta ubwenge ni bimwe mu bimenyetso bishobora kubaho mugihe cyubu bwoko bwo gufatwa.

Abantu bafite uburibwe bwa tonic-clonic bumva umunaniro mwinshi nyuma yo gufatwa kandi ntibibuke nibuka igihe ibintu byabereye.

• Mugihe cyo gufatira atonic, nubundi bwoko bwo gufatwa muri rusange, abantu bahomba guta ubwenge mugihe gito. Ijambo atony risobanura gutakaza amajwi yimitsi, bikaviramo intege nke imitsi. Iyo abantu batangiye kugira ubu bwoko bwo gufatwa, barashobora kugwa gitumo hasi niba bahagaze. Igihe cyo gufatwa cyafashwe ni munsi yamasegonda 15.

• Indwara ya Myoclonic ni ubwoko bwo gufatwa muri rusange burangwa no kwihuta kandi bidatinze mu maguru no mu mitsi yukuboko. Ubu bwoko bwo gufatwa bukunze kugira ingaruka kumatsinda yimitsi kumpande zombi zumubiri icyarimwe.

• Mugihe udafashwe, umuntu aba atitabye kandi amaso yabo ahora ahanze kumurongo umwe, kandi guta ubwenge mugihe gito. Bikunze kugaragara cyane kubana bari hagati yimyaka 4-14 kandi byitwa petit mal gufatwa. Mugihe udahari, ubusanzwe bikunda gutera imbere mbere yimyaka 18, ibimenyetso nko gukubita iminwa, guhekenya, konsa, guhora wimuka cyangwa gukaraba intoki, hamwe no guhinda umushyitsi mumaso.

Kuba umwana akomeje ibikorwa bye byubu nkaho ntakintu cyabaye nyuma yiki gihe gito cyo gufatwa ningirakamaro mugusuzuma kubwo gufatwa.

Hariho kandi uburyo bwo gufatwa na somatosensory aho harimo kunanirwa cyangwa gutitira igice cyumubiri. Mugihe cyo gufatwa mumutwe, ibyiyumvo bitunguranye byubwoba, uburakari cyangwa umunezero birashobora kwiyumvamo. Irashobora guherekezwa no kubona amashusho cyangwa kumva.

Nigute ushobora gusuzuma igicuri?

Kugirango umenye igicuri, uburyo bwo gufatwa bugomba gusobanurwa neza. Kubwibyo, abantu babona igicuri kirakenewe. Indwara ikurikirwa naba psychologue babana cyangwa bakuze. Ibizamini nka EEG, MRI, computing tomografiya na PET birashobora gusabwa gusuzuma umurwayi. Ibizamini bya laboratoire, harimo no gupima amaraso, birashobora gufasha mugihe ibimenyetso byigicuri bikekwa ko biterwa nindwara.

Electroencephalography (EEG) ni ikizamini gikomeye cyo gusuzuma igicuri. Muri iki kizamini, ibikorwa byamashanyarazi bibera mubwonko birashobora kwandikwa bitewe na electrode zitandukanye zashyizwe kumutwe. Ibi bikorwa byamashanyarazi bisobanurwa na muganga. Kumenya ibikorwa bidasanzwe bitandukanye nibisanzwe birashobora kwerekana ko hari igicuri muri aba bantu.

Mudasobwa ya tomografiya (CT) ni isuzuma rya radiologiya ryemerera amashusho yambukiranya ibice no gusuzuma igihanga. Bitewe na CT, abaganga basuzuma ubwonko butandukanye kandi bakamenya cysts, ibibyimba cyangwa amaraso ashobora gutera indwara.

Magnetic resonance imaging (MRI) ni ikindi kizamini cyingenzi cya radiologiya cyemerera gusuzuma neza ubwonko bwubwonko kandi ni ingirakamaro mugupima igicuri. Hamwe na MRI, ibintu bidasanzwe bishobora gutera igicuri birashobora kugaragara mubice bitandukanye byubwonko.

Mu isuzuma rya positron emission tomografiya (PET), ibikorwa byamashanyarazi byubwonko bisuzumwa hifashishijwe urugero ruke rwibikoresho bya radio. Nyuma yubuyobozi bwibi bintu binyuze mumitsi, ibintu birategereza ko byinjira mubwonko kandi amashusho agafatwa hifashishijwe igikoresho.

Nigute ushobora kuvura igicuri?

Igicuri kivura hakoreshejwe imiti. Igicuri kirashobora gukumirwa ahanini hamwe no kuvura imiti. Ni ngombwa cyane gukoresha imiti igicuri buri gihe mugihe cyo kuvura. Mugihe hariho abarwayi batitabira kuvura ibiyobyabwenge, hariho nubwoko bwigicuri gishobora gukemura imyaka, nkigicuri cyabana. Hariho kandi ubwoko burebure bwigicuri. Ubuvuzi bwo kubaga burashobora gukoreshwa kubarwayi batitabira kwivuza.

Hariho imiti myinshi igabanya ubukana bwa antiepileptic ifite ubushobozi bwo kwirinda gufatwa:

• Imiti igabanya ubukana irimo karbamazepine ikora neza irashobora kuba ingirakamaro mugufata igicuri gikomoka mu bwonko buherereye munsi yamagufa yigihe gito (lobe yagateganyo). Kubera ko ibiyobyabwenge birimo iyi mikorere ikorana nindi miti myinshi, ni ngombwa kumenyesha abaganga imiti ikoreshwa mubindi buzima.

• Imiti ikubiyemo ibintu bifatika bya clobazam, ibikomoka kuri benzodiazepine, birashobora gukoreshwa mugihe udahari no gufatwa. Kimwe mu bintu byingenzi bigize iyi miti, igira ingaruka zo gukurura, kongera ibitotsi ndetse no kurwanya amaganya, ni uko ishobora no gukoreshwa mu bana bato. Hagomba kwitonderwa nkibisubizo byuruhu rwa allergique, nubwo bidasanzwe, bishobora kubaho nyuma yo gukoresha ibiyobyabwenge birimo ibyo bintu bikora.

• Divalproex ni ikiyobyabwenge gikora kuri neurotransmitter yitwa acide gamma-aminobutyric (GABA) kandi irashobora gukoreshwa mukuvura kubura, kwibanda, kwibanda cyane cyangwa gufatwa byinshi. Kubera ko GABA ari ikintu kigira ingaruka mbi ku bwonko, iyi miti irashobora kuba ingirakamaro mu kurwanya igicuri.

• Imiti irimo ingirakamaro ya Ethosuximide irashobora gukoreshwa muguhashya ibifata byose bidahari.

• Ubundi bwoko bwimiti ikoreshwa mukuvura indwara zifata ni imiti irimo ingirakamaro ya gabapentin. Ugomba kwitonda kuko ingaruka nyinshi zishobora kubaho nyuma yo gukoresha ibiyobyabwenge birimo gabapentin kurusha indi miti igabanya ubukana.

• Imiti irimo fenobarbital, umwe mu miti ya kera ikoreshwa mu kurwanya igicuri, irashobora kuba ingirakamaro muri rusange, yibanze hamwe na tonic-clonic. Kuzunguruka bikabije birashobora kubaho nyuma yo gukoresha imiti irimo fenobarbital, kuko igira ingaruka zigihe kirekire zo kwikiza hiyongereyeho ingaruka za anticonvulsant (gufata-kwirinda).

• Ibiyobyabwenge birimo ingirakamaro ya fenytoin nubundi bwoko bwibiyobyabwenge bigabanya imiterere ya selile nervice kandi byakoreshejwe mubuvuzi bwa antiepileptic mumyaka myinshi.

Usibye iyi miti, imiti yagutse ya antiepileptic irashobora gukoreshwa ku barwayi bahura nubwoko butandukanye hamwe no kwandura indwara bitewe no gukora cyane mu bice bitandukanye byubwonko:

• Clonazepam numuti wa bezodiazepine ukomoka kuri antiepileptic antiepileptic ikora igihe kirekire kandi irashobora gutegekwa gukumira myoclonic no kubura.
• Imiti irimo ingirakamaro Lamotrigine iri mu miti yagutse ya antiepileptic ishobora kugirira akamaro ubwoko bwinshi bwigicuri. Ugomba kwitonda nkindwara idasanzwe ariko yica uruhu yitwa Stevens-Johnson Syndrome ishobora kubaho nyuma yo gukoresha iyi miti.

• Gufata kumara iminota irenga 5 cyangwa bibaho bikurikiranye nta gihe kinini hagati yacyo bisobanurwa nka epilepticus. Imiti irimo lorazepam, ikindi kintu gikora gikomoka kuri benzodiazepine, irashobora kuba ingirakamaro mugucunga ubu bwoko bwo gufatwa.

• Imiti irimo levetiracetam igizwe nitsinda ryibiyobyabwenge bikoreshwa mukuvura umurongo wambere wo kuvura kwibanda, rusange, kubura cyangwa ubundi bwoko bwinshi bwo gufatwa. Ikindi kintu cyingenzi kiranga iyi miti, ishobora gukoreshwa mu byiciro byose, ni uko itera ingaruka nke ugereranije nindi miti ikoreshwa mu kuvura igicuri.

• Usibye iyi miti, imiti irimo aside yitwa valproic, ikora kuri GABA, nayo iri mu miti yagutse ya antiepileptic.

Nigute Umuntu Ufite Igicuri Yafashwa?

Niba umuntu afite igicuri hafi yawe, ugomba:

• Ubwa mbere, komeza utuze kandi ushire umurwayi mumwanya utazakwangiza. Byaba byiza ubihinduye kuruhande.
• Ntugerageze guhagarika ku gahato kugenda no gufungura urwasaya cyangwa gusohora ururimi.
• Kuraho ibintu byumurwayi nkumukandara, amasano hamwe nigitambara.
• Ntugerageze kumutera kunywa amazi, arashobora kurohama.
• Ntibikenewe kuzura umuntu ufite igicuri.

Ibintu abarwayi bigicuri bagomba kwitondera:

• Fata imiti yawe ku gihe.
• Gumana ikarita ivuga ko ufite igicuri.
• Irinde ibikorwa nko kuzamuka ibiti cyangwa kumanika kuri balkoni no kumaterasi.
• Ntukoga wenyine.
• Ntugafunge umuryango wubwiherero.
• Ntugume imbere yumucyo uhora ucana, nka tereviziyo, igihe kirekire.
• Urashobora gukora siporo, ariko witondere kutagira umwuma.
• Irinde umunaniro ukabije no kudasinzira.
• Witondere kutagira umutwe.

Ni uwuhe mwuga abarwayi ba Epilepsy badashobora gukora?

Abarwayi bigicuri ntibashobora gukora mu myuga nko gutwara indege, kwibira, kubaga, gukorana nimashini zikata no gucukura, imyuga isaba gukorera ahantu hirengeye, imisozi, gutwara ibinyabiziga, kuzimya umuriro, na polisi na gisirikare bisaba gukoresha intwaro. Byongeye kandi, abarwayi bigicuri bagomba kumenyesha aho bakorera ibijyanye nindwara zabo.