Ukuxoshwa, i-Epilepsy kunye neChiropractic

El Paso, TX. I-Chiropractor, uDkt. Alexander Jimenez ukhangeleka ekuthinjeni, ukuhluthwa nokunyanga.
Ukuxhamla zichazwa njenge, iintshukumo ezingaqhelekanga okanye ukuziphatha okuvela kwimisebenzi yombane engaqhelekanga engqondweni. Ukuxhamla luphawu lokuxhuzula kodwa asingabo bonke abaxhuzulayo abanesifo sokuwa. Njengoko kukho iqela lezigulo eziyeleleneyo eziphawulwa kukuxhuzula okuphindaphindiweyo.�sokuwa liqela leengxaki ezidibeneyo kwaye zibonakaliswe ngokukhawuleza. Kukho iintlobo ezahlukeneyo zokuhluthwa kunye nokuthintela. Kukho imishanguzo yokwehliswa okumiselweyo ukulawula ukugonywa, kwaye ukuhlinzwa akufuneki ukuba kufuneka ukuba unyango lungasebenzi.

Ukuxhuzula nokuwa sisifo sokuwa

• Ukuqubukana kwenzeka xa kukho ukutshatyalaliswa ngokuzenzekelayo kunye nokuqhutyelwa kweqela lama-neurons, ngokuphindaphindiweyo ekuphenduleni i-trigger njenge-compromise
• nayiphina ngengqondo unokubanjwa xa iimeko zichanekile
• Ukuxhuzula okanye ukuphazamiseka kokuxhuzula, kukonyuka ngokwengqondo kwamathuba okuxhuzula okwenzeka emntwini. ngengqondo

Iimpawu zoLungiso

• Jikelele / i-Global iyakhula

• Ukubanjwa kwemoto ngokuqhelekileyo (i-Grand mal)

• Ukungabikho kokuthatha (Petite mal)

• Ukujoliswa kokugxilwa

• Ukuhlutha okulula

• I-cortex ye-Motor (i-Jacksonian)
• Cortex
• Somatosensory
• I-Auditory-vestibular
• Visual
• I-Olfactory-yogustatory (uncinate)

• Ukunciphisa ngokukhawuleza kwinqanaba (libmbic)

• Ukuqhubeka okuqhubekayo / okuqhubekayo

• Jikelele (isimo se-epilepticus)
• I-Focal (epilepticus partialis continua)

I-Motoralized Seizure

• Ukutshatyalaliswa kombane kwee-neurons kwi-cortex yonke ye-cerebral kanyekanye
• I-Trigger ithathwa ukuba ingaphandle kwe-cortex ye-cerebral, njenge-thalamus okanye i-brainstem
• Iziqalo ziqala ngokulahlekelwa kwengqondo zilandelwa ukutyunjwa kwetoni (ukongezwa)
• Ukuphefumla kuyanqunyanyiswa, kwaye iinwele ziyakhutshwa ngaphaya kwegloti elivaliweyo (�lila�)
• Ukuphakanyiswa kwengcinezelo yegazi, abafundi abahlaziyiweyo
• Ukuqhekeka okungapheli kunye nokuphumula (umsebenzi we-clonic)
• Ngokuqhelekileyo ihlala imizuzu embalwa, kodwa ezinye izigulana zikwazi ukuhlala iiyure okanye iintsuku (isimo se-epilepticus)
• Ukuqala ngokubanzi ebuntwaneni

I-Tonic Clonic Seizure

nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy

Yam Tonic Clonic / Grand Mal Malice

Iimpawu zokuQala

• Ionic engaqhelekanga (Na, K, Ca, Mg, BUN, pH)
• Ukurhoxiswa ngokwemali kwizidakamizwa (utywala, iibharbiturates, benzodiazepines)
• Hypoglycemia
• Hypoxia
• I-Hyperthermia (ingakumbi izigulana phantsi kwe-4 iminyaka ubudala)
• Ukuxhoma kweTyxin
• I-Genetic ubuzwe obungavamile be-neurons (ngokungafanekiyo)

I-EEG ye-Grand Mal Seizure

• Isigaba se Tonic
• Isigaba seClonic
• Isigaba sokungena

I-Swenson, R. I-Epilepsy. 2010

Ukungabikho (i-Petit Mal) Ukuxhatshazwa

• Ngokuqhelekileyo kubakho abantwana
• Uvela kwi-brainstem ephezulu
• Ngokuqhelekileyo kubonakala ngathi ulahlekelwa ngumzila wesicatshulwa okanye ukhankanya kwindawo
• Aba bantwana bangaqhubeka nokuhlakulela ingxaki ekugqibeleni kamva ebomini
• Ukuxolelwa ngokukhawuleza okunokwenzeka njengoko i-neurons ekhulile

Ukungabikho kobuNtu obunjiweyo kwiKhamera

I-EEG ye-Petit Mal Seizure

• I-3-waves-spase-waves / yesibini
• Unokucetyiswa ngu-hyperventilation
• I-Spike = ukuzonwabisa
• I-Wave = inhibition

I-Swenson, R. I-Epilepsy. 2010

I-Focal Focal / Iingxaki zokuzikhethela

• Mhlawumbi mayibe kunye okanye ungenakho ukuzaliswa kwesekondari
• Isigulane sigcina sigxina
• Qalisa kwindawo engundoqo yokusebenza ye-cortex
• Izimpawu ezahlukileyo kunye nokuhlula ngokuxhomekeke kwindawo apho kwingqondo isenzo se-epileptiform sivela khona
• Iindawo ezibonakalayo zivame ukuvelisa into efanelekileyo (ukubona izibane, ukuphosa into ethile, njl, ngokuchasene nokungabi noluvo)
• Iindawo zeenqwelo-moya zingenza iimpawu ezilungileyo okanye ezimbi
• Umsebenzi wendawo yokubandakanyeka ungancitshiswa ngexesha lesithuba
• Ukuba i-motor motor cortex ibandakanyekile = "Ukukhubazeka kukaTold"

Icandelo elithile (i-Focal Seizure) 12 Yr Old Boy

Ukutyunjwa okuKhethekileyo kwi-Motor Cortex

• Ingaqala njengento yokukrokra komzimba omnye, kwicala elibhekiselele kumsebenzi we-epileptiform, kodwa isenokusasazeka ngomzimba kwipatheni yomzimba (i-Jacksonian seizure / march)

www.maxplanckflorida.org/fitzpatricklab/homunculus/science/

Ukutyunjwa okuKhethekileyo Kwi-Somatosensory Cortex

Uvelisa i-paresthesia kwicala eliphambili kwi-epilform activity kwaye linokusasazeka kwipateni yomzimba (umkhonto) ofana nohlobo lwesithuthi

xh.wikipedia.org/wiki/Cortical_homunculus

Ubuncwane boBucala kwi-Auditory-Vestibular Area

• Ukubandakanywa kommandla wexeshana
• Unokuvelisa i-tinnitus kunye / okanye i-vertigo
• I-Audiometry iya kuba yinto eqhelekileyo

Ukutyunjwa okuKhethekileyo kwi-Visual Cortex

• Unakho ukuvelisa i-hallucinations kwintsimi ebonakalayo
• I-cortex ebonakalayo (i-calcarine cortex) ivelise ukukhanya, amabala, kunye / okanye i-zig-zags zokukhanya
• I-cortex yobudlelwane bobuboniso ivelisa i-hallucinations epheleleyo njengamabhaloni athafayo, iinkwenkwezi kunye nama-polygoni

Ubuncwane obuKhethekileyo kwi-Olfactory-Gustatory Cortex

• Unakho ukuvelisa iilucucactory hallucinations
• Mhlawumbi indawo yokusabalalisa ekubanjweni kwamanye amazwe

Iingqungquthela eziKhethekileyo

• Ibandakanya i-cortices yombutho we-frontal, temporal or parietal lobes
• Ifana neendlela ezilula zokukhetha kodwa kukho ukudideka / ukuncipha
• I-Limbic Cortex (i-hippocampus, i-parahippocampal temporal cortex, i-retro-splenial-cingulate--calcallosal cortex, i-cortex e-orbito-frontal, kunye ne-insula).

• Ngako-ke olu luhlobo oluqhelekileyo lokuthwala

• Unokuvelisa iimpawu ezibonakalayo kunye neempembelelo (ubuninzi), ubunqabileyo obubi kunye neentlobo ezingenakonwabisayo kunye nezinto ezithandekayo, iimvakalelo ezinqamlekileyo zesisu, ukwesaba, ukuxhalaba, ukungabi nxamnye nobudlova, nokuxhalaba ngokwesondo ngokugqithiseleyo, ukunyanga, ukuhlafuna, ukubetheka komlomo, ukunyusa izandi, ukubetha, ukulungiswa kweepenile, ukutya, okanye ukuqhuba

Iziqeshana Zokuhlukana Kwezihlobo Ngomntwana Ofanayo

Ukuqhubela phambili / okuqhubekayo

• Iintlobo ze-2

• Jikelele (isimo se-epilepticus)

• I-Focal (epilepticus partialis continua)

• Ukuqhuma okuqhubekayo okanye okuphindaphindiweyo kwixesha elingu-30 ngaphandle kokubuyela kwisigqirha ngaphezu kwexesha
• Umsebenzi wokubamba ixesha elide okanye ukuthatha amanxeba amaninzi kufutshane ngaphandle kokuhlaziywa ngokupheleleyo phakathi
• Eyona nto ibonakala ibonakala njengesiphumo esininzi semithi ye-anticonvulsive ngenxa yokunyuka kwe-hyperexcitability
• Ukugqithisa ngokomzwelo, umkhuhlane, okanye ezinye i-hypermetabolic states, i-hypoglycemia, i-hypocalcemia, i-hypomagnesemia, i-hypoxemia, iindawo ezinobuthi (isib. I-tetanus, uremia, exogenous, i-tanus, i-uremia, i-aminophyline, i-lidocaine, i-penicillin) kunye nokuhoxisa

Isimo Epilepticus

• Ukutshatyalaliswa kokubandezeleka kokuqhubekayo kuyingozi yonyango ngenxa yokuba kunokubangela ukulimala kwengqondo okanye ukufa xa ukuxhatshazwa kwexesha elide kungekhona
• Ubushushu obuphakamileyo ngenxa yomsebenzi osisigxina, u-hypoxia ngenxa yokungena ngokwaneleyo kunye ne-lactic acidosis enokungonakalisa i-neurons
• Ukufa kunokubangelwa kukutshatyalaliswa nokugqithiswa kwe-cardiopulmonary

Epilepsia Partialis Continua

• Ubuncipheko obuncinane bokuphila ngaphandle kwesimo se-epilepticus, kodwa umsebenzi wokubanjwa kufuneka ugqitywe njengoko unokuthi uqhubele phambili kwifomu yokubanjwa ngokubanzi xa uvumelekile ukuba uqhubeke ixesha elide.
• Ingaba ngumphumo we-neoplasm, ischemia-infarction, inetyxic stimulant okanye hyperglycemia

Unyango lweNkunkuma

• Ukuba ukutshatyalaliswa kungumphumo wesimo esisisigxina, njengokusuleleka, ukuphazamiseka kwemilinganiselo yamanzi kunye ne-electrolyte, ukuxhatshazwa okungaqhelekanga kunye nokuphelelwa yintsholongwane, ukunyangwa kweemeko kufuneka kulungise umsebenzi wokubamba
• Uninzi lwamayeza e-antiepileptic anyanga iintlobo ezininzi zokuxhuzula � akagqibelelanga nangona kunjalo
• Ezinye zisebenza ngakumbi (phytotoin, carbamazepine, valproic acid kunye ne phenobarbital)
• Kukho abo baneempembelelo ezimbalwa (i-gabapentin, i-lamotrigine kunye ne-topiramate)
• Amanye amayeza aphatha uhlobo oluthile lokuthumba (njenge-ethosuximide yokungabikho kokuthinteka)

imithombo

UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
I-Swenson, R. I-Epilepsy. 2010.