Cutar cututtuka
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rare genetic epilepsy (en) da Farfaɗiya |
Ana iya rarraba mutanen da ke da farfaɗiya zuwa cututtuka daban-daban bisa ƙayyadaddun siffofi na asibiti. Waɗannan fasalulluka sun haɗa da shekarun da zazzagewa ke farawa, nau'ikan kamawa, da binciken EEG, da sauransu. Gano ciwon farfaɗo yana da amfani yayin da yake taimakawa wajen gano abubuwan da ke haifar da su tare da yanke shawarar abin da ya kamata a gwada magungunan hana kamuwa da cuta .[1][2] An fi gano cututtukan farfaɗiya a jarirai da yara. Wasu misalan cututtukan cututtukan farfadiya sun haɗa da farfaɗo na rolandic mara kyau (2.8 a cikin 100,000), rashin farfaɗo na ƙuruciya (0.8 cikin 100,000) da farfaɗo na ƙananan yara (0.7 a cikin 100,000). Cututtuka masu tsanani tare da rashin aikin kwakwalwa da suka haifar, aƙalla, ta wani bangare na farfadiya, ana kuma kiran su da encephalopathies na epileptic. Waɗannan suna da alaƙa da rikice-rikice akai-akai waɗanda ke da juriya ga jiyya da rashin ƙarfi na fahimi, alal misali Lennox-Gastaut ciwo da Ciwon Yamma.[3]
Rarraba cututtuka na Epilepsy[gyara sashe | gyara masomin]
An rarraba cututtukan farfaɗo kamar yadda shekarun farawa.
Farfaɗowa tare da farawa a lokacin ƙuruciya rukuni ne mai rikitarwa na cututtuka tare da dalilai da halaye iri-iri. Wasu mutane ba su da wata matsala ta jijiyoyi ko matsalolin rayuwa. Suna iya haɗawa da madaidaicin digiri na nakasa hankali, abubuwan Autism, wasu rikice-rikice na tunani, da matsalolin mota. Wasu suna da cututtukan da aka gada na rayuwa, chromosomal abnormalities, takamaiman ido, fata da fasalin tsarin juyayi, ko rashin daidaituwa na ci gaban cortical. Wasu daga cikin waɗannan farfaɗo za a iya karkasa su cikin cututtukan farfaɗo na gargajiya. Bugu da ƙari kuma, akwai nau'o'in cututtuka na asibiti waɗanda babban fasalin su ba farfadiya ba ne amma waɗanda ke da alaƙa da haɗari mafi girma na farfadiya. Misali tsakanin 1 zuwa 10% na masu fama da Down syndrome da kashi 90% na masu fama da cutar Angelman suna da farfadiya.[4]
Rinjayen Autosomal na gaban lobe farfadiya[gyara sashe | gyara masomin]
Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) farfadiya ce mai alaƙa da asalin asalin idiopathic wacce cuta ce ta gado wacce ke haifar da kamawa yayin barci. Farawa yawanci a cikin yara. Waɗannan rikice-rikicen suna fitowa ne daga lobes na gaba kuma sun ƙunshi haɗaɗɗun motsin motsi, kamar ɗaure hannu, ɗaga hannu / ragewa, da durƙusawa gwiwa. Surutu irin su ihu, nishi, ko kuka su ma sun zama ruwan dare.[5] ADNFLE galibi ana kuskuren ganewa a matsayin mafarki mai ban tsoro. ADNFLE yana da tushen kwayoyin halitta. Waɗannan kwayoyin halittar suna ɓoye nau'ikan masu karɓar nicotinic acetylcholine.
ciwon Rolandic farfadiya[gyara sashe | gyara masomin]
Cutar sankarau na centrotemporal lobe na ƙuruciya ko rashin lafiyar Rolandic farfadiya cuta ce mai alaƙa da asalin idiopathic wacce ke faruwa a cikin yara tsakanin shekaru 3 zuwa 13, tare da farawa mafi girma a cikin ƙarshen kuruciya. Baya ga matsalar kama su, waɗannan majiyyatan sun kasance na al'ada. Wannan ciwon yana fasalta kamun kai mai sauƙi wanda ya ƙunshi tsokoki na fuska kuma akai-akai yana haifar da faɗuwa. Ko da yake mafi yawan abubuwan da suka faru sun kasance gajere, wasu lokuta rikice-rikice suna yaduwa kuma suna mamayewa.[6] Kamewa yawanci na dare ne kuma an tsare shi cikin barci. EEG na iya nuna fitowar karu da ke faruwa a saman fatar kai na tsakiya a kan tsakiyar sulcus na kwakwalwa (Rolandic sulcus) waɗanda ke da niyyar faruwa yayin bacci ko haske. Kamewa ya ƙare a kusa da balaga. Seizure na iya buƙatar maganin tashe-tashen hankula, amma wasu lokuta ba su da yawa don ba da damar likitoci su jinkirta jiyya.[7]
Cutar sankarau ta kuruciya[gyara sashe | gyara masomin]
Benign occipital epilepsy na ƙuruciya (BOEC) farfadiya ce mai alaƙa da yanki na idiopathic kuma ta ƙunshi gungun cututtuka masu tasowa. Yawancin hukumomi sun haɗa da nau'i-nau'i biyu, nau'i na farko tare da farawa tsakanin shekaru uku zuwa biyar, da kuma farkon farawa tsakanin shekaru bakwai zuwa 10. Seizures a cikin BOEC yawanci yana nuna alamun gani kamar scotoma ko katanga (launi masu launin haske ko layi) ko amaurosis (makãho ko nakasar gani). Maƙarƙashiyar da ta haɗa da rabin jiki, ƙwanƙwasawa, ko karkatar da ido ta tilastawa ko jujjuya kai ya zama ruwan dare. Ƙananan marasa lafiya yawanci suna fuskantar alamun bayyanar cututtuka irin su migraine tare da tashin zuciya da ciwon kai, kuma tsofaffi marasa lafiya yawanci suna koka da ƙarin alamun gani. EEG a cikin BOEC yana nuna alamun da aka rubuta daga yankunan occipital (bayan kai). Tsarin EEG da tsarin kwayoyin halitta suna ba da shawarar watsawa ta atomatik kamar yadda Ruben Kuzniecky ya bayyana, et al.[8] Kwanan nan, ƙungiyar farfaɗowa mai suna Panayiotopoulos ciwo [15] waɗanda ke raba wasu sifofin asibiti na BOEC.
Rashin yaro farfadiya[gyara sashe | gyara masomin]
Farfaɗowar rashin ƙuruciya (CAE) cuta ce ta gama gari wacce ke shafar yara tsakanin shekaru 4 zuwa 12, kodayake farkon farkon yana kusan shekaru biyar zuwa shida. Waɗannan majiyyatan suna da rikice-rikice na rashi akai-akai, taƙaitaccen yanayin kallon da ba a amsa ba, wani lokaci tare da ƙananan halayen mota kamar ƙiftawar ido ko tauna da hankali. Binciken EEG a cikin CAE shine ƙaƙƙarfan karu 3 Hz da fitar da igiyar ruwa. Wasu suna ci gaba da haɓaka cututtukan tonic-clonic na gaba ɗaya. Wannan yanayin yana ɗauke da kyakkyawan hasashe saboda yara ba sa nuna raguwar fahimi ko nakasar jijiya, kuma abubuwan da ke faruwa a galibi suna dainawa ba tare da bata lokaci ba.
Dravet ciwo[gyara sashe | gyara masomin]
Ciwon Dravet, wanda a baya aka sani da mummunar farfaɗowar myoclonic na jarirai (SMEI), cuta ce ta neurodevelopmental wacce ke farawa tun tana jariri kuma tana da tsananin farfaɗiya wacce ba ta amsa da kyau ga magani. Charlotte Dravet, likitan hauka na Faransanci da likitan farfadiya ne ya bayyana wannan ciwo (an haife shi 14 ga Yuli, 1936). Dravet ya bayyana wannan ciwo yayin da yake aiki a Cibiyar Saint Paul a Jami'ar Marseille. A Cibiyar Saint Paul, daya daga cikin masu kula da ita ita ce Henri Gastaut, wanda ya bayyana ciwon Lennox-Gastaut. Ta bayyana wannan yanayin a cikin 1978 Ƙididdiga na yaduwar wannan cuta mai wuyar gaske ya kasance daga 1: 20,000 zuwa 1: 40,000 na haihuwa, ko da yake ana iya ganin abin da ya faru ya fi girma yayin da ciwon ya zama mafi ganewa kuma an gano sababbin kwayoyin halitta. Ana tsammanin yana faruwa tare da mitar irin wannan a cikin jinsin biyu, kuma bai san iyakokin yanki ko kabilanci ba. Yanayin Dravet ciwo yana canzawa sosai daga mutum zuwa mutum. Kamewa yana farawa a cikin shekarar farko ta rayuwa kuma ci gaba na al'ada ne kafin farkon su. A mafi yawan lokuta, ciwon farko yana faruwa da zazzabi kuma ana haɗa shi da tonic-clonic (grand mal) ko maƙarƙashiya (bangare ɗaya). Wadannan kamun sau da yawa ana tsawaitawa, kuma suna iya haifar da matsayi na farfadiya, gaggawar likita. A cikin lokaci, tashin hankali yana ƙaruwa kuma ya fara faruwa ba tare da zazzaɓi ba. Ƙarin nau'ikan kamuwa da cuta suna bayyana, galibi waɗannan su ne myoclonic, rashi na yau da kullun, da rikice-rikice. Ƙarin fasalulluka waɗanda ake gani a cikin adadi mai yawa na marasa lafiya tare da ciwo na Dravet na iya haɗawa da rikice-rikice na aiki na hankali da sauran halaye na bakan Autism, orthopedic ko rikicewar motsi, akai-akai ko na yau da kullun na sama da cututtukan kunne, damuwa barci, dysautonomia, da matsaloli tare da girma da abinci mai gina jiki.[9]
Farfaɗo a cikin mata masu tawayar hankali[gyara sashe | gyara masomin]
Farfaɗo a cikin mata masu nakasa na hankali, ana siffanta su ta hanyar kamuwa da cuta a cikin ƙuruciya ko ƙuruciya (watanni 6-36) da kuma rashin fahimta a wasu lokuta. Kamuwa da cuta sun kasance gabaɗaya, gami da tonic-clonic, tonic da seizures na atonic. An tsawaita nau'in nau'in nau'in halitta don haɗawa da mata marasa lafiya waɗanda ke da farkon farawar farfaɗowa encephalopathies kama da Dravet syndrome, FIRES, Gabaɗaya farfadiya tare da ciwon febrile da (GEFS+) ko farfadiya mai zurfi tare da ko ba tare da nakasa hankali ba. Halin yana haifar da maye gurbi a cikin PCDH19 (protocadherin 19).
Ciwon farfadiya mai nasaba da kamuwa da cuta[gyara sashe | gyara masomin]
Cutar cututtukan cututtukan cututtukan cututtukan cututtukan fata (FIRES)
Ciwon gaba na gaba[gyara sashe | gyara masomin]
Farfaɗowar lobe ta gaba, yawanci alama ce ko ɓarna da ke da alaƙa da cryptogenic, tana tasowa daga raunukan da ke haifar da kamawar da ke faruwa a cikin lobes na gaba na kwakwalwa. Waɗannan cututtukan na iya zama da wahala a gano su saboda alamun kamuwa da cuta na iya rikicewa cikin sauƙi tare da sihirin marasa ƙarfi kuma, saboda iyakancewar EEG, yana da wahala a “gani” tare da daidaitaccen fatar kan mutum EEG. Farfaɗowar rashin ƙuruciya cuta ce ta gama gari na idiopathic tare da farawa daga baya fiye da CAE, yawanci a cikin samartaka kafin balaga, tare da nau'in kama mafi yawan lokuta shine rashin kamawa. Gabaɗaya tonic-clonic seizures na iya faruwa. Sau da yawa, 3 Hz karu-kalaman ko mahara karu za a iya gani a kan EEG. Hasashen ya haɗu, tare da wasu marasa lafiya suna zuwa wani ciwo wanda ba shi da bambanci daga JME.
Juvenile myoklonic farfadiya[gyara sashe | gyara masomin]
Juvenile myoclonic epilepsy (JME) wata cuta ce ta gama gari wacce ke faruwa a cikin marasa lafiya masu shekaru 8 zuwa 20. Marasa lafiya suna da fahimi na yau da kullun kuma in ba haka ba sun kasance marasa lafiya. Mafi na kowa kama shi ne myoclonic jerks, ko da yake gaba ɗaya tonic-clonic seizures da rashi seizures iya faruwa ma. Myoclonic jerks yawanci tari da sassafe bayan farkawa. EEG yana bayyana juzu'i na 4-6 Hz karu ko fitar da karu da yawa. Wadannan marasa lafiya sau da yawa ana gano su a lokacin da suka sami ciwon tonic-clonic na farko daga baya a rayuwa, lokacin da suka fuskanci rashin barci (misali, shekara ta farko a koleji bayan sun yi latti don nazarin jarrabawa). Janye barasa kuma na iya zama babban abin da zai taimaka wajen samun nasarar kamawa, haka nan. Haɗarin ɗabi'a na kamawa shine tsawon rai; duk da haka, yawancin suna da kama-karya da kyau tare da magungunan kashe gobara da kuma nisantar abubuwan haɗari.
Ciwon Lennox-Gastaut[gyara sashe | gyara masomin]
Ciwon Lennox-Gastaut (LGS) cuta ce ta gabaɗaya wacce ta ƙunshi nau'ikan jinkiri na haɓaka haɓakawa ko lalatawar ƙuruciya, gauraye gama gari, da EEG yana nuna tsari na kusan 2 Hz "slow" spike- taguwar ruwa. Farawa yana faruwa tsakanin shekaru biyu zuwa 18. Ana la'akari da farfaɗo a matsayin na dindindin (ma'ana yana daɗe na dogon lokaci) yanayin da aka bayyana ta hanyar kamawa. Cutar Lennox-Gastaut (LGS) wani nau'i ne na farfadiya da ba kasafai ba kuma mai tsanani. Kamar yadda yake a cikin Ciwon Yamma, LGS yana haifar da dalilai na idiopathic, alamomi, ko cryptogenic, kuma yawancin marasa lafiya sun fara samun ciwon West. Hukumomi suna jaddada nau'o'in kamawa daban-daban masu mahimmanci a LGS, amma yawancin suna da rikice-rikice (raguwar hare-haren), tonic seizures, tonic-clonic seizures, rashi na yau da kullum, da kuma wani lokacin, ciwon kai. Magungunan anticonvulsants yawanci suna samun nasara kaɗan kawai a cikin jiyya.
Ohtahara ciwo[gyara sashe | gyara masomin]
Cutar Ohtahara cuta ce da ba kasafai ba amma mai tsanani ta farfadiya yawanci tana farawa a cikin 'yan kwanaki ko makonnin farko na rayuwa. Rikicin yakan kasance a cikin nau'i mai taurin kai amma ana iya ganin wasu abubuwan da suka haɗa da na gefe ɗaya. Electroencephalogram (EEG) siffa ce. Hasashen ba shi da kyau tare da kusan rabin jariran da ke mutuwa a farkon shekara ta rayuwa; Galibi idan ba duka jariran da suka tsira ba suna da nakasu a hankali sosai kuma da yawa suna da ciwon kwakwalwa. Babu magani mai inganci. Yawancin yara suna da rashin daidaituwar tsarin kwakwalwa.[10]
Reflex epilepsies[gyara sashe | gyara masomin]
Kusan kashi 6 cikin ɗari na masu fama da farfaɗiya suna da kamun kai wanda galibi ke haifar da takamammen abubuwan da suka faru, waɗanda aka fi sani da tashin hankali. Yawancin cututtuka na farfaɗiya, waɗanda aka sani da reflex epilepsies, suna da kamewa waɗanda kawai ke haifar da ƙayyadaddun abubuwan motsa jiki. Abubuwan da ke jawo hankulan jama'a sun haɗa da: fitilu masu walƙiya da surutai kwatsam. Wadanda ke da farfadiya mai daukar hoto na iya samun kamewa ta hanyar walƙiya. Sauran hazo na iya haifar da ciwon farfaɗiya a cikin marasa lafiya waɗanda in ba haka ba za su iya kamuwa da ciwon kai tsaye. Misali, yaran da ke fama da rashin ƙuruciyar farfadiya na iya zama masu saurin samun iska. A zahiri, fitilu masu walƙiya da haɓakar iska suna kunna hanyoyin da aka yi amfani da su a cikin EEG na asibiti don taimakawa faɗakarwa don taimakawa gano cutar. A ƙarshe, sauran hazo na iya sauƙaƙe, maimakon fararwa ta dole, kamawa a cikin mutane masu rauni. Damuwar motsin rai, rashin barci, barcin kansa, damuwa mai zafi, barasa da ciwon zazzaɓi sune misalan hazo da majiyyata masu ciwon farfaɗiya suka ambata. Musamman ma, tasirin hazo daban-daban ya bambanta da ciwon farfadiya. Hakazalika, hawan haila a cikin mata masu ciwon farfadiya na iya yin tasiri ga yanayin sake dawowa. Katamenial farfadiya ita ce kalmar da ke nuna kamawa da ke da alaƙa da yanayin haila. Farfaɗowar karatun firamare farfadiya ce ta reflex wadda aka keɓe azaman farfadiya mai alaƙa da yanki na idiopathic. Karatu a cikin mutane masu saukin kamuwa yana haifar da rikice-rikice. Catamenial epilepsy (CE) shine lokacin da kamewa ya taru a kusa da wasu sassan al'adar mace.[11]
Cigaban farfadiya na myoklonic[gyara sashe | gyara masomin]
Ci gaba na ci gaba na farfaɗowar myoclonic suna bayyana rukuni na bayyanar cututtuka na gabaɗaya wanda ke da alaƙa da ci gaba da ciwon hauka da kamawar myoclonic. Tonic-clonic seizures na iya faruwa kuma. Cututtukan da aka fi sani da su a cikin wannan rukunin sune cutar Unverricht-Lundborg, farfadiya ta myoclonus tare da ragged ja zaren (MERRF ciwo), Lafora cuta, neuronal ceroid lipofucinosis, da sialdosis.
Rasmussen's encephalitis[gyara sashe | gyara masomin]
Rasmussen ta encephalitis alama ce ta kungiyoyin da ke da alaka da wanda ke ci gaba, ciwo mai ciwon da ke shafar yara da nesa kafin shekaru 10. Ciwon ya fara a cikin rikice-rikice na musamman kuma zai iya ci gaba zuwa epilepsia partialis. continua (sau karamin dan wasa matsayi na epilepticus). Neuroimaging yana nuna kumburin encephalitis a gefe gefe na kwakwalwa zai iya yaduwa idan ba a kula da shi ba. Dementia da hemiparesis wasu damuwa ne. An yi hasashe dalilin da ya haɗa da hari na ikon akan masu aikin glutamate, wani nau'in damuwa cuta na yau da kullun a cikin kwakwalwa.[24]
Farfaɗowar lobe na ɗan lokaci[gyara sashe | gyara masomin]
Farfaɗowar lobe na ɗan lokaci (TLE) ba cuta ce ta gargajiya ba amma an ambata a nan saboda ita ce farfaɗowar manya. Yana da alamun bayyanar cututtuka da ke da alaƙa kuma a mafi yawan lokuta ana samun yankin epileptogenic a cikin tsakiyar layi (mecial) tsarin lokaci (misali, hippocampus, amygdala, da gyrus parahippocampal). Kamewa yana farawa a ƙarshen ƙuruciya da samartaka. Yawancin waɗannan marasa lafiya suna da rikice-rikice a wasu lokuta kafin aura, kuma wasu marasa lafiya na TLE kuma suna da rikice-rikice na tonic-clonic na gabaɗaya. Sau da yawa rikice-rikice ba su da isasshen amsa ga jiyya tare da magungunan kashe ƙarfi kuma ana iya la'akari da tiyatar farfadiya.[25]
Ciwon Yamma[gyara sashe | gyara masomin]
Ciwon Yamma wani nau'i ne na jinkirin ci gaba, abubuwan da ake kira spasms na jarirai, da EEG yana nuna alamar da ake kira hypsarrhythmia. Farawa yana faruwa tsakanin watanni uku zuwa shekaru biyu, tare da farawa mafi girma tsakanin watanni takwas zuwa tara. Ciwon Yamma na iya tasowa daga dalilai na idiopathic, alamomi, ko abubuwan cryptogenic. Mafi na kowa dalilin shi ne tuberous sclerosis. Hasashen ya bambanta da ainihin dalilin. Gabaɗaya, yawancin marasa lafiya da suka tsira suna kasancewa tare da ƙarancin fahimi da ci gaba da kamawa kuma suna iya canzawa zuwa wani ciwo na eponymic, ciwo na Lennox-Gastaut. Ana iya rarraba shi azaman idiopathic, syndromic, ko cryptogenic dangane da sanadin kuma yana iya tasowa daga duka mai da hankali ko raunin farfadiya gabaɗaya.
Manazarta[gyara sashe | gyara masomin]
- ↑ "Epilepsy syndromes". International league against epilepsy. Retrieved 2014-10-06.
- ↑ National Institute for Health and Clinical Excellence (January 2012). "Chapter 9: Classification of seizures and epilepsy syndromes" (PDF). The Epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care. National Clinical Guideline Centre. pp. 119–129.
- ↑ Nordli DR jr (2012). "Epileptic encephalopathies in infants and children". J Clin Neurophysiol. 29 (5): 420–4. doi:10.1097/WNP.0b013e31826bd961. PMID 23027099. S2CID 41884825.
- ↑ Jain, Puneet; Sharma, Suvasini; Tripathi, Manjari (2013). "Diagnosis and Management of Epileptic Encephalopathies in Children". Epilepsy Research and Treatment (in Turanci). 2013: 501981. doi:10.1155/2013/501981. ISSN 2090-1348. PMC 3736403. PMID 23970964.
- ↑ Pandolfo M (2013). "Pediatric epilepsy genetics". Curr Opin Neurol. 26 (2): 137–45. doi:10.1097/WCO.0b013e32835f19da. PMID 23449174.
- ↑ Thomas RH, Berkovic SF (2014). "The hidden genetics of epilepsy-a clinically important new paradigm". Nat Rev Neurol. 10 (5): 283–92. doi:10.1038/nrneurol.2014.62. PMID 24733163. S2CID 205516164.
- ↑ Allen, A. S.; Berkovic, S. F.; Cossette, P.; Delanty, N.; Dlugos, D.; Eichler, E. E.; Epstein, M. P.; Glauser, T.; Goldstein, D. B.; Han, Y.; Heinzen, E. L.; Hitomi, Y.; Howell, K. B.; Johnson, M. R.; Kuzniecky, R.; Lowenstein, D. H.; Lu, Y. F.; Madou, M. R.; Marson, A. G.; Mefford, H. C.; Esmaeeli Nieh, S.; O'Brien, T. J.; Ottman, R.; Petrovski, S.; Poduri, A.; Ruzzo, E. K.; Scheffer, I. E.; Sherr, E. H.; Yuskaitis, C. J.; et al. (2013). "De novo mutations in epileptic encephalopathies". Nature. 501 (7466): 217–21. Bibcode:2013Natur.501..217E. doi:10.1038/nature12439. PMC 3773011. PMID 23934111.
- ↑ Panayiotopolous CP (2000). "Benign childhood epileptic syndromes with occipital spikes: New classification proposed by the ILAE". J Child Neurol. 15 (8): 548–552. doi:10.1177/088307380001500810. PMID 10961795. S2CID 25866946.
- ↑ "Dravet Syndrome". Archived from the original on 2010-10-13. Retrieved 2010-09-08.
- ↑ Aicardi J and Ohtahara S. Severe neonatal epilepsies with suppression-burst pattern. Epileptic Syndromes in Infancy, Childhood and Adolescence (4th edition) Eds Roger J, Bureau M, Dravet C, Genton P, Tassinari C, and Wolf P. John Libbey Eurotext 2005 08033994793.ABA.
- ↑ Xue, LY; Ritaccio, AL (March 2006). "Reflex seizures and reflex epilepsy". American Journal of Electroneurodiagnostic Technology. 46 (1): 39–48. doi:10.1080/1086508X.2006.11079556. PMID 16605171. S2CID 10098600.