Epilepsy

ʻO Epilepsy kahi maʻi lolo kahi a ke kanaka i hana hou ai i ka hopu ʻana i ka manawa. ʻO ka hopu ʻana he mau ʻāpana o ke kīnā ʻole ʻole ʻia a me ke kī ʻana ʻole i nā hunaola o ka lolo e hiki ai ke hoʻololi i ka nānā a i ʻole ka lawena.

Hana ʻia ʻo Epilepsy ke hoʻololi ʻia ka lolo i mea e hauʻoli ai a hoʻonāukiuki paha. A ʻo kahi hopena, hoʻouna ka lolo i nā hōʻailona pono ʻole. ʻO kēia ke alakaʻi i ka hopu ʻana i nā manawa hou, hiki ʻole ke ʻike ʻole ʻia. (ʻAʻole hiki ke lūlū hoʻokahi ʻaʻole epilepsy.)

Ma muli o ke olakino a i ʻole ka ʻeha e hoʻopili ai i ka lolo ka maʻi maʻi maʻi. A i ʻole, ʻike ʻole ʻia ke kumu (idiopathic).

ʻO nā kumu maʻamau o ka maʻi epilepsy:

• Ka hahau a i ʻole ka hoʻouka ischemic kuewa (TIA)
• Dementia, e like me ka maʻi Alzheimer
• ʻO ka hōʻeha lolo lolo
• Nā maʻi āpau, e like me ka abscess o ka lolo, meningitis, encephalitis, a me HIV / AIDS
• Nā pilikia lolo e kū nei ma ka hānau ʻana (hemahema o ka lolo hānau)
• ʻO ka ʻeha o ka lolo ke hana ʻia i ka wā a kokoke paha i ka hānau ʻana
• Loaʻa nā maʻi Metabolism i ka wā hānau (e like me phenylketonuria)
• Tumo lolo
• Nā kīʻaha koko maʻamau i ka lolo
• Nā maʻi ʻē aʻe e hōʻino a hōʻino paha i kaʻiʻo o ka lolo
• Nā maʻi hopu e holo i loko o nā ʻohana (epilepsy hereditary)

Hoʻomaka ka hoʻomaka ʻana o ka hopu ʻana o ka maʻi epileptic ma waena o nā makahiki 5 a me 20. Loaʻa ka manawa kiʻekiʻe o ka hopu ʻana i nā mākua ma mua o 60. Akā hiki ke hoʻopaʻa ʻia ka maʻi epileptic i kēlā me kēia makahiki. Aia paha he moʻolelo ʻohana o ka hopu ʻana a i ʻole epilepsy.

Hoʻololi nā ʻōuli i kēlā me kēia kanaka. Loaʻa i kekahi poʻe i nā kilokilo ke nānā aku maʻalahi. ʻO ka haʻalulu ikaika a me ka nalo o ka makaʻala kekahi. Aia ke ʻano o ka hopu ʻana i ka ʻāpana o ka lolo e hoʻopili ʻia.

ʻO ka hapa nui o ka manawa, like ka hopu ʻana me ka mea ma mua ona. ʻO kekahi poʻe me ka maʻi epilepsy i kahi ʻano ʻē ma mua o kēlā me kēia hopu ʻana. Ke ʻalalā nei paha nā manaʻo, e honi ana i kahi pilau ʻaʻole i laila maoli, a i ʻole nā ​​loli manaʻo. Kapa ʻia kēia he aura.

Hiki i kāu kauka ke haʻi hou aku iā ʻoe e pili ana i ke ʻano o ka hopu ʻana i loaʻa iā ʻoe.

• ʻAʻole (petit mal) ka hopu ʻana (ke nānā aku i nā kilokilo)
• ʻO ka hopu ʻana i nā tonic-clonic (grand mal) laulā (pili i ke kino holoʻokoʻa, e like me ka aura, nā mākala paʻa, a me ka nalo ʻana o ka makaʻala)
• Ka hopu ʻana ʻāpana (focal) (hiki ke hoʻopili i kekahi o nā ʻōuli i hōʻike ʻia ma luna, e pili ana i kahi o ka lolo e hoʻomaka ai ka hopu ʻana)

E hana ke kauka i kahi hoʻokolohua kino. E hoʻopili kēia i kahi nānā kikoʻī i ka lolo a me ka ʻōnaehana.

E hana ʻia kahi EEG (electroencephalogram) e nānā i ka hana uila i ka lolo. ʻO ka poʻe me ka maʻi epilepsy e loaʻa pinepine ka hana uila i ʻike ʻia ma kēia hōʻike. I kekahi mau hihia, hōʻike ka hōʻike i kahi ma ka lolo kahi e hoʻomaka ai ka hopu ʻana. ʻIke paha ka lolo ma hope o ka hopu ʻana a ma waena o ka hopu ʻana.

No ke kuhi ʻana i ka maʻi epilepsy a i ʻole hoʻolālā i ka hana epilepsy, pono ʻoe e:

• E hoʻokomo i kahi mea hoʻopaʻa leo EEG no nā lā a i ʻole mau pule ke hele ʻoe i kou ola i kēlā me kēia lā.
• Noho i loko o kahi haukapila kūikawā kahi e hiki ai ke hoʻopaʻa i ka hana lolo ke kiʻi ʻia nā kāmela wikiō i nā mea i loaʻa iā ʻoe i ka wā o ka hopu ʻana. Kāhea ʻia kēia wikiō ʻo EEG.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Ke kemika koko
• Koko kō
• Helu piha koko (CBC)
• Nā hoʻāʻo hana hakuʻala
• Nā hoʻāʻo hana ate
• Lumbar puncture (iwi kuamoʻo tap)
• Nā hoʻāʻo no nā maʻi lele

Hana pinepine ʻia ka scan CT a MRI paha e ʻike i ke kumu a me kahi o ka pilikia i ka lolo.

ʻO ka mālama ʻana no ka maʻi epilepsy me ka lawe ʻana i nā lāʻau, nā loli o ka nohona, a i kekahi manawa ke ʻoki.

Inā pili ka maʻi epilepsy i kahi tumo, nā kīʻaha koko ʻē aʻe, a i ʻole ke kahe ʻana o ka lolo i ka lolo, ke kāʻoki ʻana e mālama i kēia mau maʻi e hoʻopau paha i ka hopu ʻana.

Nā lāʻau lapaʻau e pale aku ai i ka hopu ʻana, i kapa ʻia nā anticonvulsants (a i ʻole nā ​​lāʻau antiepileptic), hiki ke hōʻemi i ka nui o nā kaʻi e hiki mai ana:

• Lawe ʻia kēia mau lāʻau i ka waha. ʻO ke ʻano hea ʻoe e kuhikuhi ʻia ai e pili ana i ke ʻano o ka hopu ʻana i loaʻa iā ʻoe.
• Pono paha e hoʻololi i kāu mea hana i kēlā me kēia manawa. Pono ʻoe i nā hoʻokolohua koko maʻamau e nānā i nā hopena ʻaoʻao.
• Lawe mau i kāu lāʻau i ka manawa a me ke kuhikuhi. ʻO ka nalo ʻana i kahi lāʻau e hiki ai iā ʻoe ke hopu i ka maʻi. Mai hōʻoki i ka lawe a hoʻololi paha i nā lāʻau iā ʻoe iho. E kamaʻilio mua i kāu kauka.
• ʻO nā lāʻau epilepsy he nui e hōʻeha i nā hānau hānau. ʻO nā wahine e hoʻolālā e hāpai e pono e haʻi i kā lākou kauka ma mua i mea e hoʻoponopono ai i nā lāʻau.

Hiki i nā lāʻau epilepsy ke hoʻopili i ke olakino o kou mau iwi. E kamaʻilio me kāu kauka e pili ana inā pono ʻoe i nā huaora a me nā mea hoʻopili ʻē aʻe.

ʻO ka maʻi maʻi epilepsy e maikaʻi ʻole ma hope o ka hoʻāʻo ʻana o 2 a 3 mau lāʻau anti-ka hopu ʻia ua kapa ʻia ʻo "epilepsy lāʻau lapaʻau refactory." I kēia hihia, hiki i ke kauka ke paipai i ke ʻoki ʻana iā:

• Wehe i nā hunaola lolo ʻole e hoʻoʻauʻau.
• E kau i kahi vagal nerve stimulator (VNS). ʻO kēia hāmeʻa e like me ka pacemaker puʻuwai. Hiki ke kōkua i ka hōʻemi ʻana i ka nui o ka hopu ʻana.

Hoʻonoho ʻia kekahi mau keiki i ka papaʻai kūikawā e kōkua ai i ka pale ʻana i ka hopu ʻana. ʻO ka mea i makemake nui ʻia kaʻai ketogenic. ʻO kahi papaʻai haʻahaʻa i nā huaʻāpelu, e like me ka ʻai Atkins, he kōkua paha i kekahi mau mākua. E noʻonoʻo e kūkākūkā i kēia mau koho me kāu kauka ma mua o ka hoʻāʻo ʻana iā lākou.

Hiki ke hoʻonui i ka nohona a i ʻole nā ​​olakino olakino i ka hopu ʻana i nā mākua a me nā keiki me ka maʻi epilepsy. E kamaʻilio me kāu kauka e pili ana:

• Nā lāʻau hou i kuhikuhi ʻia, nā wikamina, a i ʻole nā ​​mea hoʻopili
• Kaha kaumaha
• ʻO ka maʻi, ʻo ka maʻi hoʻi
• Ka nele o ka hiamoe
• Hapai keiki
• ʻO ka haʻalele ʻana i nā lāʻau epilepsy
• Hoʻohana i ka wai ʻona a i ʻole nā ​​lāʻau leʻaleʻa ʻē aʻe
• Hōʻike i nā kukui uila a i ʻole nā ​​stimuli
• Hyperventilation

Nā manaʻo ʻē aʻe:

• Pono nā kānaka me ka maʻi epilepsy e hoʻokomo i nā mea hoʻohanohano olakino i hiki ai ke loaʻa koke ka lāʻau lapaʻau inā kū ka hopu.
• ʻO nā kānaka me ka maʻi epilepsy maikaʻi ʻole e hoʻokele. E hōʻoia i ke kānāwai o kou mokuʻāina e pili ana i ka poʻe i loaʻa ka mōʻaukala hopu i ʻae ʻia e hoʻokele.
• Mai hoʻohana i nā mīkini a hana i nā hana e hiki ai ke lilo i ka ʻike, e like me ka piʻi ʻana i nā wahi kiʻekiʻe, paikikala, a me ka ʻauʻau wale ʻana.

ʻO ke koʻikoʻi o ka loaʻa ʻana o ka epilepsy a i ʻole ke kahu o kekahi mea me ka maʻi epilepsy hiki ke kōkua pinepine ʻia e ke komo ʻana i kahi hui kākoʻo. I kēia mau pūʻulu, kaʻana like nā lālā i nā ʻike a me nā pilikia maʻamau.

Hiki i kekahi poʻe me ka maʻi epilepsy ke hōʻemi a i ʻole hoʻōki paha i kā lākou lāʻau anti-seizure ma hope o ka loaʻa ʻole o ka hopu ʻana no kekahi mau makahiki. E hele a hoʻomaikaʻi paha kekahi o nā ʻano epilepsy o ka wā kamaliʻi me ka makahiki, i ka wā maʻamau i nā makahiki he 20 a i ʻole 20.

No ka poʻe he nui, he ʻano ola ke ʻano o ka maʻi epilepsy. I kēia mau hihia, pono e hoʻomau i nā lāʻau anti-seizure. Aia kahi makaʻu haʻahaʻa loa no ka make koke me ka maʻi epilepsy.

Komo pū nā pilikia:

• Aʻo paʻakikī
• Ka hanu ʻana i ka meaʻai a i ʻole lawehala i loko o nā ake māmā i ka wā o ka hopu ʻia ʻana, kahi e hiki ai ke loaʻa i ka pulumonia aspiration
• ʻO ka hōʻeha mai ka hāʻule, nā puʻupuʻu, nā nahu hoʻomāinoino ʻia, ka hoʻokele a i ʻole nā ​​mīkini hana i ka wā o ka hopu ʻana
• Poino lolo paʻa (stroke a i ʻole nā ​​ʻino ʻē aʻe)
• Nā hopena o nā lāʻau

Kāhea i kāu helu pilikia kūloko (e like me 911) inā:

• ʻO kēia ka manawa mua o ke kaohi ʻana o ke kanaka
• Kūleʻa kahi hopu i kekahi mea ʻaʻole e kau i ka kūpeʻe ID ID (nona nā ʻōlelo kuhikuhi e wehewehe ana i ka mea e hana ai)

I ka hihia o kekahi i loaʻa i ka hopu ʻana ma mua, e kāhea iā 911 no kekahi o kēia mau hanana pilikia:

• ʻOi aku ka lōʻihi o ka hopu ʻana o ke kanaka ma mua o ka mea i loaʻa maʻamau, a i ʻole he helu ʻano ʻē o ka hopu ʻana i ke kanaka
• ʻO ka hopu hou ʻana i mau mau minuke
• ʻO nā kuʻi pinepine ʻana i kahi e ʻike ʻole ai ka hana a me ka hana maʻamau ma waena o lākou (kūlana epilepticus)

Kāhea i kāu kauka inā loaʻa nā hōʻailona hou.

• Poho lauoho
• Nausea a i ʻole ka luaʻi
• Rash
• Nā hopena o nā lāʻau, e like me ka hiamoe, hoʻomaha ʻole, huikau, hoʻomaha
• Nā haʻalulu a i ʻole nā ​​neʻe ʻole, a i ʻole nā ​​pilikia me ka hoʻohui ʻana

ʻAʻohe ala i ʻike ʻia e pale aku ai i ka maʻi epilepsy. ʻO kaʻai kūpono a me ka hiamoe, a me ka noho kaʻawale ʻana mai ka wai ʻona a me nā lāʻau kū ʻole i ke kānāwai e hoʻemi ai i ka likelihood of triggering seizures i ka poʻe me ka maʻi epilepsy.

E hoʻemi i ka pilikia no ka hōʻeha poʻo ma ke kau ʻana i ka mahiole i nā hana hoʻoweliweli. Hiki i kēia ke hoʻemi i ka likelike o kahi ʻeha lolo e alakaʻi ai i ka hopu ʻana a me ka maʻi epilepsy.

Maʻi ʻaʻai; Epileptic - epilepsy

• ʻOki kino o ka lolo - hoʻokuʻu
• Epilepsy i nā mākua - he aha e nīnau aku ai i kāu kauka
• Epilepsy i nā keiki - hoʻokuʻu
• Epilepsy i nā keiki - he aha e nīnau aku ai i kāu kauka
• Epilepsy a i ʻole ka hopu ʻana - hoʻokuʻu
• ʻO ka hopu ʻana i ka hopena - he aha e nīnau aku ai i kāu kauka
• ʻO radiosurgery Stereotactic - hoʻokuʻu

• Nā hanana lolo
• ʻŌnaehana Limbic
• Ke kuleana o ke aʻalolo vagus i ka maʻi epilepsy
• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral
• Convulsions - kōkua mua - series

Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsy. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 101.

ʻO González HFJ, Yengo-Kahn A, Englot DJ. Hoʻoulu ka nerve Vagus no ka mālama ʻana i ka maʻi epilepsy. ʻO Neurosurg Clin N Am. 2019; 30 (2): 219-230. PMID: 30898273 www.ncbi.nlm.nih.gov/pubmed/30898273.

ʻO Thijs RD, Nā Kahua R, O'Brien TJ, Sander JW. Epilepsy i nā mākua. Lancet. 2019; 393 (10172): 689-701. PMID: 30686584 pubmed.ncbi.nlm.nih.gov/30686584/.

Wiebe S. ʻO nā epilepsy. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 375.