Epilepsy i nā keiki

ʻO Epilepsy kahi maʻi lolo kahi a ke kanaka i hana hou ai i ka hopu ʻana i ka manawa.

Hoʻohuli koke kahi hopu ʻana i ka uila a me ka hana kemika i ka lolo. ʻO ka hopu ʻana hoʻokahi e kū hou ʻole ana ia, ʻaʻole ia ʻo 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.

ʻO nā kumu maʻamau o ka maʻi epilepsy:

• ʻO ka hōʻeha lolo lolo
• Poino a scarring paha ma hope o nā maʻi o ka lolo
• Nā kīnā hānau e pili ana i ka lolo
• ʻO ka ʻeha o ka lolo ke hana ʻia i ka wā a kokoke paha i ka hānau ʻana
• Nā maʻi Metabolic i kēia manawa i ka wā hānau (e like me phenylketonuria)
• Tumo lolo poʻo liʻiliʻi, pinepine liʻiliʻi loa
• Nā kīʻaha koko maʻamau i ka lolo
• Hahau
• Nā maʻi ʻē aʻe e hōʻino a hōʻino paha i kaʻiʻo o ka lolo

Hoʻomaka ka hoʻomaka ʻana o ka hopu ʻana o ka maʻi epileptic ma waena o 5 a 20 mau makahiki. Akā hiki iā lākou ke hana i kēlā me kēia makahiki. Aia paha he moʻolelo ʻohana o ka hopu ʻana a i ʻole epilepsy.

ʻO ka hopu ʻana i ka febrile he konulion i loko o kahi keiki i hoʻomaka ʻia e ke kuni. ʻO ka hapanui o ka manawa, ʻaʻole ka hemo ʻana o ka febrile i hōʻailona no ka maʻi ʻeha o ke keiki.

Kūlike nā ʻōuli mai ke keiki a ke keiki. Nānā wale paha kekahi mau keiki. E lulu ikaika paha kekahi poʻe a haʻalele i ka makaʻala. Pili paha nā neʻe a i ʻole nā ​​ʻōuli o ke kāʻili ʻana i ka ʻāpana o ka lolo i hoʻopili ʻia.

Hiki i ke kahu mālama ola o kāu keiki ke haʻi hou aku iā ʻoe e pili ana i ke ʻano o ka hopu ʻana i loaʻa i kāu keiki:

• ʻAhi ʻole (petit mal) ka hopu ʻana: Nānā maka
• ʻO ka hopu ʻana i nā tonic-clonic (grand mal) laulaha: Hoʻopili i ke kino holoʻokoʻa, me ke 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 i ka lolo e hoʻomaka ai ka hopu ʻana.

ʻO ka hapa nui o ka manawa, like ka hopu ʻana me ka mea ma mua ona. He ʻano ʻē ko kekahi mau keiki ma mua o ka hopu ʻana. Ke kaniʻuhū nei paha nā ʻona, e honi ana i kahi pilau ʻaʻole i laila, e makaʻu ana a hopohopo paha no ka kumu ʻole a i ʻole ke ʻano déjà vu (e manaʻo ana ua hana kekahi mea ma mua). Kapa ʻia kēia he aura.

E hāʻawi ka mea hoʻolako i:

• E nīnau e pili ana i ka moʻolelo lapaʻau a me ka moʻolelo o kāu ʻohana ma ke kikoʻī
• E nīnau e pili ana i ka māhele hopu
• Hana i kahi hoʻokolohua kino o kāu keiki, me kahi nānā kikoʻī i ka lolo a me ka ʻōnaehana

E kauoha ka mea hāʻawi i kahi EEG (electroencephalogram) e nānā i ka hana uila i ka lolo. Hōʻike pinepine kēia hōʻike i nā hana uila uila ʻole i ka lolo. 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 paha i kāu keiki e:

• E hoʻokomo i kahi mea hoʻopaʻa leo EEG no kekahi mau lā i nā hana o kēlā me kēia lā
• Noho i ka haukapila kahi e hiki ai ke nānā i ka hana lolo ma nā kāmela wikiō (wikiō EEG)

E kauoha paha ka mea hāʻawi i nā hoʻokolohua ʻē aʻe, e like me:

• 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. ʻOi aku ka liʻiliʻi, makemake ʻia ka PET scan o ka lolo e kōkua i ka hoʻolālā ʻana i ke ʻoki.

ʻO ka mālama ʻana no ka maʻi epilepsy:

• Nā Lapaʻau
• Hoʻololi ka nohona
• ʻOki kino

Inā pili ka maʻi epilepsy o kāu keiki i kahi tumo, nā kīʻaha koko ʻole, a i ʻole ke kahe ʻana o ka lolo i ka lolo, pono paha ke ʻoki.

Kapa ʻia nā lāʻau e pale aku ai i ka hopu ʻana i nā lāʻau anticonvulsants a i ʻole nā ​​lāʻau antiepileptic. Hiki paha i kēia mau mea ke hōʻemi i ka helu o ka hopu ʻana i ka wā e hiki mai ana.

• Lawe ʻia kēia mau lāʻau i ka waha. Ke ʻano o ka lāʻau i kuhikuhi ʻia ma muli o ke ʻano o ka hopu ʻana o kāu keiki.
• Pono e hoʻololi i ke ana mai kēlā me kēia manawa. Kauoha paha ka mea hāʻawi i nā hoʻokolohua koko maʻamau e nānā i nā hopena ʻaoʻao.
• E hōʻoia mau i kāu keiki i ka lāʻau i ka manawa a me ke kuhikuhi. ʻO ka nalo ʻana i kahi lāʻau e hiki ai i kāu keiki e hopu i ka maʻi. Mai hōʻoki a hoʻololi paha i nā lāʻau iā ʻoe iho. E kamaʻilio mua me ka mea hāʻawi.

Hiki i nā lāʻau epilepsy ke hoʻopili i ka olakino iwi o kāu keiki. E kamaʻilio me kāu mea hoʻolako e pili ana inā makemake kāu keiki i nā huaora a me nā mea hoʻopili ʻē aʻe.

Epilepsy ka mea ʻaʻole i kāohi maikaʻi ʻia ma hope o ka hoʻāʻo ʻana i kahi helu o nā lāʻau antiseizure i kapa ʻia ʻo "epilepsy refactory medically." 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 pū kekahi. E noʻonoʻo pono e kūkākūkā i kēia mau koho me ka mea hoʻolako i kāu keiki ma mua o ka hoʻāʻo ʻana.

ʻO ka maʻi Epilepsy kahi ola mau a maʻi mau paha. ʻO nā pilikia hoʻokele koʻikoʻi e pili pū me:

• Lawe ʻana i nā lāʻau
• Noho palekana, e like me ka ʻau ʻole ʻana hoʻokahi, hāʻule-hōʻoia ʻana i kou home a pēlā aku
• Ka mālama ʻana i ke koʻikoʻi a me ka hiamoe
• Ka pale ʻana i ka ʻalekohola a me ka hōʻino lāʻau
• Ke hoʻomau nei i ke kula
• Ka mālama ʻana i nā maʻi ʻē aʻe

ʻO ka mālama ʻana i kēia ʻano nohona a i ʻole nā ​​pilikia olakino ma ka home ke lilo i mea paʻakikī. E noʻonoʻo pono e kamaʻilio me kāu mea hāʻawi aku inā loaʻa kāu hopohopo.

ʻO ke koʻikoʻi o ke kiaʻi o kahi keiki 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.

ʻO ka hapa nui o nā keiki me ka maʻi epilepsy e ola i kahi ola maʻamau. 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. Inā ʻaʻole i loaʻa i kāu keiki ka mai lele no kekahi mau makahiki, hiki i ka mea hāʻawi ke hoʻōki i nā lāʻau.

No nā keiki he nui, ke ʻano he epilepsy ke ola holoʻokoʻa. I kēia mau hihia, pono e hoʻomau i nā lāʻau.

Hiki i nā keiki i loaʻa i nā maʻi hoʻomohala ke hoʻohui i ka epilepsy ke kū i nā pilikia i ko lākou ola.

ʻO ka ʻike hou e pili ana i ke kūlana e kōkua iā ʻoe e mālama pono i ka maʻi epilepsy o kāu keiki.

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
• Paʻi kuʻi ʻole
• Ka ʻeha mai ka hāʻule ʻana, nā puʻupuʻu, a nā nahu kumu ponoʻī i ka wā o ka hopu ʻana
• Poino lolo paʻa (stroke a i ʻole nā ​​ʻino ʻē aʻe)
• Nā hopena o nā lāʻau

Kāhea iā 911 a i ʻole ka helu kūloko kūloko inā:

• ʻO kēia ka manawa mua o ka hopu ʻana o kāu keiki
• Kū ka hopu ʻia i loko o kahi keiki ʻaʻohe ona komo i ka kūpeʻe lima ID (ʻo ia ka ʻōlelo kuhikuhi e wehewehe ana i ka mea e hana ai)

Inā loaʻa ka maʻi o kāu keiki ma mua, e kāhea iā 911 a i ʻole ka helu kūloko kūloko no kekahi o kēia mau hanana pilikia.

• ʻOi aku ka lōʻihi o ka hopu ʻana ma mua o ka maʻamau a ke keiki a i ʻole he helu maʻamau ʻole o ka hopu ʻana o ke keiki
• Ua hoʻomau hou ke keiki i ka hopu ʻana ma mua o kekahi mau minuke
• Ua hopu hou ke keiki i ka hopu ʻana i ka ʻike a me ka hana maʻamau i loaʻa ʻole ma waena o lākou (kūlana epilepticus)
• Hōʻeha ke keiki i ka wā o ka hopu ʻana
• Pilikia ke keiki i ka hanu ʻana

Kāhea i ka mea hāʻawi inā loaʻa kāu keiki i nā ʻōuli hou.

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

Kāhea aku i ka mea hoʻolako inā he maʻamau kāu keiki ma hope o ka pau ʻana o ka hopu ʻana.

ʻAʻohe ala i ʻike ʻia e pale aku ai i ka maʻi epilepsy. Hiki i kaʻai kūpono a me ka hiamoe ke hoʻemi i ka manawa o ka hopu ʻana i nā keiki me ka maʻi epilepsy.

E hoʻemi i ka makaʻu o ka hōʻeha poʻo i nā hana makaʻu. 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 - keiki; Hoʻohuli - epilepsy kamaliʻi; Epilepsy ʻōpio kamaliʻi; Anticonvulsant - epilepsy kamaliʻi; Lāʻau antiepileptic - epilepsy kamaliʻi; AED - epilepsy kamaliʻi

Dwivedi R, Ramanujam B, Chandra PS, et al. ʻOki kino no ka lāʻau epilepsy kūpaʻa lāʻau i nā keiki. N Engl J Med. 2017; 377 (17): 1639-1647. PMID: 29069568 pubmed.ncbi.nlm.nih.gov/29069568/.

ʻO Ghatan S, McGoldrick PE, Kokoszka MA, ʻo Wolf SM. ʻOki kino epilepsy Pediatric. I: Winn HR, hoʻoponopono. ʻO Youmans a me Winn Neurological Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 240.

Kanner AM, Ashman E, Gloss D, et al. Hoʻomaʻamaʻa kuhikuhi alakaʻi hōʻuluʻulu manaʻo: ka pono a me ka hoʻomanawanui ʻana i nā lāʻau antiepileptic hou I: ka mālama ʻana i ka epilepsy hou: hōʻike o ka American Epilepsy Society a me ka Development Guide, Dissemination, a me ka Subcommite hoʻokō o ka American Academy of Neurology ʻO Epilepsy Curr. 2018; 18 (4): 260-268. PMID: 30254527 https://pubmed.ncbi.nlm.nih.gov/30254527/.

Mikati MA, Tchapyjnikov D. Ka hopu i ka wā kamaliʻi. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 611.

Momi PL. ʻO ka nānā ākea o ka hopu ʻana a me ka epilepsy i nā keiki. I: Swaiman K, Ashwal S, Ferriero DM, et al, eds. ʻO Swaiman's Pediatric Neurology: Nā Kumuhana a me nā Hana. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2017: chap 61.