Lokacin da Ka Dakatar Da Rushewa Amma MS MS Worsens
An kiyasta kimanin kashi 85 cikin dari na mutanen da ke dauke da kwayar cutar (MS) da farko da aka gano tare da MSP (RRMS). Yawancin mutanen nan zasu cigaba da bunkasa MS (SPMS) na biyu, wanda ke nuna yawan ci gaban bayyanar cututtuka da nakasa da ƙananan ko a'a.
Kafin maganin cututtukan cututtuka ya zama yadu, kimanin kashi 90 cikin dari na mutanen RRMS sun bunkasa SPMS a cikin shekaru 25 da kusan rabin cikin shekaru 10.
Yanzu ba a san abin da ke faruwa ba wajen maganin cututtuka na cutar da ci gaba na MS, amma an ɗauka (kuma yana fatan) cewa wannan raƙuman ba shi da ƙananan, kuma SPMS yana da hankali don bunkasa.
Wanene Yafi Ƙarƙashin Gyara Daga RRMS To SPMS?
Mutane za su iya canzawa daga samun RRMS zuwa SPMS a kowane lokaci, kuma tsari yana karuwa sosai. A gaskiya, sau da yawa wani wuri mai launin toka tsakanin RRMS da SPMS-lokacin da mutum ke motsawa zuwa MS na cigaba amma har yanzu yana dawowa MS. Kullum magana, duk da haka, wannan canji ya faru a cikin shekaru 5 zuwa 20 bayan an fara cutar.
Dangane da dalilai waɗanda zasu iya rinjayar da sauyi daga sake dawo da MS zuwa na gaba na MS, nazarin (a cikin marasa lafiya marasa lafiya marasa lafiya) ya nuna cewa maza suna nuna cewa SPPS za ta cigaba da sauri kuma a cikin matashi fiye da mata. Bugu da ƙari, waɗanda suke da alamun motsa jiki a farkon MS, kamar wahalar tafiya, inganta SPMS sauri.
Alamar da RRMS ta zama ko ake zama SPMS
Yana da muhimmanci a fahimci cewa babu wata cikakkiyar jagora ko ka'idojin da ke bayyana lokacin da mutum ya motsa daga RRMS zuwa SPMS. A ƙasa, duk da haka, wasu alamu ne ko alamu da cewa mutum da MS da likitanta zasu iya amfani da lokacin da aka gane ko wannan canji ya kasance ko ya faru.
Magunguna ku ba suyi aiki ba: Duk da kokarinku da haɗin kai , wasu mutane tare da RRMS akan maganin cututtukan cututtuka na yau da kullum sun fara nuna rashin karuwar rashin lafiya ba tare da karuwa mai yawa a yawan adadin da ake yi a kan MRI ba. Wannan yana iya zama alamar cewa suna motsawa cikin lokaci na gaba na MS ko SPMS.
A gefe guda kuma, magani naka da ba aiki ba yana iya zama saboda wani dalili. Alal misali, idan neutralizing kwayoyin cutar zuwa daya daga cikin kwayoyin da ake amfani da interferon suna zuwa, likitan ku na iya canza ku zuwa wani.
A madadin, wasu mutane sun damu cewa suna shiga cikin matakan na MS saboda sun dakatar da komawa baya. Amma wannan zai iya zama abu mai kyau, kamar yadda zai iya nufin magungunan cutarka yana aiki.
Saukewa suna canzawa: Tarihin halitta na RRMS shine a sami adadin sake koma baya a cikin lokaci. Duk da haka, sakewa da ke faruwa zai iya zama mai tsanani, yana kawo alamun alamun, maimakon kawai ya shafi wani yanki na aiki. Bugu da ƙari, sake dawowa daga sake dawowa ba zata cika ba, ma'anar cewa ko bayan bayan lokaci mai tsawo na sake komawa, wasu alamun bayyanar da / ko rashin lafiya sun kasance. Bugu da ƙari, mutumin bai sake amsawa (ko a kowane lokaci) zuwa Solu-Medrol ba a lokacin da aka sake komawa.
Ƙari mafi girma na nakasa: Lokacin da aka auna ta Ƙarƙashin Ƙarƙashin Ƙaƙƙwarar (EDSS), mutane da RRMS suna da kashi hudu ko žasa. Mutanen da SPMS, a gefe guda, yawanci suna da kashi shida ko mahimmanci ma'ana cewa ana bukatar wasu nau'i na taimako don tafiya. Mutane tare da RRMS waɗanda suka isa matakin 4 zuwa 5.5 (wanda aka nuna ta rashin iya tafiya fiye da mita 500 ba tare da hutawa) yakan bunkasa SPMS a cikin lokaci kaɗan ba.
Za a sami karin abubuwan rashin hauka a lokacin jarrabawar neuro. Wannan yana nuna cewa ƙwaƙwalwar ba zata iya ramawa ba saboda ƙaddamarwa daga MS.
A ƙarshe, mutanen da suke ci gaba da SPMS sun nuna nuna damuwa da yawa. Wannan shi ne mafi kusantar saboda matsananciyar atrophy a cikin kwakwalwa, wadda aka haɓaka sosai ga rashin tausayi . Abinda wannan ke nufi shi ne cewa kwakwalwa ba zai iya ramawa ba saboda lalacewa, musamman ma inda akwai cikakkiyar lalacewa (cututtukan filaye), wanda ya haifar da ramukan baki.
Babban adadin lalacewar da aka gani akan MRI:
- Ƙananan zubar da jini: Wannan yana nufin cewa akwai mafi yawan jinsunan, wanda ya kasance:
- A kusa da ventricles (cavities a kwakwalwa da ke cike da ruwan sanyi)
- Kashewa
- Rashin hankali a cikin kwakwalwar kwakwalwa da kashin baya
- Ƙarin lalacewar gatari da kuma "ramukan bakar baki": Yankunan da suke nunawa kamar duhu (hypointense) aibobi a kan T1 scan ana kiransa "ramukan baki". Wadannan yankunan da aka ci gaba da ƙonewa, wanda ke haifar da lalacewar duka myelin da Sannan yankunan sun dace da rashin lafiya.
- Ƙara ƙaddamar da ventricles cike da CSF a cikin kwakwalwa: Wannan ma'auni ne na atrophy , saboda akwai ƙananan kwakwalwa, don haka wurare a ciki da cikin kwakwalwa sun fi girma.
- Raguwar ciwon gadolinium-enhancing raunuka: Daidai ne, yawan sababbin raunin gadolinium na cigaba da raguwa a cikin matakai na RRMS. Wannan shi ne saboda cutar ta fi dacewa ta zama mafi girma fiye da na jini.
Kalma Daga
Duk da yake lafiyar cutar ka iya taimakawa jinkiri daga saukewar MS zuwa MS na gaba, wannan tsari zai iya faruwa a wasu. Saboda haka, kada ka sanya kanka a kuskure idan ka koma daga lokacin sada zumunta na MS zuwa lokaci na cigaba - wannan tsari ne, na musamman ga kowane mutum, kuma ba saboda wani abu da ka yi ba.
Sources
Coyle, Patricia K. da Halper, Yuni. Rayuwa tare da Ci-gaba mai Girma Sclerosis: Cin nasara da Kalubale (2nd Ed.) New York: Ƙwararrun Magunguna na Demos. 2008.
Koch M, Kingwell E, Rieckmann P, Tremlett H, UBC MS Clinic Neurologists. Tarihin halitta na cigaba da yawa na sclerosis. Journal of Neurology, Neurosurgery, & Psychiatry, 2010; 81 (9): 1039-43.
Lublin FD et al. Ƙayyade tsarin gwaji na ƙwayar sclerosis. Ma'anar ilimin halitta. 2014 Jul 15; 83 (3): 278-86.
MS Society na kasa. Secondary Progressive MS.
Tremlett H, Yinshan Zhao, Devonshire V. Tarihin halitta na cigaba mai zurfi na sclerosis. Multiple Sclerosis , 2008; 14 (3): 314-24.