Ubufakazi boshintsho odabeni olumhlophe oluzungeze ama-neurons, i-leukoencephalopathy eqhubekayo ye-multifocal yisifo sezinzwa esithinta ngasikhathi sinye izifunda eziningana zobuchopho futhi siqhubeke kancane kancane. Izimbangela zayo ziningi. 

Ama-Neurons (amangqamuzana emizwa ebuchosheni) enwetswa yimicu yezinzwa, ebizwa ngama-axon, ezoxhumana nabanye ebuchosheni ngama-synapses (emaphethelweni e-axon). Le micu yezinzwa izungezwe i-sheath (myelin) eyihlukanisa komunye nomunye futhi iyingxenye yendaba emhlophe yobuchopho.

I-progressive multifocal leukoencephalopathy (PML) ifakaza ngoshintsho ezindaweni eziningana zobuchopho balo mgodla ozungeze ama-axon, okubangela ukujikeleza okufushane phakathi kwawo. Lezi zifunda ezimfushane zisemsuka wokungasebenzi kahle kobuchopho maqondana nokuhlanganisa imisipha, umsebenzi wobuchopho (umcabango noma ukuqonda) kanye nemicu yezinzwa yokuzwela. Ngakho-ke kwenzeka ukukhubazeka, ukuphazamiseka komcabango nokuzwela.

Lesi sifo sezinzwa esiwohlokayo sivame ukuqhubekela phambili, siguqukela ku-spurts noma kancane kakhulu futhi kanyekanye sithinte amasayithi amaningana obuchopho (i-multifocal). Izimbangela zayo ziningi futhi izimpawu zayo zincike kumasayithi athintekile.

Izimbangela ze-progressive multifocal leukoencephalopathy (PML) ziningi futhi ziyahlukahluka ngokwemvelo:

Ufuzo noma ufuzo

Kwesinye isikhathi kuqala kusenesikhathi njengakwamanye ama-syndromes noma izifo ezifana nesifo sikaCadasil esixhunyaniswe nokuguquka kwezakhi zofuzo, i-Childhood Ataxia syndrome lapho kuvela khona izimbotshana ezindabeni ezimhlophe zobuchopho ngokubhujiswa kwe-myelin, multiple sclerosis (MS) eyenzeka ku ifa futhi kwesinye isikhathi kubanga izimbotshana (ifomu le-MS), noma izifo eziwohlokayo ebuchosheni ezinjenge-X syndrome ethambile noma isifo se-mitochondrial.

Umsuka we-Vascular

Kuwukuwohloka komqondo kwemithambo okubangelwa ukulimala emithanjeni emincane yobuchopho (i-microangiopathy), ehlobene nobudala, umfutho wegazi ophakeme nongalingani noma isifo sikashukela.

Imvelaphi enobuthi 

Ngokuthatha izidakamizwa ezithile ezifana ne-methotrexate esetshenziswa ekwelapheni umdlavuza othile noma izifo ezizimele (isifo samathambo noma i-RA, njll.), ubuthi be-nitric oxide (ukushisa ngegesi engasebenzi) noma ukuhogela umhwamuko we-heroin (ukusebenzisa umlutha). Ukwelashwa ngemisebe nakho kungashintsha indaba emhlophe ebuchosheni.

Yemvelaphi ewohlokayo

Kuxhunyaniswe nezinqubo zokuvuvukala ezithinta isimiso sezinzwa ezifana ne-MS, i-leucoaraiosis, noma i-Alzheimer's, ngezinye izikhathi imvelaphi yofuzo kodwa hhayi ngaso sonke isikhathi, nesifo sokugcina sokuqoqwa kwamadiphozithi azophazamisa ukudluliswa kwe-neuronal (i-amyloid deposits kanye ne-neurofibrillary degeneration ehambisana nesifo sofuzo). ukutholakala kwamaprotheni ebuchosheni, i-beta-amyloid peptide kanye ne-tau protein).

Umsuka othathelwanayo

Akuvamile ezifweni ezibangelwa amagciwane ezifana ne-papillomavirus (JC virus) noma i-AIDS (2 kuya ku-4% wabantu be-HIV +).

Izimpawu ze-leukoencephalopathy eqhubekayo ye-multifocal leukoencephalopathy (PML) ziyahlukahluka ngokuya ngezindawo ezithintekile nembangela yale nqubo yokuwohloka ebuchosheni:

• ukuzizwa ubuthakathaka, kunzima ukukhuluma noma ukucabanga ekuqaleni kwesifo;
• ukuthuthumela ngamabomu (i-cerebellar syndrome) nokuphazamiseka kokuhambahamba ku-X syndrome entekenteke noma isifo se-mitochondrial, ukuphazamiseka kokuxhumana ngokuzithandela, izimpawu ezivezwa ekuqaleni kwalezi zifo zofuzo noma zofuzo futhi ziqhubeka kancane kancane futhi ngokungenakugwenywa ...;
• ukuphazamiseka kwengqondo ngesikhathi sokuwohloka kwemvelaphi ye-vascular, evame ukwenzeka kamuva kubantu asebekhulile abanezinkinga zemizwelo, ukuphazamiseka kwengqondo (i-temporo-spatial disorientation, ukuphazamiseka kwenkumbulo), ngezinye izikhathi ukukhohlisa nokudideka;
• ukuzwela okukhubazekile kanye namakhono emoto ekuwohlokeni kwemvelaphi enobuthi;
• ukwehla komqondo ekuwohlokeni kobuchopho njengesifo i-Alzheimer's ngenkumbulo ekhubazekile, ukuma, ukunaka, ukuxazulula izinkinga, ukuhlela nokuhlela, ukucabanga;
• ingozi yengozi ye-cerebrovascular (stroke) iyanda ku-leukoencephalopathy ye-multifocal eqhubekayo;
• migraines kanye nesithuthwane.

Izimpawu zomtholampilo sezivele zisikisela ngalesi sifo, kodwa kuzoba ukucabanga kobuchopho okufana neMagnetic Resonance Imaging (MRI) okuzokwenza kube nokwenzeka ukuthola izilonda ezisikisela indaba emhlophe yobuchopho.

Ukutholakala kwegciwane le-JC ngokubhoboza i-lumbar ngezinye izikhathi kuboniswa uma kwenzeka ukusola kwe-leukoencephalopathy ye-multifocal eqhubekayo yemvelaphi yegciwane.

Ukuxilongwa kwengculazi kuvame ukwenziwa futhi uma kungenjalo, kufanele kucwaningwe.

Ukwelashwa kwe-leukoencephalopathy eqhubekayo ye-multifocal yilesi sizathu:

• sesha izimbangela ezinobuthi (izidakamizwa, i-heroin, njll.) futhi uziqede; 
• ukuqinisekiswa kokuxilongwa kwe-cerebral degeneration ye-Alzheimer's disease, i-MS, i-leukoaraiosis, ukuwohloka komqondo wemvelaphi ye-vascular.

Izilonda zodaba olumhlophe zizohlala zingenakuhlehliswa futhi ukwesekwa kwengqondo nokuvuselela ingqondo kuzobambezela ukuqhubeka kwalesi sifo ngezinye izikhathi esishintsha eminyakeni embalwa.