I-Little's syndrome ifana ne-infantile spastic diplegia.

I-Infantile spastic diplegia yiyona cerebral palsy eyaziwa kakhulu. Ibonakala ngokuqina kwemisipha esihlokweni esithintekile, ikakhulukazi emilenzeni futhi kancane kancane ezingalweni nasebusweni. I-hyperactivity emathanjeni emilenze ibonakala futhi kule pathology.

Lokhu kuqina kwemisipha emilenzeni yomuntu othintekile kubangela ukungafani kokunyakaza kwemilenze nezingalo.

Ezinganeni ezine-Little's syndrome, ulimi nobuhlakani ngokuvamile kuyinto evamile. (1)

Le cerebral diplegia ngokuvamile iqala ezinsaneni noma ezinganeni ezincane.

Abantu abanalesi simo banokwanda kwethoni yemisipha eholela emisipha ye-muscle. Lesi senzakalo ithoni yemisipha ephakeme futhi ehlala njalo yemisipha ekuphumuleni. Ukukhalipha okuyihaba ngokuvamile kuwumphumela. Lokhu kuqina kwemisipha kuthinta ikakhulukazi imisipha yemilenze. Imisipha yezingalo, ngakolunye uhlangothi, ayithinteki kangako noma ayithinteki.

Ezinye izimpawu zingaba semqoka kulesi sifo. Lokhu kunjalo, isibonelo, ukuhamba ngezinzwane noma ukuhamba okungahambisani.

Lokhu kungahambi kahle kwethoni yemisipha kuwumphumela wokuphazamiseka kwama-neurons obuchopho noma ukukhula kwawo okungavamile.

Kuncane okwaziwayo ngembangela yalesi sifo semizwa. Noma kunjalo, abanye abacwaningi baye bacabanga ukuthi kunobuhlobo nokuguqulwa kwezakhi zofuzo, ukukhubazeka kokuzalwa kobuchopho, izifo noma imfiva kumama ngesikhathi ekhulelwe noma ngisho nezingozi phakathi nokubeletha noma ngokushesha ngemva kokuzalwa. ukuzalwa. (3)

Kuze kube manje, azikho izindlela zokwelapha lesi sifo. Ngaphezu kwalokho, ezinye izidakamizwa zikhona kuye ngezimpawu, izimpawu kanye nobukhulu besifo. (3)

Izinhlobo ezahlukahlukene zobukhulu besifo zikhona.

Izimpawu zesifo sikaLittle's zihlukile kwesinye isiguli kwesinye.

Emongweni we-cerebral palsy ngenxa yokungajwayelekile kwemizwa, izimpawu zivela ekuqaleni kwengane. Izimpawu zomtholampilo ezihambisana nazo wukuphazamiseka kwemisipha (ikakhulukazi emilenzeni) okuphazamisa ukulawulwa kwemisipha nokuxhumana.

Ingane ehlushwa yi-pathology iveza ithoni yemisipha ephakeme kunezimo ezivamile neziyihaba (umphumela wokuthuthukiswa kwe-spasticity).

Ezinye izimpawu zingase zibe izimpawu zokuthuthukiswa kwe-diplegia ye-spastic yezingane. Izimpawu ezithile ezibonisa ukubambezeleka kwamakhono emoto engane, ukuhamba kubekwe ezinzwaneni, ukuhamba ngokungalingani, njll.

Ezimweni ezingavamile, lezi zimpawu ziyashintsha phakathi nokuphila komuntu. Nokho, ngokuvamile lezi aziguquki ngendlela engalungile. (3)

Ngaphezu kwalezi zimpawu zamakhono emoto, okunye okungajwayelekile kungase kuhlobane nesifo kwezinye izimo: (3)

- ukukhubazeka kwengqondo;

- ubunzima bokufunda;

- ukudlikizela;

- ukukhula okukhubazekile;

- okungavamile emgogodleni;

- i-osteoarthritis (noma i-arthritis);

- ukungaboni kahle;

- ukulahlekelwa ukuzwa;

- ubunzima bolimi;

- ukulahlekelwa ukulawula umchamo;

- ukuqina kwemisipha.

I-Infantile spastic diplegia (noma i-Little's syndrome) i-cerebral palsy ebangelwa ukukhula okungavamile kwengxenye yobuchopho elawula amakhono okunyakaza.

 Lokhu kukhubazeka ekukhuleni kobuchopho kungabangelwa ngaphambi, phakathi, noma ngokushesha ngemva kokuzalwa.

Ezimweni eziningi, imbangela yangempela yokuthuthukiswa kwe-pathology ayikaziwa.

Nokho, kucatshangwa ukuthi kuye kwenziwa, njengalokhu: (1)

- ukungahambi kahle kwezakhi zofuzo;

- ukukhubazeka kokuzalwa ebuchosheni;

- ukuba khona kwezifo noma imfiva kumama;

- ukulimala kwe-fetus;

- njll.

Kuqhakambiswe neminye imvelaphi yalesi sifo: (1)

– ukopha nge-intracranial okungase kuphazamise ukuhamba kwegazi okuvamile ebuchosheni noma kubangele ukuphuka kwemithambo yegazi. Lokhu kopha kuvame ukubangelwa ukushaqeka kwe-fetus noma ukwakheka kwehlule legazi ku-placenta. Umfutho wegazi ophakeme noma ukukhula kwezifo kumama ngesikhathi sokukhulelwa nakho kungaba yimbangela;

- ukuncipha komoyampilo ebuchosheni, okuholela ku-cerebral asphyxia. Lesi simo ngokuvamile sivela ngemva kokubeletha okucindezela kakhulu. Ukunikezwa kwe-oksijini okuphazanyisiwe noma okuncishisiwe ngakho-ke kuholela ekulimaleni okukhulu enganeni: iyi-encephalopathy (EHI) engekho emthethweni. Lesi sakamuva sichazwa ngokucekelwa phansi kwezicubu zobuchopho. Ngokungafani nesimo sangaphambilini, i-hypoxic ischemic encephalopathy ingaba ngumphumela we-hypotension kunina. Ukuqhekeka kwesibeletho, ukuhlukana kwe-placenta, izinkinga ezithinta inkaba noma ukuhlukumezeka kwekhanda ngesikhathi sokubeletha nakho kungaba yimbangela;

- ukungavamile engxenyeni emhlophe ye-cerebral cortex (ingxenye yobuchopho enesibopho sokudlulisa izimpawu ezivela ebuchosheni kuya kuwo wonke umzimba) futhi kuyimbangela eyengeziwe yokuthuthukiswa kwesifo;

- ukukhula okungavamile kobuchopho, umphumela wokuphazamiseka enqubweni evamile yokukhula kwawo. Lesi simo sixhunyaniswe nokuguqulwa kwezakhi zofuzo ezifaka ukwakheka kwe-cerebral cortex. Ukutheleleka, ukuba khona kwemfiva ephindaphindiwe, ukuhlukumezeka noma indlela yokuphila engalungile ngesikhathi sokukhulelwa kungaba ingozi eyengeziwe yokuthuthukiswa kobuchopho okungavamile.

Izinto eziyingozi eziyinhloko zokuthuthukisa i-Little's syndrome yilezi: (1)

- ukungahambi kahle emazingeni ezakhi zofuzo ezithile okuthiwa zidala;

- ukukhubazeka kokuzalwa ebuchosheni;

- ukuthuthukiswa kwezifo kanye nemfiva ephezulu kumama;

- izilonda ze-intracranial;

- ukwehla kwe-oxygen ebuchosheni;

- ukuthuthuka kokuthuthuka kwe-cortex yobuchopho.

Izimo zezokwelapha ezengeziwe zingase zibe isihloko sengozi eyengeziwe yokuthuthukisa i-cerebral palsy ezinganeni: (3)

- ukuzalwa ngaphambi kwesikhathi;

- isisindo esincane ngesikhathi sokuzalwa;

- izifo noma ukushisa okukhulu ngesikhathi sokukhulelwa;

- ukukhulelwa okuningi (amawele, amawele amathathu, njll.);

- ukungalingani kwegazi phakathi kukamama nengane;

- okungavamile ku-thyroid, ukukhubazeka kwengqondo, amaprotheni amaningi emchameni noma ukudlikizeka kumama;

- ukuzalwa kwebele;

- izinkinga ngesikhathi sokubeletha;

- inkomba ephansi ye-Apgar (inkomba yesimo sezempilo sengane kusukela ekuzalweni);

- i-jaundice yosana olusanda kuzalwa.

Ukuxilongwa kwe-diplegia ye-spastic yezingane kufanele kwenziwe ngokushesha ngemva kokuzalwa kwengane ukuze kube nenhlalakahle yengane nomndeni wayo. (4)

Ukubhekwa kwezifo eduze kakhulu kufanele kwenziwe. Lokhu kusho ukuthuthukisa ukuqapha kwengane ngesikhathi sokukhula nokukhula kwayo. Uma lokhu kulandelela kwengane kuvela ukuthi kunemiphumela ekhathazayo, ukuhlolwa kokuhlolwa kokukhula kungenzeka.

Lokhu kuhlolwa okuphathelene nokukhula kwengane kubangela izivivinyo zokuhlola ukubambezeleka okungaba khona ekukhuleni kwengane, njengokulibaziseka kwamakhono emisipha noma ukunyakaza.

Uma kwenzeka ukuthi imiphumela yalesi sigaba sesibili sokuxilongwa itholakale ibalulekile, udokotela angakwazi ukuqhubeka nokuxilongwa ekuhloleni okuthuthukisiwe kwezokwelapha.

Inhloso yesigaba sokukhula sokuxilongwa kwezokwelapha ukugqamisa ukungahleleki okuthile ekukhuleni kwengane.

Lokhu kuxilongwa kwezempilo kuhlanganisa nokuhlola okuthile kokubona okungavamile okuqondene nalesi sifo, yilezi: (3)

- ukuhlaziywa kwegazi;

- isithwebuli se-cranial;

- MRI yekhanda;

- i-electrencephalogram (i-EEG);

- electromyography.

Mayelana nokwelashwa, okwamanje alikho ikhambi lalesi sifo.

Nokho, ukwelashwa kungathuthukisa izimo zokuphila zeziguli. Lezi zindlela zokwelapha kufanele zinqunywe ngokushesha ngangokunokwenzeka ngemva kokutholakala kwesifo.

Izindlela zokwelapha ezivame kakhulu izidakamizwa, ukuhlinzwa, ukuxhumanisa, nokwelapha ngokomzimba (physiotherapy) kanye nokwelapha ngolimi (ukwelapha ngenkulumo).

Izinsiza zesikole zinganikezwa futhi kubantu abanalesi sifo.

Ukubikezelwa okubalulekile kweziguli ezinalesi sifo kuyehluka kakhulu kuye ngezimpawu nezimpawu ezikhona kumuntu.

Ngempela, ezinye izifundo zithinteka ngendlela elinganiselayo (akukho mkhawulo ekuhambeni kwazo, ukuzimela, njll.) kanti ezinye kakhulu (ukungakwazi ukwenza ukunyakaza okuthile ngaphandle kosizo, njll.) (3).