I-Paraparesis iwuhlobo oluthambile lokukhubazeka komugqa ophansi oluwufuzo noma olubangelwa igciwane. Ubuhlungu nama-spasms kungaqedwa ngemithi, futhi ukwelashwa ngokomzimba nokuzivocavoca kungagcina ukuhamba kanye namandla emisipha.

Incazelo ye-paraparesis

I-Paraparesis yigama lezokwelapha elisetshenziselwa ukukhombisa ubuthakathaka obuqhubekayo obuhambisana nezinkontileka zemisipha (ubuthakathaka be-spastic) emaphethelweni aphansi. Kuwuhlobo oluthambile lwe-paraplegia (ukukhubazeka kwezitho ezingezansi).

I-Spastic paraparesis yiqembu lezifo ezibangelwa ukuphazamiseka komgogodla.

Izinhlobo ze-paraparesis

I-spastic paraparesis ingaba ngofuzo noma ibangelwa igciwane.

I-hereditary spastic paraparesis

Zihlukaniswe zibe ezingacacile (noma ezihlanzekile) neziyinkimbinkimbi (noma eziyinkimbinkimbi) esimweni lapho izimpawu zakudala ze-spasticity ephansi yemilenze zihambisana nezinye izimpawu ezifana nalezi:

• I-Cerebellar atrophy: ukwehla kwevolumu noma usayizi we-cerebellum
• I-corpus callosum encane (ukuhlangana phakathi kwama-hemispheres amabili obuchopho)
• I-Ataxia: ukuphazamiseka kokuxhumanisa ukunyakaza ngenxa yokulimala kwe-cerebellum

Ngokofuzo, i-spastic paraparesis ingahlukaniswa ngokwendlela yokudlulisela:

• Okuvelele: kwanele ukuthi ukungavamile kuthinta ikhophi eyodwa yofuzo ukuze isifo sithuthuke.
• Ukweqile: I-anomaly kumele ithinte womabili amakhophi ofuzo, ngalinye elizuzwe njengefa komunye wabazali, ukuze lesi sifo sikhule.
• Okuxhunywe ku-X: Amadoda, ane-X chromosome eyodwa kuphela, athola lesi sifo uma ephethe okungavamile ekhophini yawo eyodwa yofuzo.

I-Tropical spastic paraparesis

Ebizwa nangokuthi i-HTLV-1 ehambisana ne-myelopathy, wukuphazamiseka okukhula kancane komgogodla okubangelwa igciwane le-lymphotrophic T eliwuhlobo 1 (HTLV-1).

Izinkinga ze-spastic paraparesis

I-hereditary spastic paraparesis ingaba umphumela wezinhlobo eziningi zokungajwayelekile kwezakhi zofuzo noma ingaba khona ngokwayo. Njengamanje, izinhlobo ezingama-41 ze-hereditary spastic paraparesis zaziwa, kodwa ziyi-17 kuphela okuhlonzwe ngazo isakhi sofuzo esinomthwalo wemfanelo.

I-Tropical spastic paraparesis ibangelwa igciwane le-HTLV-1.

kwesifo

I-Hereditary spastic paraparesis isolwa ngenxa yokuba khona komlando womndeni nanoma yiluphi uphawu lwe-spastic paraparesis.

Ukuxilongwa kuqala kusekelwe ekukhishweni kwezinye izimbangela ezingenzeka:

• I-Adrenoleukodystrophy, isifo se-neurodegenerative esixhunywe ku-X
• multiple sclerosis
• Isifo esibandakanya i-upper motor neuron (i-primary lateral sclerosis noma i-amyotrophic lateral sclerosis)
• Ukutheleleka nge-HIV noma i-HTLV-1
• Ukuntuleka kwevithamini B12, i-vitamin E noma ithusi
• I-Spinocerebellar ataxia, isifo se-neuromuscular esithinta i-cerebellum
• Ukukhubazeka kwe-arteriovenous yomgogodla
• Isimila somnkantsha
• I-Cervicoarthritis myelopathy, ukuncipha komsele womgogodla ocindezela intambo yomlomo wesibeletho

Ukuxilongwa kwe-hereditary spastic paresis ngezinye izikhathi kwenziwa ngokuhlolwa kofuzo.

Abantu abathintekayo

I-Hereditary paraparesis ithinta bobabili ubulili ngokungakhethi futhi ingenzeka kunoma ibuphi ubudala. Ithinta abantu aba-3 kuya kwabayi-10 kwabayi-100.

Izici zengozi

Ingozi yokuthola i-hereditary paraparesis inkulu uma kunomlando womndeni. Endabeni ye-tropical spastic paraparesis, ubungozi bokuthola lesi sifo buhambisana nobungozi bokuchayeka egciwaneni i-HTLV-1, elisakazwa ngocansi, ukusetshenziswa kwezidakamizwa ezingekho emthethweni ngomthambo noma ngokuchayeka egazini. Ingadluliselwa futhi isuka kumama iye enganeni ngokuncelisa ibele.

I-Spasticity yemilenze engezansi

I-Spasticity ichazwa ukwanda kwe-tonic stretch reflex, okusho ukuthi ukufinyela kwemisipha ye-reflex okweqile. Kubangela ithoni yemisipha ephakeme kakhulu engaba imbangela yobuhlungu nama-spasms, futhi ibangele ukungasebenzi kahle kwezitho.

Ukushoda kwezimoto

Abantu abane-paraparesis bavame ukuba nobunzima bokuhamba. Ziyakwazi ukukhubeka ngoba zivame ukuhamba ngezinzwane, izinyawo zibheke ngaphakathi. Izicathulo zivame ukulimala kuzwane omkhulu. Abantu bavame ukuba nobunzima bokwehla ezitebhisini noma emithambekeni, bangene esihlalweni noma emotweni, bagqoke, bazilungise.

I-Asthenia

I-Asthenia ukukhathala okungavamile lapho iphikelela ngisho nangemva kokuphumula. Kubangela umuzwa wokungakwazi ukwenza imisebenzi yansuku zonke.

Iziyaluyalu ze-proprioceptive

Ukulahlekelwa umuzwa wokuma kwezinyawo nezinzwani

Ezinye izimpawu

Ngamafomu alula, singabona futhi:

• Ukuphazamiseka okuncane kokuzwela kokudlidliza
• Izimpawu zokuchama (incontinence)
• Izinyawo ezingenalutho

Ngamafomu ayinkimbinkimbi,

• I-Ataxia, ukuphazamiseka kokuxhumanisa ukunyakaza kwemvelaphi yezinzwa
• I-Amyotrophie
• I-Optic atrophy
• I-retinopathy pigmentosa
• Ukukhubazeka kwengqondo
• Izimpawu ze-Extrapyramidal
• I-Dementia
• Ukuzizwa
• I-neipathy neuropathy
• Isithuthwane

Ukwelashwa kunezimpawu, kuhlanganise nokwelapha ukukhulula i-spasticity.

• Ukwelashwa kwezidakamizwa ezihlelekile: i-baclofen, i-dantrolene, i-clonazepam, i-diazepam, i-tizanidine, i-benzodiazepines
• Ukwelashwa kwendawo: i-anesthetic block, ubuthi be-botulinum (i-intromuscular ehlosiwe), utshwala, ukuhlinzwa (i-neurotomy ekhethiwe)

Ukwelashwa ngokomzimba nokuzivocavoca kungasiza ukugcina ukuhamba namandla emisipha, ukuthuthukisa ukunyakaza nokukhuthazela, ukunciphisa ukukhathala, nokuvimbela ama-spasms.

Ezinye iziguli ziyahlomula ngokusebenzisa izintambo, induku noma izinduku.

Nge-tropical spastic paraparesias, izindlela zokwelapha ezimbalwa zingaba usizo ukulwa negciwane:

• I-Interferon alpha
• I-Immunoglobulin (ngokungena emthanjeni)
• I-Corticosteroids (njenge-oral methylprednisolone)

Ukuze ugweme ukuthola i-tropical spastic paraparesis, ukuthintana negciwane le-HTLV-1 kufanele kuncishiswe. Idluliselwa ngu:

• Ukuthintana ngokocansi
• Ukusebenzisa izidakamizwa ezingekho emthethweni ngomjovo
• Ukuchayeka egazini

Ingadluliselwa isuka kumama iye enganeni ngokuncelisa. Kuvame kakhulu phakathi kwezifebe, abasebenzisi bezidakamizwa abajovayo, abantu abasebenzisa i-hemodialysis kanye nenani labantu ezindaweni ezithile ezihlanganisa nenkabazwe, eningizimu ye-Japan naseNingizimu Melika.