Epilepsy rau menyuam yaus

Epilepsy yog lub hlwb tsis zoo uas tus neeg tau ua rau qaug dab peg ntau dhau sijhawm.

Qhov qaug dab peg yog qhov kev hloov ntawm hluav taws xob thiab tshuaj lom neeg hauv lub hlwb. Qhov chua leeg ib zaug uas tsis tshwm sim dua yog TSIS tau qaug dab peg.

Epilepsy tuaj yeem yog vim muaj mob lossis raug mob uas cuam tshuam rau lub hlwb. Los yog vim li cas tej zaum yuav tsis paub.

Feem ntau cov mob vwm vwm muaj xws li:

• Mob puas hlwb
• Puas tsuaj lossis caws pliav tom qab kis kab mob ntawm lub hlwb
• Cov teeb meem thaum yug los uas cuam tshuam nrog lub hlwb
• Lub hlwb raug mob uas tshwm sim thaum lub sijhawm lossis ze rau kev yug menyuam
• Kev ntshaib plab cov kab mob tam sim no thaum yug los (xws li phenylketonuria)
• Benign mob qog, feem ntau me me
• Cov hlab ntsha tsis zoo hauv lub hlwb
• Mob stroke
• Lwm yam mob uas ua mob lossis ua kom mob hlwb

Epileptic qaug dab peg feem ntau pib ntawm hnub nyoog 5 thiab 20. Tab sis lawv tuaj yeem tshwm sim thaum muaj hnub nyoog li cas. Tej zaum yuav muaj tsev neeg muaj keeb kwm ntawm qaug dab peg los yog mob vwm.

Txoj kev chua plaub hau mos yog yam ua paug ntawm tus me nyuam los ntawm ua npaws. Yuav luag txhua lub sijhawm, mob plaub hau mos mos tsis yog qhov qhia tias tus menyuam muaj mob vwm.

Cov tsos mob mas nws txawv ntawm ib tus me nyuam mus rau lwm tus. Qee tus menyuam yuav ntsia ntsoov. Lwm tus yuav tshee hnyo thiab ua rau tsis tsaug zog. Cov kev txav lossis cov tsos mob ntawm qaug dab peg tuaj yeem nyob ntawm ib feem ntawm lub hlwb uas cuam tshuam.

Koj tus menyuam tus kws saib xyuas kev noj qab haus huv tuaj yeem qhia koj ntxiv txog hom kev qaug dab peg uas koj tus menyuam muaj:

• Qhaj Tsis Tuaj (foob me me) qaug dab peg: Cov hnoos qeev zoo
• Generalized tonic-clonic (pog mal) qaug dab peg: Ua rau tag nrho lub cev, suav nrog aura, cov leeg nruj, thiab tsis nco qab
• Ib nrab (focal) qaug dab peg: Yuav koom nrog ib qho ntawm cov tsos mob tau piav qhia saum toj no, nyob ntawm seb qhov twg ntawm lub hlwb chua leeg

Feem ntau, qhov qaug dab peg yog zoo li ib qho ua ntej nws. Qee tus menyuam yaus muaj qhov txawv txav ua ntej qaug dab peg. Cov kev hnov ​​yuav yog tingling, hnov ​​ntxhiab tsw tsw uas tsis muaj nyob rau hauv, muaj kev ntshai lossis ntxhov siab yam tsis muaj qab hau lossis muaj kev hnov ​​déjà vu (hnov tias muaj qee yam ua dhau los). Qhov no yog hu ua aura.

Tus kws khomob yuav:

• Nug koj tus menyuam li keeb kwm kev khomob thiab tsev neeg keeb kwm
• Nug txog ntu qaug dab peg
• Ua kev soj ntsuam lub cev ntawm koj tus menyuam, suav nrog kev saib lub hlwb thiab lub paj hlwb

Tus kws kho mob yuav xaj EEG (electroencephalogram) los kuaj xyuas qhov hluav taws xob hauv lub hlwb. Qhov kev ntsuam xyuas no feem ntau qhia cov hluav taws xob tsis zoo hauv lub hlwb. Hauv qee kis, kev xeem ntawv qhia thaj chaw hauv lub hlwb uas pib chua leeg. Lub hlwb yuav tshwm sim zoo tom qab qaug dab peg lossis nruab nrab ntawm qaug dab peg.

Txhawm rau kuaj mob epilepsy los yog npaj rau kev phais mob vwm, koj tus menyuam yuav tsum:

• Hnav EEG lub kaw cia rau ob peb hnub thaum nruab hnub
• Nyob hauv tsev kho mob qhov chaw ua si lub hlwb tuaj yeem saib xyuas lub koob thaij duab (video EEG)

Tus kws kho mob tseem yuav hais tau lwm cov kev ntsuam xyuas, suav nrog:

• Qhia txog ntshav ntshav
• Ntshav qab zib
• Ua kom tiav cov ntshav suav (CBC)
• Kuaj lub raum kev ua haujlwm
• Kev kuaj mob siab ua haujlwm
• Xaus caj pas (txha caj qaum)
• Kev kuaj mob kis kab mob

Lub taub hau CT lossis MRI scan feem ntau ua kom pom qhov laj thawj thiab thaj chaw teeb meem hauv lub hlwb. Ntau tsawg dua, PET scan ntawm lub hlwb xav tau los pab npaj phais mob.

Kev kho mob rau mob vwm

• Cov tshuaj kho mob
• Txoj kev ua neej hloov
• Kev phais mob

Yog tias koj tus menyuam mob vwm vim yog lub qog, ntshav hlab ntsha tsis zoo, lossis ntshav tawm hauv lub hlwb, yuav tsum muaj kev phais mob.

Cov tshuaj noj kom tiv thaiv qhov qaug dab peg yog hu ua cov tshuaj anticonvulsants los yog cov tshuaj tiv thaiv kabmob. Cov no tuaj yeem txo cov qaug dab peg ntawm yav tom ntej.

• Cov tshuaj no yog noj ntawm qhov ncauj. Hom tshuaj uas tau teem tseg nyob rau ntawm koj tus menyuam muaj qaug dab peg.
• Qhov ntau npaum no yuav tsum tau hloov los ntawm lub sijhawm. Tus kws kho mob yuav yuam kom kuaj ntshav tas li kom ntsuas seb puas muaj tshwm sim.
• Koj yuav tsum paub meej tias koj tus menyuam noj tshuaj kom raws sij hawm thiab raws li qhia. Plawv koob lawm yuav ua rau koj tus menyuam muaj mob nriaj tes nriaj taw. Tsis txhob tso tseg lossis hloov cov tshuaj ntawm koj tus kheej. Tham nrog tus kws kho mob ua ntej.

Ntau yam tshuaj vwm phaum mob yuav ua rau koj tus menyuam lub pob txha tsis zoo. Nrog koj tus menyuam tus kws khomob tham seb koj tus menyuam puas xav tau cov tshuaj vitamins thiab lwmyam tshuaj ntxiv.

Epilepsy uas tsis tuaj yeem tswj tau tau zoo tom qab sim siv ntau cov tshuaj tua kab mob hu ua "kev kho mob puas ntsoog tas li." Hauv qhov no, tus kws kho mob yuav pom zoo kom phais rau:

• Tshem tawm cov hlwb tsis txaus ua rau ua rau chua leeg.
• Tso rau qhov paum ntawm qhov chaw mos (VNS). Cov cuab yeej no zoo ib yam li lub plawv dhia ceev. Nws tuaj yeem pab txo qis ntawm qaug dab peg.

Qee cov menyuam yaus tau muab cov zaub mov tshwj xeeb los pab tiv thaiv ua rau chua leeg. Qhov nrov tshaj plaws yog ketogenic. Kev noj haus uas tsis muaj cov carbohydrates ntau, xws li cov zaub mov Atkins, kuj tseem yuav pab tau thiab. Nco ntsoov sib tham txog cov kev xaiv no nrog koj tus menyuam tus muab kev pab ua ntej sim lawv.

Epilepsy feem ntau yog tas sim neej lossis mob ntsws ntev. Cov teeb meem kev tswj tseem ceeb muaj xws li:

• Noj tshuaj
• Nyob hauv kev nyab xeeb, xws li tsis txhob da dej ib leeg, pov thawj lub tsev thiab lwm yam
• Tswj kev ntxhov siab thiab pw tsaug zog
• Zam kev haus dej haus cawv thiab quav yeeb tshuaj
• Cia rau hauv tsev kawm ntawv
• Tswj hwm lwm yam mob

Kev tswj hwm cov kev ua neej no los yog kev kho mob hauv tsev tuaj yeem ua kev nyuaj. Nco ntsoov nrog koj tus me nyuam tus kws zov me nyuam tham yog tias koj muaj kev txhawj xeeb.

Kev ntxhov siab los ntawm kev saib xyuas ib tus menyuam nrog mob qaug dab peg feem ntau tuaj yeem tau txais txiaj ntsig los ntawm kev koom nrog ib pab txhawb nqa. Hauv cov pab pawg no, cov tswvcuab sib koom ua ke ntau yam thiab teeb meem.

Feem ntau cov menyuam yaus uas muaj mob vwm tuaj ntawm lub neej yuav nyob li qub. Qee hom mob ntsig txog menyuam yaus mus deb lossis txhim kho nrog lub hnub nyoog, feem ntau yog cov hluas lig lossis 20s. Yog tias koj tus menyuam tsis qaug dab peg tau ob peb xyoos, tus kws khomob yuav txiav cov tshuaj noj.

Rau ntau tus menyuam, tus mob vwm vwm yog lub neej nyob mus ib txhis. Hauv cov rooj plaub no, cov tshuaj yuav tsum tau txuas ntxiv.

Cov menyuam yaus uas muaj kev loj hlob tsis zoo nrog rau kev mob vwm tseem tuaj yeem ntsib kev cov nyom hauv lawv lub neej.

Yog koj paub ntau ntxiv txog tus mob yuav pab koj saib xyuas koj tus menyuam kom huam sai.

Teeb meem yuav suav nrog:

• Kev kawm tsis tshua yooj yim
• Kev ua pa rau zaub mov lossis qaub ncaug rau hauv lub ntsws thaum qaug dab peg, uas tuaj yeem ua rau mob ntsws
• Lub plawv dhia tsis xwm yeem
• Raug mob los ntawm ntog, pob, lossis nws tus kheej tom tsiaj thaum lub qhov chua leeg
• Puas kho hlwb tas mus li (mob stroke lossis lwm yam kev puas tsuaj)
• Sab sij huam tshuaj

Hu 911 lossis tus npawb xov tooj thaum muaj xwm ceev yog tias:

• Nov yog thawj zaug uas koj tus menyuam mob foob
• Qhov qaug dab peg tshwm sim hauv tus menyuam uas tsis coj daim npav ID txhawm rau mob (uas muaj cov lus qhia piav qhia tias yuav ua li cas)

Yog tias koj tus menyuam tau qaug dab peg ua ntej lawm, hu 911 lossis tus npawb xov tooj xwm ceev hauv ib qho xwm txheej kub ntxhov ceev no:

• Qhov qaug dab peg ntev dua li tus menyuam ib txwm muaj lossis tus menyuam muaj qee zaum txawv txav
• Tus me nyuam pheej rov qab mob dua li ob peb feeb
• Tus menyuam tau rov qab ua qhov tsis meej pem uas tsis nco qab lossis tus cwj pwm ib txwm tsis rov ua ntawm lawv (qhov xwm txheej mob rov huam dua)
• Tus me nyuam tau raug mob thaum qaug dab peg
• Tus menyuam muaj kev ua pa nyuaj

Hu rau tus kws khomob yog koj tus menyuam muaj mob tshiab:

• Xeev siab los ntuav
• Pob pob
• Cov kev mob tshwm sim ntawm cov tshuaj, xws li tsaug zog, nyob tsis tswm, lossis tsis meej pem
• Kev qoj ib ce lossis txawv txav, lossis teeb meem nrog kev sib koom tes

Tiv toj rau tus kws kho mob txawm hais tias koj tus me nyuam ib txwm nyob tom qab qaug dab peg.

Tsis muaj ib txoj kev paub uas yuav tiv thaiv tau kev mob vwm. Noj zaub mov kom zoo thiab pw tsaug zog yuav txo qhov feem ntau ntawm qaug dab peg rau cov menyuam yaus uas muaj mob vwm.

Txo txoj kev pheej hmoo ntawm lub taub hau thaum lub sijhawm muaj kev pheej hmoo. Qhov no tuaj yeem txo qhov pheej hmoo ntawm lub hlwb raug mob uas ua rau qaug dab peg thiab qaug dab peg.

Teeb meem mob qaug dab peg - menyuam yaus; Cuam Tshuam - me nyuam yaus mob vwm; Cov tshuaj tiv thaiv mob hlwb thaum muaj mob vwm; Anticonvulsant - menyuam yaus qaug dab peg; Antiepileptic siv yeeb tshuaj - me nyuam muaj mob vwm; AED - menyuam qaug dab peg

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Ghatan S, McGoldrick PE, Kokoszka MA, Hma SM. Kev phais mob rab phom pediatric. Hauv: Winn HR, ed. Youmans thiab Winn Neurological phais. 7 tus ed. Philadelphia, PA: Elsevier; 2017: chap 240.

Kanner AM, Ashman E, Gloss D, li al. Cov txheej txheem kev hloov kho tshiab cov ntsiab lus: kev ua tau zoo thiab tiv taus ntawm cov tshuaj tshiab antiepileptic I: kev kho mob tshiab-pib kev mob vwm: ceeb toom ntawm American Epilepsy Society thiab Cov Txheej Txheem Kev Txhim Kho, Kev Tshawb Fawb, thiab Kev Siv Tshuaj Me los ntawm American Academy of Neurology. Tshuaj Mob Ntsiav Quav. 2018; 18 (4): 260-268. PMID: 30254527 https://pubmed.ncbi.nlm.nih.gov/30254527/.

Mikati MA, Tchapyjnikov D. Qaug foob thaum yau. Hauv: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Phau Ntawv ntawm Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 611.

Hlaws PL. Saib xyuas ntawm qaug dab peg thiab epilepsy hauv cov menyuam yaus. Hauv: Swaiman K, Ashwal S, Ferriero DM, li al, eds. Swaiman's Pediatric Neurology: Cov Ntsiab Cai thiab Kev Coj Ua. 6 tus ed. Philadelphia, PA: Elsevier; 2017: chap 61.