Zonke iintlobo zentshukumo ziphela kuphela ephupheni. Kukho iintlobo ezimbini eziphambili zalo - ukuthuthumela kwezilwanyana kunye nezifo.
TEMOR PHYSIOLOGICAL
Iyenzeka kumntu onempilo. Ngokomzekelo, ngokuxhalabisa kakhulu kunye noyiko, ngenxa yokusebenzisana kweenkqubo eziphambili kunye neendlela ze-neurophysiological, ukuphazamiseka okuphindaphindiweyo nokuphumla kwezihlunu. Ingqungquthela enjalo, njengomthetho, ayibonakali esuka ngaphandle kwaye ayivekanga ngumntu ngokwakhe. Ngenxa yokuxhatshazwa kwemisipha, ukukhathala, ukupholisa, okanye ukuvusa umzwelo, ukuzamazama kunokuba namandla kwaye kubonakale - kuthiwa kukunyanzeliswa komzimba. Inomlinganiselo omkhulu, kodwa inqanaba elifanayo njengento elula yomzimba.
UKUPHATHWA KWENKQUBO
Iyenzeka ngezifo ezahlukahlukeneyo kwaye ibonakala kwiso iso. Inayo impawu ezininzi. Isiseko soluhlalutyo lweklinikhi lokugubhazelayo kukumiselwa kweemeko apho zibonakalisa khona.
ISITHOMBE SEMPOSTO
Ivela ngexesha apho imisipha ikhululekile kwaye ingenzi ukunyakaza okusebenzayo. Ukomeleza ngokuxhalaxwa kunye nokukhathazeka kwengqondo, kunokunciphisa ngokunyanzelana ngokuzithandela kwesigxina esithintekayo. Olu hlobo lwenkqantosi luninzi kakhulu kwi-parkinsonism.
ISIKHUMBUZO SOMSEBENZI
Naluphi na ukuthuthumela okwenzekayo kunye nokuqhaqhaqhaqhaza kweentlungu. Iquka ukuhamba kweso postural, isometric kunye nokuthuthumela (kinetic).
Inyikima ye-Postural ibonakala ngokubhekiselele kwimeko engemuva yokuxhatshazwa kwemisipha ekhuselekileyo ngelixa igcinwe i-posture, ngokuchasene namandla okudalwa kwamandla. Unokuba ngumntu onobunono kwaye unokubonakalisa ukuzalwa. Kusenokuthetha ukuba ukhathazeka okwenyukayo, kwenzeka xa isifo se-thyroid sichaphazelekayo. Ukugubha kwesi sifo kungabangela ukuziyeka (ukuphuka) ngenxa yokuchitha iindleko ezinkulu zotywala okanye iziyobisi. Xa ukudlula izidakamizwa ezithile okanye utyhefu kunye neekhemikhali kunokukhawuleza ukuthuthumela ngokukhawuleza, umzekelo, xa utyhefu ngeetrodi zensimbi ezinzima (mercury). Inyibiliko engasemva kwesigxina esiphezulu nesezantsi ibalaseleyo xa isigulane sithatha zombini izandla kwaye sizama ukusasaza iminwe yakhe - ngulo msebenzi umgqirha we-neuropathologist anikezela isigulane ngexesha loviwo.
Inyikima ye-Isometric iyenzeka xa izihlunu zisebenza, xa isenzo sabo sichasene nento esetyenzisiweyo (umzekelo, xa umntu efaka izandla kwitafile).
Ukuthuthumela kwe-Kinetic kwenzeka ngexesha lokunyanzelisa. Ukutshintsha kwakhe kukukrokra ngokukodwa kunye nezenzo ezithile (ngokubhala, ukwenza umsebenzi othile wobugcisa), kodwa kungekhona nezinye izinto ezibandakanya iintlobo ezifanayo.
Uhlobo lokuthuthumela, ukusasazwa kwalo, ubunzima, ukuqala kweminyaka kunye nezinye iimpawu zenza isifo sokuthuthumela. Ukusekwa kokugqibela kubalulekile ekuqaliseni iindlela ezichanekileyo zonyango.
Kukho ama-syndromes amancinci amancinci angaphezulu. Iyona nto ibaluleke kakhulu yinto ebalulekileyo. Ngokuqhelekileyo kubonakaliswe ngokuthuthumela kwezandla zangasemva, ngokuqhelekileyo kudibaniswa nentuthuko yentloko, imilomo, intambo, imilenze, isithintelo. Isiqingatha sezigulane sinesifo esinesifo esibulalayo, esingafuni unyango olukhethekileyo. Nge-jitter ephawulekayo, ugqirha ngokuqhelekileyo ugunyazisa ipropranolol okanye i-primidone.
Ukuxubha kweParkinsonian ngokusoloko kubonakalisa njengentlanzi yokuphumla okanye ukudibanisa kunye neentshukumo zezenzo. Kwiimeko eziqhelekileyo, izandla zibandakanyeka, ukucotha, ubunzima bokunyakaza kubonwa. Ukuthuthumela kwe-Parkinsonian kunokunciphisa phantsi kwefuthe leziyobisi ze-dopaminergic (i-levodopa, i-dopamine agonists), i-anticholinergics.
Inyikima ye-cerebellum, ngokukhawuleza, ngenkuthalo enkulu ivela, ngezinye ihambisane neengcambu zengxowankulu. Kwi-pathologies ye-cerebellar, kukho amathuba eeklinikhi ezahlukeneyo ze-jitter (umzekelo, isicengechunge sesigxina se-head and trunk-titity). Uloyiko olukhulu luhlobo lwenkohlakalo ebizwa ngokuba yi-asterixis, ukunyakaza kwezandla apho kufana nokuphosa kwamaphiko. Ingakwazi ukuvela kwisifo sikaWilson-Konovalov (isifo esibalulekileyo esiyifumene esifana nokuqokelela ubhedu kwindawo yengqondo, igazi kunye nesibindi sesibindi), ukungafihli komzimba okanye ukungazinzi, kunye nomonakalo kwi-midbrain. Xa i-cerebellum ishukunyiswa, ezininzi iinkqubo ze-neurotransmitter, malunga nokukhethwa kwonyango kunzima.
Ingqungquthela yaseHolmes ibonakalisa intlangano yokuqala yokuphumla kunye nokuthuthumela kwezenzo. Ngokuqhelekileyo kubalulekile ukunyuka ngokukhawuleza xa uzama ukugcina isigxina kwimali. Ukuthuthumela okukhulu, ukuphakama okukhulu kweengalo, imilenze, kunye ne-trunk kuphazamiseka yiintlobo ezininzi. Ingqungquthela yaseHolmes isoloko ivela emva kokutshatyalaliswa kwezilwanyana, kunye ne-multiple sclerosis nezinye izifo. Unyango luyinkinga, kwezinye iimeko, iilvodopa zamachiza, anticholinergics, valproate, propanolol.
IIMFOMO ZEZICWANGCISO ZENKQUBO
Zineembonakalo ezahlukeneyo zekliniki, inhlanganisela engavamile yeentlobo zokuthuthumela (amaninzi amaninzi). Ingqungquthela iqala ngokukhawuleza ize ivele nje ngokukhawuleza. Ukuba uguqula ingqalelo yesigulane, ukuthuthumela kunciphisa. Kubalulekile ukudibana nomgqirha kunye nokunikezela ukuxhalabisa, ukuxhalabisa.
Amachiza kunye nokuthuthumela okunobuthi kungabangelwa ziintlobo zezinto. Ingqungquthela ephezulu kakhulu, esondeleyo kwinani leempawu zayo kwintuthuko yezemvelo. Ingenzeka emva kokusetyenziswa kwe-sympatho-mimetics (ephedrine) okanye i-anti-pressressants (amitriptyline). Inyikima ye-Parkinson inokwenzeka emva kokunyanga nge-neuroleptic okanye nezinye izidakamizwa ze-antidopaminergic (reserpine, flunarizine). Ukugubha okukhulu kunokusetyenziswa ngokusetyenziswa kwamanzi amachiza kunye nezinye iziyobisi. Ingqungquthela, eyenzeka emva kokutywala utywala okanye utywala, kufuneka ihlukaniswe nentshukumo yokusetyenziswa kotywala okungapheliyo okubandakanyeka nokubandakanyeka kwe-cerebellar.
Iimpawu ezixutywayo ze-trendor syndromes zamacandelo angaphezulu nakwezantsi azikhupheli zonke iintlobo ezahlukeneyo zeenkliniki. Kukho inhlanganisela engavumelekanga ukuba akunakwenzeka ngokukhawuleza ukuba abanike nawuphi na uhlobo. Oku kubangela ukungavumeleki kokuzonyango kunye nesidingo sokudibana nogqirha ukuze uviwo kunye nokunyulwa kwonyango.
Kuloo matyala xa impembelelo yamachiza kunyango lwezityalo eziphezulu kunye nezantsi ezaneleyo, ukusetyenziswa kwe-stereotactic kwingqondo kusetyenziswa. Ukusebenza okunjalo kwenziwa ngama-neurosurgeons we-RNPC ye-Neurology ne-Neurosurgery. Impumelelo ephunyeziweyo ekufundeni ukuthuthumela, ukubonakala kwamachiza amatsha kunokunceda inani elinyukayo yezigulane kwaye lijonge kwixesha elizayo ngethemba.