Matenda a psychopathological catatonia (kuchokera ku Greek "kukoka, mavuto") anayamba kufotokozedwa kumapeto kwa zaka za zana la khumi ndi zisanu ndi zitatu. Karl Ludwig Kalbaum wa ku Germany. Anazilemba ndi kuziphunzira ngati psychosis, koma otsatira a Kalbaum anayamba kuona catatonia ngati gawo la schizophrenia.
Kodi catatonia ndi chiyani?
Kuwonetsetsa kwa matendawa ndi matenda oyendetsa magalimoto - kunyong'onongeka, khalidwe lopsa mtima kapena kusokonezeka. Kupsinjika mu mawu a minofu akhoza kugwirizanitsidwa ndi kuwonongeka kwa ubongo (chifukwa cha kupweteka, chifuwa, matenda a Tourette, matenda opatsirana ndi mavuto, kumwa mankhwala ena, mankhwala osokoneza bongo, etc.). Psychosis ikuwonekera ngati chizindikiro cha matenda osiyanasiyana a m'maganizo. Odwala ena ndizosatheka kudziwa zomwe zimayambitsa matenda.
Catatonia ndi matenda omwe amachititsa mikangano pakati pa akatswiri padziko lonse lapansi. Chifukwa chenichenicho cha chiyambi chake sichikudziwika, ndipo pali lingaliro chabe. Choncho, maonekedwe a matendawa amachokera ku:
- kuperewera kwa chiberekero cha gamma-aminobutyric asidi;
- kuwonongeka kwadzidzidzi mu ubongo wa hormone ya dopamine;
- Ntchito yowonjezereka ya machitidwe a serotonergic ndi cholinergic (pambuyo pa kutuluka kwadzidzidzi kwa clozapine);
- Kuwonekera kwa kusintha kwa chisinthiko;
- Kusokonezeka kwa magetsi komwe kumagwirizanitsa m'maso ndi thalamus.
Matenda a Catatoic
Mkhalidwe wa catatonia umaphatikizapo mavuto a magalimoto, nthawi zina kuphatikizapo delirium, malingaliro, kusokonezeka kwa chidziwitso ndi matenda ena opatsirana pogonana. Kutulukira kwa matendawa kumakhazikitsidwa poganizira mbiriyakale, zizindikiro za kuchipatala, kufufuza kwa ubongo ndi zotsatira zafukufuku. Katswiri wa zamaganizo ayenera kudziwa zomwe zimachititsa kuti matendawa apitirire. Matendawa amatha kupezeka ngati zizindikiro zake ziwiri zibwerezedwa mobwerezabwereza kwa milungu iwiri.
Zizindikiro za katatoni
Matenda a catatonic amakhudza anthu a msinkhu uliwonse - ana ndi akulu (makamaka mpaka zaka 50). Pachiyambi choyamba, matendawa amawoneka ngati amatsitsimutsa komanso amachititsa kuti magalimoto azichita zinthu mopitirira muyeso. Zomwe amachititsa kuti azichita zinthu zosasangalatsa kapena zonyansa. Zizindikiro za matenda azimayi kwa zaka makumi asanu ndi zisanu ndi zisanu ndi zisanu (40-55) zingakhale zolakwika chifukwa cha zovuta: kufotokozera nkhope ndi kulankhula, nkhope, mafilimu ndi zina zotero. Nthawi zambiri, zizindikiro za matendawa ndi izi:
- owonetsa - odwala mobwerezabwereza amaberekana zochitika, kusuntha;
- zizindikiro - kubwereza mau ndi mawu ena;
- kusaganizira kapena kusasamala - kusakwaniritsa zopempha kapena zochita zina);
- kuphulika ndi kuwonongeka - kutayika mu malo osakhala achilendo.
Pa chitukuko cha matendawa akhoza kusonyeza zizindikiro zotero monga chisangalalo chokhazikika, chikhalidwe cha malingaliro kwa munthu kapena phunziro lomwelo, kutsekedwa, kutonthozedwa kwathunthu (mutism) kapena kutulutsa mawu, kuthamanga kwa minofu, chizindikiro cha "mtsitsi wa mpweya" (munthu ali pamalo osasangalatsa ndi mutu wake woukitsidwa), maso otseguka, kuganizira.
Matenda a katatoni
Chikhalidwe chachikulu cha catatonia ndi chimbudzi chodziwika ndi mitsempha ya m'magazi ndi bata. Pali mitundu itatu ya chikhalidwe ichi: kugwidwa kwa cataleptic, kunyalanyaza ndi kuswa. Odwala akhoza kukhala ndi thupi linalake kapena maonekedwe a nkhope kuchokera maola angapo mpaka miyezi ingapo. Khalidwe lochepa kwambiri la catatonic likuchedwa kuyendetsa galimoto, pomwe thupi lachilengedwe limakhala losazolowereka kapena losayenera. Kusintha kwa matenda omwewo - kusokonezeka ndi kusuntha kopanda cholinga, osagwirizana ndi chilengedwe.
Kusokonezeka kwa katatoni
Ngati wodwalayo ali ndi mafoni, akhama komanso amachita zinthu zogwira mtima komanso zopanda cholinga, pali chisokonezo cha catatonic, zomwe zizindikiro zake zingagawidwe mu mitundu iwiri. Chidwi chachisangalalo chimadziwika ndi kukula kwapang'onopang'ono, ndipo sikunatchulidwe kwambiri: chimayamba ndi kusintha kwa maganizo, khalidwe losayenera, kulankhula mokwiya. Mtundu wachiwiri wa zokopa ndi wopupuluma, momwe kukula kwakukulu kwa zizindikiro ndi khalidwe. Wodwalayo amachita mwankhanza, mwakhama, molimbika, pamlingo waukulu, akhoza kudzivulaza yekha ndi ena; Zochita zake ndizoopsa.
Sachizophrenia ya Catato
Chosavuta, choopsa komanso, monga lamulo, matenda osagwidwa ndi matenda ndi matenda a schizophrenia. Zimapezeka peresenti (1-3) ya schizophrenics. Matendawa amakhudza ntchito zonse za thupi, ndipo kuwonongeka kwakukulu kwa magalimoto kumawonedwa. Odwala a catatoni akhoza kukhala pa malo amodzi kwa nthawi yaitali, ngakhale zitakhala zovuta kuchokera kumalo a munthu wamba (ataimirira pa mwendo umodzi kapena kutambasula mkono kumtunda). Zizindikiro zenizeni za matenda a catatomy schizophrenia ndizo kusinthasintha komanso kusangalala.
Kusokonezeka kwa katatoni
Choyamba, matenda a catatonic schizophrenia amadziwika ndi vuto lopanda mphamvu. Koma ndi zizindikiro zina: zopanda pake, zopusa, ndi zina zotero. M'kupita kwa nthawi, matendawa amayamba. Mankhwala a catatonic, monga lamulo, amapezeka ndi chibwibwi, pamene wodwalayo amawombera kwa nthawi yayitali, samayankha mofuula kwa iye ndipo amapezeka kuti azilankhulana momasuka.
Catatonia popanda mtambo wa chidziwitso amatchedwa Lucic. Pafupipafupi nthawi zonse zimakhala ndi schizophrenia. Mtundu wa matendawa umakhala ndi kuphwanya kufotokoza kwa dziko lenileni, kusagwirizana kwa kuganiza, kusokonezeka, amnesia (kwathunthu kapena tsankho). Madokotala ena amaona kuti catatonia yachisiyiti ndiyo njira yovuta kwambiri yowononga. Matenda a catatonic amtundu uwu amayamba pokhapokha.
Chikhalidwe cha katatoni
Matenda a Oyneroid amasonyeza kusokonezeka kwa chidziwitso cha wodwala ndi zochitika monga maloto, kusintha kwakukulu kwa mtima komanso kusokonezeka. Maloto a catatonic ndi odzaza ndi zochitika zosangalatsa komanso zozizwitsa. Amatha kugwirizana ndi zenizeni. Wodwala ali nawo mbali yowonongeka, pali chisokonezo mlengalenga mwayekha "I". Pali kusintha kosakhalitsa kwachisangalalo cha kusokonezeka.
Kusokonezeka kwa Catato
Matenda a catatonic amapanga onse palimodzi komanso pamodzi ndi matenda ena. Kawirikawiri matendawa amaphatikizidwa ndi kupanikizika, komwe kumawonjezera zizindikiro za katatonia. Mwachitsanzo, wodwalayo amatha kusiya nthawi yayitali, akumva kupweteka ngakhale kusuntha chala - zonse zakuthupi ndi zamaganizo. Mkhalidwe wovuta umakhala chifukwa cha malo onse a wodwalayo.
Kupha Catatonia
Pali njira yowopsa ya schizophrenia, yomwe imadziwika ndi kuyambira kovuta, chitukuko chofulumira, kukondweretsa kachipatala kowonjezera, kutentha kwa thupi, kutentha kwa thupi komanso kusintha kwa thupi, kusintha kwa kutopa ndi kutentha. Dzina lina la matendawa ndi hypertoxic schizophrenia. Chizindikiro cha matendawa n'chosavomerezeka, ngakhale katatonia yoopsa imachiritsidwa.
Catatonia - mankhwala
Munthu amene amapezeka ndi catatonia sangathenso kupita kuchipatala chisanafike matenda omwe amachititsa kuti matendawa apitirire. Phunziro lapadera liyenera kuchitidwa kuti lisagwiritse ntchito zina zomwe zimayambitsa matendawa komanso kupeza zovuta za catatonia. Ngati catatonia ikukula chifukwa cha schizophrenia ndi vuto lililonse la maganizo, chithandizo chiyenera kuyamba ndi kuchiritsa wodwala za zizindikiro za matendawa. Wodwalayo akupitilizidwa ku dokotala, amaikidwa m'chipatala.
Matenda odwala catatonic akuyenera kuchitika magawo angapo a chithandizo. Pachiyambi choyamba, wodwala amapatsidwa mankhwala osakwanira a caffeine ndi 10% ya barbamyl. Pamene njira zamagalimoto zimayambiranso, kuyendetsa mankhwalawa kumatha. Mankhwala othandiza kwambiri amagwiritsidwa ntchito ndi thandizo la ECT - mankhwala opangira magetsi komanso benzodiazepine. Panthaŵi imodzimodziyo pogwiritsa ntchito ultrasound matenda, wodwalayo amafunsidwa kawirikawiri kuti adziwe momwe amachitira.
Pali zifukwa zambiri za matenda a catatomy, zomwe zimapanga chithandizo chamankhwala. Pa msinkhu wamakono wa chitukuko cha mankhwala, chikhalidwe ichi cha maganizo a psychopathological si chigamulo. Ochiritsidwa mwachibadwa akhoza kutchedwa odwala 40%. Nthaŵi zambiri, akatswiri amatha kukwanitsa kukhululukidwa kwathunthu kapena kupitirizabe kusintha kwa mkhalidwe wa wodwalayo.