He aha te pokanga mō te mate roro? Te Whāinga, te Hātepe & ngā Hua

Ko te pokanga mō te mate roro he hātepe rongoā e tango ana, e momotu ana rānei i te wāhi o tō roro e tīmata ana ngā pākia. I hangaia mō ngā tāngata kāore e pai ana te urupare o ngā pākia ki ngā rongoā, ā, he nui te pānga ki ō rātou oranga o ia rā.

Ka taea e tēnei momo pokanga te huri i te oranga mō ngā kaitono tika. Ki te tīmata ngā pākia mai i tētahi wāhi motuhake o te roro ka taea te tango marie, ka whai tūmanako te pokanga mō te herekore i ngā pākia, te whakaheke nui rānei i te auau o ngā pākia.

He aha te pokanga mō te mate roro?

Kei roto i te pokanga mō te mate roro te tango, te whakarerekē rānei i te kiko roro hei aukati, hei whakaiti rānei i ngā pākia. Ko te whāinga he whakakore i te arotahi pākia i te wā e tiaki ana i tō mahi roro noa.

He maha ngā momo pokanga mō te mate roro, he mea whakarite ia momo ki tō āhuatanga motuhake. Ko te huarahi tino noa e tango ana i te wāhi iti o te kiko roro e tīmata ana ngā pākia. Ko ētahi atu hātepe e momotu ana i ngā ara e tuku ana i ngā pākia kia horapa puta noa i te roro.

Ka whiriwhiri tō tākuta roro i te huarahi pai rawa atu i runga i te wāhi e tīmata ana ō pākia, me pēhea te horapa, me ngā mahi roro e hiahia ana kia tiakina. E whakamahi ana ngā tikanga pokanga hou i ngā whakaahua matatau me te aroturuki hei hanga i ēnei hātepe kia haumaru, kia whai hua hoki.

He aha te take e mahia ana te pokanga mō te mate roro?

E tūtohu ana te pokanga mō te mate roro i te wā e haere tonu ana ngā pākia ahakoa te whakamātau i ngā rongoā maha hei aukati i ngā pākia. Ko tēnei āhuatanga e kīia ana ko te mate roro ātete rongoā, ā, e pā ana ki te kotahi hautoru o ngā tāngata e mate roro ana.

Ko te whakatau mō te pokanga e whakawhirinaki ana ki ētahi mea. Me nui te pānga o ō pākia ki tō kounga oranga, te haumaru, te kaha rānei ki te mahi me te pupuri i ngā hononga. Me tīmata ngā pākia mai i tētahi wāhi motuhake o te roro ka taea te tango marie me te kore e pā ki ngā mahi nui pēnei i te kōrero, te neke, te mahara rānei.

He mea nui te pokanga ina waiho nga haumanu i a koe i te tūponotanga o te whara, te mate ohorere i roto i te mate roro (SUDEP). Mēnā he maha ngā hinganga, ngā pānga, ngā aituā rānei i puta mai i ō haumanu, tērā pea ka pai ake te tiaki a te pokanga i te whakamātau tonu i ngā rongoā.

Ka whakaaro hoki ētahi tāngata ki te pokanga hei whakaiti i ngā pānga wā-roa o ngā haumanu auau ki te mahi roro me te oranga ngākau. Ko te noho me ngā haumanu kāore i te whakahaerehia ka pā ki tō mana motuhake, ō whanaungatanga, me tō hauora hinengaro i ngā huarahi ka āwhina pea te pokanga angitu ki te whakahoki mai.

He aha te tikanga mō te pokanga mate roro?

Ka tīmata te tukanga pokanga ki te whakamātautau nui i mua i te pokanga hei tārai i tō roro me te kimi i te pūtake o te haumanu. Ko te wā aromatawai nei e pā ana ki te maha o ngā wiki, me te whai i ngā whakamātautau me ngā kōrero maha.

I te wā o te aromatawai i mua i te pokanga, ka whai koe i ngā rangahau whakaahua roro taipitopito. Kei roto pea i ēnei ngā karapa MRI whakatau-nui, ngā karapa PET, me te aroturuki EEG motuhake ka roa pea te maha o ngā rā. E hiahia ana ētahi tāngata ki te aroturuki whakaeke me ngā hiko i tū tika ana i runga i te roro, i roto rānei i te roro hei tohu i te wāhi tika o te haumanu.

I te rā o te pokanga, ka whiwhi koe i te rongoā whānui mō te nuinga o ngā tikanga. Heoi, me noho mātau koe i te wā o ētahi pokanga kia taea e te tākuta te whakamātau i ngā mahi roro pēnei i te kōrero me te nekehanga. Kāore pea tēnei e pai ki te rongo, engari kāore te roro ake e rongo i te mamae, ā, ka whiwhi koe i ngā rongoā hei pupuri i a koe kia pai.

He rerekē te tikanga pokanga i runga i te momo pokanga e hiahia ana koe:

• Ka tangohia e te lobectomy temporal tetahi wāhanga o te temporal lobe, he maha ngā wā ka uru te hippocampus
• Ka tangohia e te lesionectomy tētahi wāhi koretake motuhake pēnei i te puku, i te kiko kōpiko rānei
• Ka momotu, ka tangohia rānei e te hemispherectomy tētahi hemisphere roro i ngā tūāhua tino kaha
• Ka tapahia e te corpus callosotomy te hononga i waenga i ngā haurua e rua o te roro
• Ka mahia e te multiple subpial transection ngā tapahi iti hei aukati i te horapa o te hopu

Ko te tikanga, e rua ki te ono haora te roa o te pokanga, i runga i te uaua. Kei roto i tō rōpū pokanga ngā neurosurgeons, neurologists, anesthesiologists, me ngā nēhi motuhake e aroturuki ana i tō mahi roro i te wā o te tukanga.

Me pēhea te whakarite mō tō pokanga epilepsy?

Ko te whakarite mō te pokanga epilepsy e hāngai ana ki te whakarite tinana me te aronganui i roto i ngā wiki, i ngā marama rānei. Mā tō rōpū hauora koe e ārahi i ia wāhanga kia mōhio ai koe kua rite mō te tukanga.

Tuatahi, ka whakaoti koe i ngā whakamātautau me ngā arotakenga i mua i te pokanga. Kei roto i tēnei ko te mahi toto, ngā whakamātautau ngākau, me te whakaahua roro anō pea. Ka tūtaki koe ki ngā tohunga rerekē tae atu ki te neurosurgeon, neurologist, neuropsychologist, me tētahi kaimātai hinengaro, kaimahi pāpori rānei i ētahi wā.

Me whakatika tō hōtaka rongoā i mua i te pokanga. Ka hoatu e tō tākuta ngā tohutohu motuhake mō ngā rongoā hei haere tonu, hei whakamutu, hei huri rānei. Kaua rawa e whakatika i ō rongoā hopu me te kore e tirotirohia e te tākuta, nā te mea ka puta ake pea ētahi atu hopu.

Kei roto i te whakarite tinana te pupuri i te hauora pai i ngā wiki i mua i te pokanga. Ko te moe pai, te kai pai, me te noho wai ka āwhina i tō tinana ki te whakahaere i te ahotea o te pokanga me te whakaora. Mēnā e paowa ana koe, ka tino tūtohu tō tākuta kia mutu i ngā wiki i mua i te tukanga.

He mea nui hoki te whakarite i te taha o te ngākau. Whakaarohia te kōrero ki tētahi kaitohutohu, te uru atu ki tētahi rōpū tautoko, te hono atu rānei ki ētahi atu i pērā te pokanga. Mā te whai i ngā tūmanako tūturu mō te hāora whakaora me ngā hua ka āwhina i te whakaiti i te āwangawanga.

Ko ngā whakaritenga whaihua ko te whakarite i te wā ki te mahi, te whakarite i te āwhina i te kāinga, me te whakarite i tō wāhi noho mō te whakaora. Me whai tangata koe hei taraiwa i a koe ki ngā hui me te āwhina i ngā mahi o ia rā mō ētahi wiki i muri i te pokanga.

Me pēhea te pānui i ngā hua o tō pokanga mate pāpā?

Ko ngā hua o te pokanga mate pāpā e inea ana e ngā hua o te hopu, e whakarōpūhia ana mā te whakamahi i ngā tauine paerewa. Ko te pūnaha tino noa e wehe ana i ngā hua ki ngā akomanga i runga i te auau me te kaha o te hopu i muri i te pokanga.

Ko te hua o te Akomanga I te tikanga he kore hopu koe, he hopu wāhanga noa rānei tōna, kāore he ngaronga o te māramatanga. Koinei te hua pai rawa atu, ā, ka puta i te 60-70% o ngā tāngata i pokangia ki te roro o te taha o te wā. Ko te Akomanga II te tikanga he hopu onge tōna, kāore e neke atu i te 3 rā hopu i ia tau.

E tohu ana te Akomanga III i te whakapai ake whaihua me te whakaiti nui i te hopu engari kei te mau tonu ētahi hopu haua. Ko te Akomanga IV te tikanga kāore he whakapai ake nui i te whakahaere hopu. Ka arotakehia e tō tākuta tō hua i te 6 marama, 1 tau, me te 2 tau i muri i te pokanga, i te mea ka taea tonu te whakapai ake i ngā tauira hopu i te roanga o te wā.

I tua atu i te whakahaere hopu, ko te angitu ko te whakapai ake i te kounga o te oranga, te kaha ki te mahi, te taraiwa, me te pupuri i ngā hononga. Ka kite ētahi tāngata i te pai ake o te ngākau, te whakanui i te mana motuhake, me te whakaiti i ngā pānga taha o te rongoā ahakoa kāore rātou i te kore hopu.

Ka āta aroturukihia hoki te mahara me te mahi hinengaro i muri i te pokanga. Ahakoa ka kite ētahi tāngata i ngā huringa mahara ngawari, he tokomaha e kite ana ka pai ake te mahi hinengaro whānui i te mea ka whakahaerehia ngā hopu, ā, ka taea te whakaiti i ngā horopeta rongoā.

Me pēhea te arotau i tō whakaora pokanga mō te mate pāpā?

Ko te whakaora mai i te pokanga mō te mate pāpā, e hāngai ana ki te wā o te whakaora tonu me ngā whakarerekētanga wā-roa hei whakanui i tō angitu pokanga. E hia marama te roa o te tukanga, me te pai tonu o te whakapai ake ka taea mō te rua tau.

I ngā wiki tuatahi i muri i te pokanga, arotahi ki te okioki me ngā mahi ngawari. E hiahia ana tō roro ki te wā ki te whakaora, ā, ko te pūhi rawa i te wawe ka raru i te whakaora. Whaia ngā tohutohu motuhake a tō tākuta pokanga mō ngā here mahi, te tiaki i te patunga, me te wā ki te tīmata anō i ngā mahi noa.

He mea nui te whakahaere rongoā i te wā whakaora. Ka noho pea tō tākuta i a koe ki ngā rongoā anti-seizure mō te rua tau i muri i te pokanga, ahakoa ka kore koe e pā i te seizure. Kaua rawa e mutu, e whakaiti rānei i ngā rongoā me te kore he tirotiro hauora, nā te mea ka puta pea ngā seizures i te wā o te whakaora.

He nui te pānga o te kounga o te moe ki te whakaora me te whakahaere seizure. Kia mau ki ngā hōtaka moe auau, waihanga i tētahi taiao okioki, me te whakatika i ngā raruraru moe me tō rōpū hauora. Ka puta pea ngā seizures i te moe kino ahakoa i muri i te pokanga angitu.

He mea nui te whakahaere i te ahotea me te tautoko aronganui i te whakaora. Whakaarohia te tohutohu, ngā rōpū tautoko, ngā tikanga whakaiti ahotea pērā i te whakaaroaro, i te whakakori tinana ngawari rānei. Ka pā pea ētahi tāngata i ngā huringa aronganui i a rātou e urutau ana ki te ora me te whakapai ake i te whakahaere seizure.

He mea nui ngā whakaritenga whai-a-runga auau mō te aroturuki i tō ahunga whakamua me te whakatika i ngā whakaritenga e tika ana ki tō mahere maimoatanga. Ka aroturukihia e tō rōpū ngā tauira seizure, ngā taumata rongoā, me te oranga whānui hei whakarite i te putanga pai rawa atu.

He aha ngā āhuatanga tūpono mō ngā raruraru pokanga mō te mate pāpā?

He maha ngā āhuatanga ka pā ki tō tūponotanga o ngā raruraru mai i te pokanga mō te mate pāpā. Mā te māramatanga ki ēnei ka āwhina i a koe me tō rōpū hauora ki te whakatau i ngā whakataunga mōhio mō te tika o te pokanga mōu.

He mea nui te wāhi o tō pūtake pōrearea ki te whakatau i te tūponotanga. Ko te pokanga tata ki ngā wāhi roro nui pēnei i ngā pokapū kōrero, ngā wāhi motuka, rānei ngā rohe mahara, he nui ake ngā tūponotanga o ngā huringa mahi. Heoi anō, nā ngā tikanga pokanga matatau me te mahere roro i pai ake ai ēnei tikanga i ngā wā o mua.

Ka pā te tau ki ngā tūponotanga pokanga me ngā putanga. He pai ngā putanga o ngā tamariki, ā, ka tere te ora, i te wā e nui ake ana ngā tūponotanga o ngā pakeke, engari ka whai hua tonu rātou i te pokanga. Ka pā hoki tō āhua hauora whānui, tae atu ki te mahi o te ngākau, te pūkahukahu, me te whatukuhu, ki te tūponotanga pokanga.

Ka pā te momo me te whānuitanga o te hē o te roro ki te uaua me te tūponotanga. Ko te tango i tētahi whara kotahi, kua tino tautuhia, te tikanga he iti ake ngā tūponotanga i ngā tikanga whānui ake. Ko te pokanga roro o mua, rānei te pūhihi nui, ka nui ake ngā wero hangarau.

Ko ngā āhuatanga tūponotanga onge engari nui ko:

• Ngā mate toto, te whakamahi rānei i ngā rongoā whakaheke toto
• Ngā mate kaha, rānei te pūnaha ārai mate kua ngoikore
• Ngā āhuatanga hinengaro nui pea e uaua ai te ora
• He maha ngā āhuatanga hauora e nui ake ai ngā tūponotanga anahēhia
• Ngā tūmanako kāore i te pono mō ngā putanga pokanga

Ka āta arotake tō rōpū pokanga i ēnei āhuatanga katoa i te wā o te arotake i mua i te pokanga. Ka kōrero rātou mō tō āhuatanga tūponotanga takitahi, ā, ka āwhina i a koe ki te mārama me pēhea te pā o ēnei āhuatanga ki tō āhuatanga motuhake.

He pai ake te pokanga kirika i te rongoā tonu?

Mō ngā tāngata e mate kirika ana e kore e aro ki te rongoā, he maha ngā wā ka pai ake te whakahaere i te kirika i te wā roa i te whakamātau rongoā tonu. Heoi anō, ka whakawhirinaki te whakatau ki ō āhuatanga takitahi me te tūponotanga o te angitu pokanga.

E whakaatu ana te rangahau ko nga kaitono pokanga e tika ana he 60-80% te tupono ka kore he hauhautanga, ka whakatauritea ki te iti iho i te 5% te tupono me nga rongoa taapiri anake. Ka tukuna ano e te pokanga te kaha ki te whakaiti i nga rongoa, ka taea te whakapai ake i te kounga o te oranga ma te whakaiti i nga paanga taha.

He mea nui te wa o te pokanga. Ko te pokanga wawe, ina tika, he maha nga wa ka pai ake nga hua me te aukati i te kohinga o nga whara e pa ana ki te hauhautanga me nga raru hinengaro. Ko te tatari roa rawa ka puta he maha atu nga huringa roro me te iti o nga reeti angitu pokanga.

Heoi, karekau te pokanga e pai ake mo te katoa. Ko etahi tangata he hauhautanga kaore i te pai mo te maimoatanga pokanga, na te mea ka puta mai i nga waahi roro maha, ka uru ranei ki nga waahi roro nui e kore e taea te tango haumaru. Ko etahi atu ka pai ki te whakamahi tonu i nga rongoa mena he iti, he ngawari ranei o ratou hauhautanga.

Kei roto ano i te whakatau te pauna i nga tupono me nga painga i runga i o whainga o te oranga, te ahuatanga o te whanau, me nga uara whaiaro. Ko etahi tangata e whakanui ana i te tupono ki te kore he hauhautanga, ko etahi atu e tino awangawanga ana mo nga tupono pokanga pea, mo nga huringa ranei i roto i te mahi roro.

He aha nga raruraru ka puta mai i te pokanga epilepsy?

Pērā i ngā pokanga roro katoa, he tūponotanga me ngā raruraru ka puta mai i te pokanga epilepsy. Heoi, he onge nga raruraru nui, a he pai te ōwehenga tūponotanga-painga mō ngā kaitono e tika ana.

Ko nga raruraru noa, he wa poto te nuinga, ko te mamae o te mahunga, te ngenge, me te rangirua ngawari i nga ra i muri i te pokanga. Ko etahi tangata ka pa ki te ngoikore o te wa poto, nga uaua ki te korero, ki nga raruraru mahara ranei e pai ake ana i roto i nga wiki ki nga marama i te wa e ora ana te roro.

Ko nga raruraru nui ake engari he iti ake te noa ka uru:

• Te mate i te wāhi pokanga, i te roro rānei
• Te toto, te pūpū toto rānei
• Te whiu, ētahi atu raruraru rānei o ngā oko toto
• Te ngoikore tonu, ngā raruraru rānei o te ruruku
• Ngā uaua ki te kōrero, ki te reo rānei
• Ngā raruraru o te mahara, inā koa i muri i te pokanga o te lobe temporal
• Ngā huringa o te āpure tirohanga
• Ngā huringa o te ngākau, o te āhua rānei

Ko ngā raruraru onge engari he nui te kino ko te nui o te toto, te whiu nui, te mate rānei e whakatuma ana i te ora. Ka puta ēnei i roto i te iti iho i te 1-2% o ngā tūāpānga i ngā whare rongoā epilepsy e mōhiotia ana. He iti rawa te tūponotanga o te mate i te pokanga epilepsy, te tikanga iti iho i te 0.5%.

Ka pā ki ētahi tāngata te kore o te whakahaere i te hopu, te hokinga mai rānei o te hopu i muri i te wā tuatahi kāore he hopu. Kāore tēnei e kī ana i te kore o te pokanga, nā te mea ka taea e te whakapai ake i te wāhanga te whakarei ake i te kounga o te ora.

Ka kōrero tō rōpū pokanga i tō kōtaha tūponotanga motuhake i runga i te momo pokanga e whakamahere ana, me ō āhuatanga takitahi. Mā rātou koe e āwhina ki te mārama ki te pēhea te pānga o ēnei tūponotanga whānui ki tō āhuatanga, me ngā mahi ka mahia e rātou hei whakaiti i ngā raruraru.

Āhea au e kite ai i te tākuta mō te pokanga epilepsy?

Me kōrero koe i te pokanga epilepsy ki tō neurologist mēnā kei te haere tonu ō hopu ahakoa te whakamātau i ngā rongoā anti-seizure maha. I te nuinga, mēnā kua whakamātau koe i te 2-3 rongoā tika me te kore e tutuki te whakahaere i te hopu, tērā pea koe he kaitono mō te arotake pokanga.

Whakaarohia te kōrero pokanga mēnā ka pā nui ō hopu ki tō oranga o ia rā, mahi, whanaungatanga, rānei, te mana motuhake rānei. Kei roto i tēnei ko ngā hopu e whara pinepine ana, e aukati ana i a koe ki te taraiwa, e aukati ana rānei i tō kaha ki te noho motuhake, ki te pupuri mahi rānei.

He mea nui te wā mō te tuku ki te pokanga. Kaua e tatari kia nui rawa te raruraru o te ora, te whara rānei i ngā hopu. Ka taea e te arotake wawe te wā mō te whakamātau me te whakamahere whānui, ā, ko te pokanga wawe ka hua te pai ake o ngā hua.

Ko ngā āhuatanga motuhake e tika ana kia kōrerohia te pokanga ko:

• Ngā pāngia e puta ana ia wiki, ia marama rānei ahakoa te rongoā
• Ngā pāngia e pā ana ki te hinga, te whara, te aituā rānei
• Ngā pāngia e raru ana i te mahi, te kura, te whanaungatanga rānei
• Ngā pānga taha mai i ngā rongoā e whakawhāiti ana i tō kounga oranga
• Ngā pāngia e puta ana i te wā e moe ana, e pā ana ki te okiokinga
• Tetahi tauira pāngia e whakawhāiti ana i tō mana motuhake, i tō haumaru rānei

Me rapu hoki koe i te kōrero pokanga mēnā he whara roro tō, e tūpono ana ka pā ngā pāngia, ahakoa kei te whakahaerehia ō pāngia i tēnei wā mā te rongoā. I ētahi wā, mā te tango i te whara ka taea te whakaiti, te whakakore rānei i te rongoā.

Kia mahara, ko te arotake pokanga kāore e here ana i a koe ki te pokanga. Mā te tukanga arotake e āwhina ki te whakatau mēnā he kaitono pai koe, ā, ka whakarato i ngā kōrero hei āwhina i a koe ki te whakatau whakatau mō ngā kōwhiringa maimoatanga.

Ngā pātai auau mō te pokanga mate pāpā

P1: He whai hua te pokanga mate pāpā mō ngā momo pāngia katoa?

He pai te mahi a te pokanga mate pāpā mō ngā pāngia arotahi e tīmata ana i tētahi wāhi roro motuhake. Tata ki te 60-80% o ngā tāngata e pā ana ki te mate pāpā o te taha o te roro o te wā, ka kore pāngia i muri i te pokanga. He iti ake te whai hua o te pokanga mō ngā pāngia whānui e pā ana ki te roro katoa mai i te tīmatanga, ahakoa ka taea e ētahi tikanga pēnei i te corpus callosotomy te āwhina ki te whakaiti i te kaha o te pāngia i ngā wā motuhake.

P2: Ko te pokanga mate pāpā te tikanga e kore rawa ahau e pāngia anō?

Ahakoa he maha ngā tāngata ka kore pāngia i muri i te pokanga, kāore i te taurangi mō te katoa. Tata ki te 60-70% o ngā tāngata e pokanga ana i te taha o te roro o te wā ka tutuki i te herekore pāngia katoa, i te wā e pā ana ki ētahi atu te whakaiti nui o te pāngia. Ahakoa kāore koe i te herekore pāngia katoa, ka taea e te pokanga te whakaiti i te auau me te kaha o te pāngia kia nui ake te whakapai ake i tō kounga oranga.

P3: Kia pēhea te roa o te whakaora mai i te pokanga mate pāpā?

Ko te whakaora tuatahi e 4-6 wiki te roa, i roto i tenei wa me whakaiti koe i nga mahi me te karo i te taraiwa. Ka roa pea te whakaora katoa i te 3-6 marama, me etahi whakapainga e haere tonu ana mo te rua tau. Ka taea e te nuinga o nga tangata te hoki ki te mahi i roto i te 6-12 wiki, i runga i nga whakaritenga o ta ratou mahi me te ahunga whakamua o te whakaora.

Q4: Me tango tonu e au nga rongoa hopu i muri i te pokanga?

Ka mau tonu te nuinga o nga tangata ki te tango rongoa anti-hopu mo te iti rawa e rua tau i muri i te pokanga, ahakoa ka kore he hopu. Ka awhina tenei ki te aukati i nga hopu i te wa o te whakaora me te tuku wa ki te whakatau i te angitu mo te wa roa o te pokanga. Mena ka noho kore koe i te hopu, ka whakaiti pea to taakuta i nga rongoa, ahakoa ka whiriwhiri etahi tangata ki te noho tonu ki te horopeta iti mo te haumarutanga atu.

Q5: Ka taea e te pokanga epilepsy te pa ki taku mahara, ki oku kaha whakaaro ranei?

Ka puta pea nga huringa mahara, ina koa i muri i te pokanga o te lobe temporal e uru ana ki te hippocampus. Heoi, he maha nga tangata e kite ana ka pai ake te mahi hinengaro whanui i muri i te pokanga na te pai ake o te whakahaere hopu me te whakaiti i nga paanga o nga rongoa. Ka whakahaerehia e to roopu pokanga nga whakamatautau neuropsychological taipitopito i mua me muri i te pokanga hei aroturuki i nga huringa me te awhina i a koe ki te urutau ki te hiahiatia.