Carruurnimada Xanuunada Kobcinta Neuro

El Paso, TX. Chiropractor, Dr. Alexander Jimenez wuxuu eegayaa cilladaha korriinka caruurnimada, oo ay la socdaan calaamadahooda, sababaha iyo daaweynta.

Cudurka Dabaysha (Cerebral Palsy)

• Noocyada 4

• Cudurka maskaxda ee Spastic

• ~80% kiisaska CP

• Dyskinetic Cerebral Palsy (sidoo kale waxaa ku jira athetoid, choreoathetoid, iyo dystonic cerebral palsy)

• Ataxic Cerebral Palsy

• Isku-dhafan Cerebral Palsy

Carqalada Autism Spectrum

• Xanuunka Ootiisamka

• Cudurka Asperger

• Xanuunka Koritaanka Baahsan �Aan Si Kale Loo Sheegin (PDD-NOS)

• Burburka Carruurnimada (CDD)

Calaamadaha Casaanka ah ee Autism Spectrum Disorder

• Isgaarsiinta Bulshada

• Isticmaal xaddidan ee dhaqdhaqaaqyada
• Hadalka oo daah ama hadal la'aan
• Codad qaawan ama cod aan caadi ahayn
• Dhibaato samaynta indhaha, dhaqdhaqaaqyada iyo erayada isku mar
• Ku dayashada yar ee dadka kale
• Hadda ma isticmaasho erayadii ay isticmaali jireen
• Wuxuu u adeegsadaa gacan qof kale qalab ahaan

• Is dhexgalka bulshada

• Indhaha oo ay ku adkaato
• Hadal farxad la'aan
• La'aanta ka jawaabista magaca
• Iskuma dayo inuu ku tuso waxyaabaha ay xiisaynayaan

• Dabeecadaha soo noqnoqda & danaha xaddidan

• Hab aan caadi ahayn oo ay u dhaqdhaqaajiyaan gacmahooda, farahooda ama jidhkooda
• Wuxuu horumariyaa caadooyin, sida inuu safeeyo walxaha ama ku celcelinta waxyaabaha
• Diirada saara walxaha aan caadiga ahayn
• Xiisaha xad dhaafka ah ee shay gaar ah ama hawlo faragelinaya isdhexgalka bulshada
• Danaha dareenka aan caadiga ahayn
• Hoosta ama ka badan falcelinta galinta dareenka

Shuruudaha ogaanshaha ASD (DSM-5)

• Hoos u dhac joogta ah ee isgaarsiinta bulshada iyo is dhexgalka bulsheed ee dhinacyo badan, sida ay muujinayaan kuwan soo socda, hadda ama taariikhda (tusaaleyaal waa tusaaleyn, ma aha mid dhammaystiran; eeg qoraalka):

• Hoos u dhac ku yimaadda is-dhaafsiga shucuurta-bulsheed, oo u dhexeeya, tusaale ahaan, laga bilaabo hab-bulsheed oo aan caadi ahayn iyo guul-darrida wada-hadallada caadiga ah ee gadaal-iyo-ka-baxa; in la yareeyo wadaaga danaha, shucuurta, ama saameeya; inay ku guul darreysato inay bilowdo ama ka jawaabto isdhexgalka bulshada.

• Hoos u dhac ku yimaadda hab-dhaqannada is-gaarsiinta ee aan hadalka ahayn ee loo isticmaalo is-dhexgalka bulshada, oo u dhexeeya, tusaale ahaan, xiriirka af iyo aftahanimo oo liidata isku-dhafan; cilladaha aan caadiga ahayn ee xiriirka indhaha iyo luqadda jirka ama daciifnimada fahamka iyo isticmaalka dhaqdhaqaaqyada; guud ahaan la'aanta tibaaxaha wejiga iyo isgaarsiinta aan afka ahayn.

• Waxyeellada xagga horumarinta, ilaalinta, iyo fahamka cilaaqaadka, inta u dhaxaysa, tusaale ahaan, laga bilaabo dhibaatooyinka la qabsiga hab-dhaqanka si ay ugu habboonaato xaaladaha bulshada ee kala duwan; in ay ku adkaato in la wadaago ciyaarta mala-awaalka ah ama samaynta saaxiibo; maqnaanshaha xiisaha asxaabta.

Shuruudaha ogaanshaha ASD

• Habdhaqanka, danaha, ama hawlaha soo noqnoqda, xaddidan, sida ay muujiyeen ugu yaraan laba ka mid ah kuwan soo socda, hadda ama taariikhda (tusaaleyaal waa tusaaleyn, maaha mid dhammaystiran; eeg qoraalka):

• Dhaqdhaqaaqa mootooyinka ee la iskiciyay ama soo noqnoqda, isticmaalka walxaha, ama hadalka (tusaale, mootooyinka fudud ee mootooyinka, alaabta ciyaarta safka ah ama walxaha rogrogaya, echolalia, odhaahyo sarbeeb ah).

• Ku adkeysiga isku midnimada, u hoggaansanaanta dabacsanaanta joogtada ah, ama qaababka dhaqanka afka ama aan hadalka ahayn (tusaale, xad dhaaf ah cidhiidhi ku jira isbeddellada yaryar, dhibaatooyinka kala-guurka, hababka fikirka adag, caadooyinka salaanta, waxay u baahan yihiin in la qaato waddo isku mid ah ama cunto isku mid ah maalin kasta).

• aadka u xaddidan, danaha go'an ee aan caadiga ahayn xoog ahaan ama diiradda saaraya (tusaale, ku dheggan xooggan ama ku mashquulida walxo aan caadi ahayn, si xad dhaaf ah loo guday ama dulqaadasho danaha).

• Hyper- ama Hyporeactivity ee gelinta dareenka ama xiisaha aan caadiga ahayn ee dhinacyada dareenka deegaanka (tusaale danayn la'aanta muuqata ee xanuunka / heerkulka, jawaab celinta xun ee dhawaaqyada gaarka ah ama textures, ur xad dhaaf ah ama taabashada walxaha, xiisaha aragga ee iftiinka ama dhaqdhaqaaqa).

Shuruudaha ogaanshaha ASD

• Calaamaduhu waa in ay muuqdaan xilliga korriinka hore (laakin waxa laga yaabaa in aanay si buuxda u muuqan ilaa ay baahida bulshadu dhaafto awoodo xaddidan, ama laga yaabo in lagu qariyo xeelado la bartay nolosha dambe).

• Calaamaduhu waxay sababaan cillad caafimaad oo weyn xagga bulshada, shaqada, ama meelaha kale ee muhiimka ah ee shaqada hadda jirta.

• Rabshadahan si fiican looma sharaxo itaaldarrada garaadka (cilladda korriinka garaadka) ama daahitaanka korriinka caalamiga ah. Naafanimada maskaxeed iyo xanuunka autism-ka ee spectrum spectrum si joogto ah ayaa u dhaca; si loo sameeyo baadhitaanada isku dhafan ee xanuunka autism-ka iyo naafanimada garaadka, xidhiidhka bulshadu waa inuu ka hooseeyaa heerka la filayo heerka korriinka guud.

Shuruudaha ogaanshaha ASD (ICD- 10)

A. Horumar aan caadi ahayn ama daciifin ayaa ka muuqda ka hor da'da 3 sano ugu yaraan mid ka mid ah meelaha soo socda:

• Luuqadda soo dhawaynta ama muujinta sida loo isticmaalo xidhiidhka bulshada;

• Kobcinta isku xirnaanta bulsheed ee xulashada ah ama isdhexgalka bulsho ee isdhaafsiga;

• Ciyaar hawleed ama calaamad.

B. Wadarta ugu yaraan lix calaamadood oo ka yimid (1), (2) iyo (3) waa inay jiraan, ugu yaraanna laba ka yimid (1) iyo ugu yaraan mid kasta oo ka mid ah (2) iyo (3)

1. Laxaad la'aanta tayada ee isdhexgalka bulshada waxay ka muuqataa ugu yaraan laba ka mid ah meelaha soo socda:

a. ku guuldareysiga in si ku filan loo isticmaalo fiirsashada isha, muuqaalka wejiga, muuqaalka jirka, iyo dhaqdhaqaaqyada si loo xakameeyo isdhexgalka bulshada;

b. guuldarada in ay horumarto (hab ku habboon da'da maskaxda, iyo in kasta oo ay jiraan fursado badan) xidhiidhada asaagga ah ee ku lug leh wadaagga danaha, hawlaha iyo dareenka;

c. la'aanta is-dhaafsiga shucuurta-bulsho-bulsho sida ay muujisay jawaab-celin daciif ah ama ka leexday shucuurta dadka kale; ama habdhaqan la'aanta habdhaqanka sida uu qabo
macnaha guud ee bulshada; ama is dhexgalka daciifka ah ee dabeecadaha bulsheed, shucuureed, iyo isgaarsiinta;

d. la'aanta raadinta kediska ah si ay ula wadaagaan raaxaysiga, danaha, ama guulaha dadka kale (tusaale la'aanta muujinta, keenida, ama u tilmaamida dadka kale walxaha xiisaha u gaarka ah).

2. Is-gaarsiinta aan caadiga ahayn ee tayada leh sida ka muuqata ugu yaraan mid ka mid ah meelaha soo socda:

a. daahitaanka ama wadarta la'aanta, horumarinta luqadda lagu hadlo oo aan la socon isku dayga lagu magdhabo iyadoo la adeegsanayo tilmaanta ama mime-ka qaab kale oo isgaarsiineed (inta badan waxaa ka horreeya la'aanta af-gambiyeedka isgaarsiinta);

b. ku guuldaraysiga in la bilaabo ama la joogteeyo isweydaarsiga wada hadalka ( heer kasta oo ay tahay xirfad luqadeed), kaas oo ay jirto jawaab celin is-dhaafsi ah oo ku aaddan isgaarsiinta qofka kale;

c. isticmaalka afka qallafsan ee soo noqnoqda ama isticmaalka ereyada ama odhaahyada;

d. la'aanta ciyaar iskeed u gaar ah oo kala duwan ama (marka ay yar tahay) ciyaarta ku dayashada bulshada

3. Habdhaqanka, xiisaha, iyo hawlaha xaddidan, soo noqnoqda, iyo qaab-dhismeedku waxay ka muuqdaan ugu yaraan mid ka mid ah kuwan soo socda:

a. Mashquul koobsan oo leh hal ama in ka badan oo la isku halleyn karo oo qaababka xiisaha leh ee aan caadiga ahayn ee nuxurka ama diiradda; ama mid ama in ka badan oo dano ah oo aan caadi ahayn xooggooda iyo dabeecadda hareeraysan inkasta oo aanay ku jirin nuxurkooda ama diiradda;

b. Sida muuqata u hoggaansanaanta qasabka ah ee gaarka ah, caadooyinka aan shaqaynayn ama caadooyinka;

c. Dhaqdhaqaaq dhaq-dhaqaaq ah oo soo noqnoqda oo soo noqnoqda oo ku lug leh gacan ama farta oogada ama leexinta ama dhaqdhaqaaqa jirka oo dhan kakan;

d. Ku mashquulida walxaha qayb ka mid ah walxaha aan shaqaynayn ee alaabta ciyaarta (sida oderkooda, dareenka dushooda, ama buuqa ama gariirka
dhalin).

C. Sawirka bukaan-socodku maaha mid loo aaneynayo noocyada kale ee cudurrada korriinka ee baahsan; cillad horumarinta gaarka ah ee luqadda soo dhaweynta (F80.2) oo leh dhibaatooyin bulsheed-dareen labaad, cillad ku-xirnaansho falcelineed (F94.1) ama cillad la'aanta lifaaqa (F94.2); Dib u dhac maskaxeed (F70-F72) oo leh qaar ka mid ah xanuunada shucuureed ama habdhaqanka; schizophrenia (F20.-) ee bilawga aan caadiga ahayn; iyo Rett Syndrome (F84.12).

Shuruudaha ogaanshaha cudurka Asperger Syndrome (ICD-10)

• A. Laxaad la'aanta tayada ee isdhexgalka bulshada, sida ay muujiyeen ugu yaraan laba ka mid ah kuwan soo socda:

• cillado calaamadeysan ee isticmaalka dhaqamo badan oo aan hadal ahayn sida indho-u-eegis, muujinta wejiga, muuqaalka jirka, iyo dhaqdhaqaaqyada lagu xakameynayo isdhexgalka bulshada.
• ku guuldareysiga in la horumariyo xiriirka asxaabta ku haboon heerka korriinka.
• la'aanta raadinta kediska ah si ay ula wadaagto raaxaysi, dan, ama guulo lala wadaago dadka kale (tusaale la'aanta muujinta, keenista, ama tilmaamida walxaha ay xiiseynayaan dadka kale).
• la'aanta is-dhaafsiga bulsho ama dareen.

• B. Hababka dhaqanka, danaha, iyo hawlaha soo noqnoqda ee la xaddiday, sida uu muujiyay ugu yaraan mid ka mid ah kuwan soo socda:

• oo koobaya mashquulinta hal ama ka badan oo qaabaysan oo xaddidan qaababka xiisaha taas oo aan caadi ahayn ama xoog ahaan ama diiradda.
• u hoggaansanaan la'aan sida muuqata, caadooyin gaar ah, aan shaqaynayn ama caadooyin.
• hab-dhaqan-dhaqaale maskaxeed oo soo noqnoqda (tusaale, gacanta ama farta oo ruxma ama maroojin, ama dhaqdhaqaaqyo jidhka oo dhan kakan).
• mashquulka joogtada ah ee qaybo ka mid ah walxaha.
  

  C. Khalkhalku wuxuu keenaa cillad caafimaad oo weyn xagga bulshada, shaqada, ama meelaha kale ee muhiimka ah ee shaqada

  D. Ma jiro dib u dhac guud oo caafimaad ahaan muhiim ah oo luqadda ah (tusaale, kelmado keli ah oo ay adeegsadaan da'da 2 sano, weedhaha isgaadhsiinta ee loo isticmaalo da'da 3 sano).

  E. Ma jiro dib u dhac caafimaad oo weyn oo ku yimaadda horumarka garashada ama horumarinta xirfadaha is-caawinta ee ku habboon da'da, hab-dhaqan la-qabsiga (marka laga reebo isdhexgalka bulshada), iyo xiisaha loo qabo deegaanka carruurnimada.

  F. Shuruudaha laguma daboolin cudur kale oo gaar ah oo korriin ah ama Schizophrenia.

Feejignaan-Deficit/Xan-karnimo (ADHD)

• Diidmada – si fudud uga baxa hawsha
• Dhiirranaanta - waxay u muuqataa inay si joogto ah u socoto
• Saameyn la'aan - wuxuu sameeyaa falal degdeg ah oo dhaca wakhtigan xaadirka ah isaga oo aan marka hore ka fikirin

Arrimaha Khatarta ADHD

• genetics
• Sigaar cabista, isticmaalka khamriga, ama isticmaalka maandooriyaha xilliga uurka
• Soo-gaadhista sunta deegaanka xilliga uurka
• Soo-gaadhista sunta deegaanka, sida heerarka sare ee rasaasta, da'da yar
• Miisaanka ilmaha yar
• Maskaxda dhaawacyo

Baaritaanka Koritaanka

www.cdc.gov/ncbddd/autism/hcp-screening.html

Falcelinta asaasiga ah

• Moro
• Spinal Galant
• Reflex Tonic Tonic ah
• Ka-soo-celinta Qoorta Tonic-ka ah
• Reflex tonic Labrynthine
• Dareen-celinta Palmomental
• Dib-u-kicinta Snout

Daawaynta Dib u Dhaca Korniinka

• Dib u hagaaji falcelin kasta oo la hayo
• Bar waalidiinta bixinta deegaan habaysan
• Kor u qaad hawlaha dheellitirka maskaxda
• Wax ka qabashada dareenka cuntada oo ka saar cuntooyinka dhibka leh
• U dawee mindhicirka bukaanka – probiotics, glutamine, iwm.

Cudurka Carruureedka Ba'an-Bilawga Neuropsychiatric Syndrome

(PANS)

• Bilawga lama filaanka ah ee OCD ama qaadashada cunto aad u xaddidan

• Calaamadaha si fiican looma sharaxo xanuunka neerfaha ama xanuunka caafimaad ee la yaqaan

• Sidoo kale ugu yaraan laba ka mid ah kuwan soo socda:

• Walaaca
• Awood-niyad ahaan iyo / ama niyad-jabka
• Xanaaq, gardarro iyo/ama dabeecado mucaaradnimo daran
• Dib-u-dhac ku yimaada hab-dhaqan/horumar
• Waxqabadka dugsiga oo sii xumaanaya
• Xasaasiyadaha ama miyir-beelka
• Calaamadaha somatic oo ay ku jiraan hurdo la'aan, enuresis ama inta jeer ee kaadida

• *Bilawga PANS waxa laga yaabaa in uu ku bilaabo walaxyo faafa oo aan ahayn strep. Waxa kale oo ka mid ah bilawga kiciyeyaasha deegaanka ama hawlgabka difaaca

Cudurada Isgaadhsiinta Carruurta ee La Xiriira Streptococcus

(PANDAS)

• Joogitaanka waswaaska muhiimka ah, qasbida iyo/ama tics

• Calaamadaha sida lama filaanka ah u bilaabma ama koorsada soo noqnoqonaysa ee calaamadaha darnaanta

• Bilawga qaangaadhnimada ka hor

• La qabsiga caabuqa streptococcal

• La qabsiga calaamadaha kale ee neerfayaasha (oo ay ku jiraan mid ka mid ah calaamadaha PANS ee la socda)

Tijaabooyinka PANS/PANDAS

• Dhaqanka Swab/Step
• Tijaabada dhiigga ee strep
• Strep ASO
• Anti-DNase B Titer
• Streptozyme
• Tijaabi maaddooyinka kale ee faafa
• MRI ayaa doorbiday laakiin PET waa la isticmaali karaa haddii loo baahdo
• EEG

Negative been ah

• Dhammaan carruurta qabta strep ma laha shaybaar sare

• Kaliya 54% carruurta qaba strep waxay muujiyeen koror weyn oo ASO ah.
• Kaliya 45% waxay muujisay koror anti-DNase B.
• Kaliya 63% waxay muujisay koror ASO iyo/ama anti-DNase B.

Daawaynta PANS/PANDAS

• Antibiyootikada
• IVIG
• Plasmaphoresis
• Nidaamyada ka hortagga bararka
• Daawooyinka isteeroodhka
• Omega-3s
• NSAIDS
• fogaado

Rugta Caafimaadka Dhaawaca: Dhakhaatiirta laf dhabarta (lagu taliyay)

Ilaha

1. �Attention Deficit Hyperactivity Disorder.
2. Autism Navigator, www.autismnavigator.com/.
   �Autism Spectrum Disorder (ASD).
3. Hordhaca Ootiisamka.� Interactive Autism Network, iancommunity.org/introduction-autism
4. Shet, Anita, iyo al. Jawaabta Difaaca ee Kooxda A Streptococcal C5a Peptidase ee Carruurta: Saamaynta Horumarinta Tallaalka. 188, maya. 6, 2003, bogga 809�817., doi:10.1086/377700.
5. Waa maxay PANDAS?