2025 Movement Disorders Clinical Practice Ongororo yeGore
Kutyisidzira kuri kuuya kwe subacute sclerosing panencephalitis: Kudanwa kwechiito

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Gwirikwiti, rinokonzerwa ne Utachiona hweMorbillivirus Virusi remagumbeze (MeV), riri kuwedzera pasi rose pari zvino, nekuwedzera kukuru kwakaonekwa muna 2024-2025 munzvimbo dzakasiyana siyana, kusanganisira US, Europe, Canada neMexico.¹ Subacute sclerosing panencephalitis (SSPE) ndeimwe yematambudziko akaipisisa enguva refu egwirikwiti, ayo anokura mushure meavhareji yekunonoka kwemakore 7-10 mushure mekugwinhwa. Kunyangwe huwandu hwekureruka kwechirwere hunosvika 6% hwakataurwa, SSPE inowanzo enderera mberi uye pakupedzisira inouraya. Kusashanda zvakanaka kwejekiseni hakuna kungokonzera kupararira kwegwirikwiti chete, asiwo kune njodzi yekunonoka kwehuwandu hwezviitiko zveSSPE mumakore anotevera. SSPE inokonzerwa nekuramba kuripo kweMeV yakachinja muuropi, zvichikonzera kukuvara kwetsinga uye kuzvimba.  

SSPE inokanganisa vana nevechiri kuyaruka, kunyange hazvo nyaya dzevakuru dzichiri kuzivikanwa zvakanyanya. Inoratidzwa nekusangana kwakasiyana kwezvirwere zvepfungwa zvinofambira mberi, kurasikirwa nekuona, pfari, uye matambudziko ekufamba. Kuongororwa kunoenderana nekusanganiswa kwezviratidzo zvekiriniki nerabhoritari.^2,3 Chinonyanya kubatsira pakuongororwa kwechirwere ndechekuvapo kwemagetsi akajairika, marefu, uye ma generalized periodic complexes pa electroencephalography, anonzi Radermecker discharges, pamwe ne higher serum uye cerebrospinal fluid anti-glands antibody titers. Nzira iyi inowanzo enderera mberi, ichiguma nerufu. Parizvino, hapana mushonga unorapa, uye kurapwa kunoenderana nekurapa kunotungamirirwa nezviratidzo pamwe chete ne antiviral uye/kana immunomodulatory therapy, izvo zvisinganyanyi kushanda mukuderedza kufambira mberi kwechirwere.⁴ Ongororo ichangobva kuburitswa mu Movement Disorders Clinical Practice (MDCP) uye yakapihwa "2025 Review Article of the Year" muMDCP yakatsanangura zvinhu zvakakosha, pathophysiology, kurapwa uye mhedzisiro yezvirwere zvekufamba muSSPE.⁵ Basa iri, rakaitwa pasi pechirongwa cheMDS Infection-Related Movement Disorders Study Group, rakanangana nekuwedzera ruzivo uye kuwedzera kuzivikanwa kweSSPE pakati penyanzvi dzezvirwere zvekufamba. 

Matambudziko ekufamba anoonekwa muhuwandu hwakawanda hwevarwere vane SSPE, kubva pa1.6-56% yevarwere. Zvinofadza kuti, matambudziko ekufamba anogona kuitika chero padanho ripi zvaro rechirwere uye dzimwe nguva ndiwo anowanzoonekwa. Izvi zvinosanganisira ataxia, hyperkinetic (myoclonus, dystonia, chorea, tics, stereotypies, repetitive behaviors, operating faults, eye movement abnormalities) uye hypokinetic (parkinsonism, akinetic-rigid states). Kushanduka kwenguva kwezviratidzo izvi zvekufamba kunowanzoita kuti chirwere chienderane, neataxia, chorea, uye dystonia zvichitora matanho ekutanga, uye parkinsonism ichizobuda gare gare, zvichizoguma ne preterminal akinetic-rigid state.  

Kufamba kusingawanzoitiki, kunoonekwa sechiratidzo cheSSPE, i myoclonus. Myoclonus, inoonekwa mu84-92% yevarwere, ine chiitiko chinoshamisa, chinoratidzwa nedanho rekutanga nekukurumidza rinoteverwa nekuzorora zvishoma nezvishoma. Nekuda kwehunhu hwayo hwakasiyana, tsananguro dzakadai se 'dystonic' myoclonus, 'hung-up' myoclonus, uye pseudomyoclonus dzakashandiswa. Zvechokwadi, mavambo e myoclonus muSSPE achiri nyaya yemakakatanwa, vanachiremba veepilept vachiti mavambo e cortical epileptic (achitsigirwa nehunhu hwayo hwenguva refu neEEG discharges uye mhinduro yakajairika kumishonga ye anti-myoclonus antiseizure) uye nyanzvi dze movement disorder dzinofarira subcortical mavambo nekuda kwekupedzisira kwayo kunononoka kuzorora. Chimwe chirwere che movement disorder chinowanzoitika i dystonia, iyo inogona kufambira mberi kuita status dystonicus. Pasinei nezviratidzo zvekiriniki zvakanaka, radiological correlates haisati yawanikwa, ne MRI yakajairika isingaratidze zviratidzo zvakasiyana zve movement disorder-specific. 

Nerombo rakanaka, SSPE chirwere chinodzivirirwa nejekiseni. Sangano reWorld Health Organization (WHO) rinotsigira madosi maviri ekudzivirira gwirikwiti muvana, sezvo dosi imwe chete ingasapa dziviriro yehupenyu hwese.⁶ Hukama huripo pakati pekubaiwa nhomba nemhedzisiro yakananga pakudzikira kwegwirikwiti uye SSPE inotevera hwakasimbiswa zvakanaka mukuongorora kwezvirwere.⁷  

Saka kumukazve kwechirwere chegwirikwiti pasi rose kuri kuda kuti pavezve nemabasa ekudzivirira chirwere ichi, uye panguva imwe chete, kusimbisa tsvakiridzo yekurapa zvirwere zveSSPE. Kune nyanzvi dzezvirwere zvekufamba, kungwarira kwakakosha, kwete chete pakuzivikanwa nekukurumidza uye kurapwa kwezviratidzo asiwo pakubatsira mukutsigira kudzivirirwa kwezvirwere zvakasiyana-siyana. 

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References 

1. CDC. Nyaya dzeGuruva neKupararira kweGuruva. ​​Guruva (Rubeola). Mbudzi 5, 2025. Yakasvikwa musi wa9 Mbudzi, 2025. https://www.cdc.gov/measles/data-research/index.html 
2. Jafri SK, Kumar R, Ibrahim SH. Subacute sclerosing panencephalitis - maonero aripo iye zvino. Pediatric Health Med Ther. 2018;9:67-71. doi:10.2147/PHMT.S126293 
3. Dyken PR. Subacute sclerosing panencephalitis. Mamiriro azvino. Neurol Clin. 1985;3(1):179-196. 
4. Garg D, Sharma S. Kurapa Kuchinja Zvirwere muSubacute Sclerosing Panencephalitis: Nzvimbo yeRima. Ann Indian Acad Neurol. 2023;26(1):3-9. doi:10.4103/aian.aian_655_22 
5. Garg D, Patel S, Sankhla CS, nevamwe. Matambudziko ekufamba muvarwere vane Subacute Sclerosing Panencephalitis: Ongororo Yakarongeka. Mov Disord Clin Pract. 2024;11(7):770-785. doi:10.1002/mdc3.14062 
6. Gwirikwiti. Yakasvikwa musi wa9 Mbudzi, 2025. https://www.who.int/news-room/fact-sheets/detail/gwikwiti 
7. Mishonga yekudzivirira gwirikwiti. Yakasvikwa musi wa9 Mbudzi, 2025. https://www.who.int/groups/global-advisory-committee-on-vaccine-safety/topics/measles-vaccines 

 

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