BBC / عندما بدأ جون سيرل ينهار ويفقد ذاكرته، كان يظن نفسه يعاني الأعراض الأولى لمرض الخرف، لكن اتضح أنه يعاني مرضا نادرا عادة ما يخطئ الأطباء في تشخيصه، ويعرف في الأوساط الطبية باسم “الاستسقاء الدماغي الطبيعي الضغط”، وهو مرض له علاج.
وقبل بضعة أعوام، ظن جون سيرل أن حياته انتهت؛ كان جسمه قد بدأ في التوقف عن العمل، وكان يعاني مشاكل في المشي.
كان جون ينهار، وكانت ذاكرته القصيرة تخونه، ولاحظ أعراض الإصابة بسلس البول وهو في التاسعة والستين.
كان نسقًا من الانهيار يعرفه جون سيرل جيدا؛ ذلك أن أخت هذا المهندس الكندي ماتت مصابة بألزهايمر وهي في الخمسينيات من عمرها، ومات أبوه بالخرف في أوائل الثمانينيات من عمره، ومن ثم أخذ جون سيرل يخطط لمستقبل لن يكون قادرا على المشاركة في أنشطته.
لم يتمكن الأطباء من إعطائه تشخيصا حاسما، مما أجج غضب المهندس المتقاعد. ولم يُجْدِ معه علاج الشلل الرعاش نفعا؛ إذْ لم يكن مصابا بألزهايمر. وبحلول عام 2018، كان جون سيرل في حاجة إلى كرسي متحرك للتنزّه خارج المنزل وإلى مساند للمشي داخل المنزل.
يقول جون: “لم يكن هنالك من أمل، كنت أجلس في الشرفة أرقب حركة الحياة”.
وتقول زوجته بابارا: “كان غاضبا – بل كان قد تجاوز مرحلة الغضب. ومرت ليال كنت أفكر في أنني ربما اضطررت إلى بيع المنزل … لأنه كان عليّ أن أفعل أي شيء”.
لكن ذلك تغيّر بعد أن قابل الدكتور ألفونسو فاسانو، أخصائي الأعصاب في عيادة اضطرابات الحركة في مستشفى تورونتو التعليمي في كندا، والذي شخص المرض على أنه الاستسقاء الدماغي الطبيعي الضغط.
ويحدث ذلك الاضطراب نتيجة زيادة السائل النخاعي في بطينات الدماغ، حيث مركز الاتصالات في الدماغ.
هذه الزيادة في السائل يمكن أن تورث صعوبات في الحركة، ومشاكل في الذاكرة وفي الإدراك وأن تتسبب في الإصابة بـسلس البول – وهي أعراض عادة ما تصاحب الأمراض الانتكاسية كـ ألزهايمر والشلل الرعاش والخرف.
وبحسب تقديرات مؤسسة “هايدروسيفالوس كندا” فإن واحدا بين كل 200 كندي فوق سن 55، أو ما يزيد على 57 ألف شخص في كندا، يعانون من اضطراب الاستسقاء الدماغي الطبيعي الضغط.
وفي الولايات المتحدة، تقدر “رابطة الاستسقاء الدماغي” أن 700 ألف أمريكي مصابون بالمرض، لكن نسبة 20 في المئة فقط من هؤلاء المرضى يُشخّصون بشكل صحيح.
يقول دكتور فاسانو: “الاستسقاء الدماغي الطبيعي الضغط هو مرض لم تُكشَف غوامضه بشكل تام حتى الآن. وقد ينتهي الحال بمصابيه، إذ لم يتلقوا علاجا مناسبا، في بيت لرعاية العجَزة، أو الموت جراء المضاعفات. وهذا ما لا نرغب في رؤيته، أو أن يُترَك الناس بلا أمل”.
وكانت المرة الأولى التي سمع فيها جون سيرل عن الاستسقاء الدماغي الطبيعي الضغط عندما زار أحد الأخصائيين لعلاج صداع نصفي أصابه عام 2003، وكشف التصوير بالرنين المغناطيسي عن تجمّع سائل في بطينات الدماغ، ولكن لخلوّه من الأعراض المثيرة للشكوك، فإنه لم يُشخّص بذلك الاضطراب الدماغي.
وفي عام 2014، بعد عدة أعوام من اختبار أعراض محددة، كفقد الذاكرة وصعوبة الحركة، لجأ الأطباء إلى عمل “بزل قطني” لسحب بعض السائل من الدماغ ورؤية ما إذا كانت الأعراض ستختفي أو ستتحسن، في فحص متبّع للاستسقاء الدماغي الطبيعي الضغط.
ولمّا لم تختفِ الأعراض عن جون أو تتحسن حالته، قرر الأطباء المعالجون أن الاستسقاء الدماغي الطبيعي الضغط ليس سبب تلك الأعراض.
وبعد ثماني سنوات، تدهورت فيها صحته، التقى جون الدكتور فاسانو ووافق على إجراء الفحص مرة أخرى.
وفي هذه المرة، لاحظت زوجته باربارا تحسنا طفيفا للغاية، لدرجة أن زوجها لم يلحظ ذلك.
UNIVERSITY HEALTH NETWORKImage captionد. ألفونسو فاسانو يقول إنه وبينما يتم تشخيص معظم مرضى الخرف تشخيصا صحيحا، فإن نسبة صغيرة منهم يمكن أن تكون مصابة بالاستسقاء الدماغي الطبيعي الضغط
واقترح دكتور فاسانو إدخال أنبوب تحويلي في دماغ المريض لسحب السائل، وهو خط العلاج الأمامي لمواجهة مرض الاستسقاء الدماغي الطبيعي الضغط، وقد أثبت معدلات نجاح عالية بحسب الدراسات الحديثة.
وبعد مضيّ أكثر من عام، يقول جون سيرل إنه بدأ في استرداد حياته، وقد تحسنت مشيته وكذلك ذاكرته، وهو منتظم مع مدرب شخصي في صالة تمارين رياضية، كما يواظب على المشي لاستعادة قواه.
يقول جون: “العملية تقدم 50 في المئة فقط، والباقي على طريقة تفكير المريض”.
ورغم أن جون لم يستعِدْ بعدُ رخصته الخاصة بقيادة السيارة، فإنه وزوجته عاودا السفر مرة أخرى، وقد ذهبا إلى فلوريدا الشتاء الماضي، وهما يخططان للقيام برحلات إلى لاس فيغاس وغامايكا.
تقول باربارا إن التحدي الأكبر كان يتمثل في مزاج زوجها وحالته النفسية: “زال عنه ما أصابه من همّ، وعادت إليه روحه المرحة”.
ويقول دكتور فاسانو إنه ومنذ نشر قصة جون سيرل على وسائل الإعلام، اجتاح العيادة سيلٌ من طلبات المرضى ممن يؤملون أن يكونوا قد خضعوا لتشخيص خاطئ وأنهم يعانون مرض الاستسقاء الدماغي الطبيعي الضغط.
وعلى الرغم من شيوع مشكلة خطأ تشخيص مرض الاستسقاء الدماغي الطبيعي الضغط، فإن دكتور فاسانو يحذر من أن معظم المرضى الذين تم تشخيصهم بأنهم يعانون الشلل الرعاش أو ألزهايمر لم يخطئ الأطباء في تشخيصهم – لا سيما إذا كانوا خضعوا لفحص أخصائي أعصاب.
وبحسب دراسة يابانية جديدة، فإن نسبة تصل إلى ثلاثة في المئة من السكان ممن تجاوزت أعمارهم 65 عاما ربما يعانون مرض الاستسقاء الدماغي الطبيعي الضغط.
وتقدّر منظمة الصحة العالمية أن أمراض الخرف ومن بينها ألزهايمر، تصيب نسبة تتراوح بين خمسة إلى ثمانية في المئة من السكان الذين تتجاوز أعمارهم الستين عاما.
ويقول فاسانو: “هذا مرض ربما يكون شائعا أكثر مما نظن، وهو مرض قابل للعلاج بدرجة جيدة جدا، مما يهيء تغيرًا كبيرا في جودة حياة هؤلاء المرضى”.
ويضيف: “في الوقت ذاته، يظن الناس اليوم إذا ما كانوا يعانون الشلل الرعاش أنهم قد أسيء تشخيصهم، وكلهم يؤمل أن يكون الطبيب مخطئا”.
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