Convulsions in children are not uncommon. This is due to the hereditary characteristics of nerve cells, the immaturity of the brain and the central nervous system. Not the last role was played by the increased number of successfully nursed children, who in the past centuries simply did not live up to seizures, children from emergency CS due to placental abruption, premature babies weighing less than 1.5 kg. Thus, today, approximately one in 50 children suffer from the syndrome, and more than half of all cases occur in the first three years of life.
Seizures: symptom description and types
Cramps are involuntary muscle contractions. Of course, experts know what to do in this case. But when this happens to a child, parents and adults who are nearby can be confused. This spectacle is not for the faint of heart, so you need to know how you can help the baby. First aid will be discussed later. Now consider the types of seizures in children.
Tonic isprolonged muscle tension or spasm. The child can throw back his head, strain and stretch his lower limbs, turn his palms outward, spread his arms. In some cases, difficulty in breathing with cyanosis of the nasolabial triangle, reddening of the face is characteristic. Clonic - fast, usually 1-3 twitches per second.
According to localization and prevalence, clonic seizures can be focal, myoclonic, tonic-clonic or fragmentary. Focal are characterized by twitching of the arms and legs, parts of the face. Myoclonic are contractions of a particular muscle or group of muscles.
Fragmentary convulsions are characterized by head nodding, limb flexion, eye symptoms, and there may be loss of consciousness or cessation (significant difficulty) of breathing. Tonic-clonic are characterized by alternating contractions and increased muscle tone.
Epileptic convulsions
All convulsions in children are divided by doctors into epileptic and non-epileptic ones, and the latter can “grow” into the former over time. Only a specialist can make a diagnosis of epilepsy by carefully examining the child's medical record. At the same time, attention is paid not only to the possible causes of the convulsive syndrome and risk factors, but also to whether there is a hereditary predisposition to seizures. If there is no unfavorable heredity, the child's central nervous system is normal, there are no characteristic changes on the electroencephalogram, then doctors refrain from an accurate diagnosis of epilepsy, considering seizures to be non-epileptic.
Non-epileptic seizures
Such convulsionschildren occur relatively often. Seizures can be caused by many factors. As a rule, convulsive syndrome is observed in infants, but older babies can also suffer from it, for example, with high fever and infectious diseases. Consider first the causes of seizures in a child in the first month of life:
- birth trauma (brain hemorrhage, tissue damage);
- low sugar (hypoglycemic cramps);
- oxygen starvation, which leads to cerebral edema;
- low zinc in newborn blood (fifth day cramps);
- toxic effects of bilirubin on the central nervous system (hemolytic disease);
- violation of calcium metabolism (spasmophilia, or tetanic convulsions);
- violation of the metabolism of vitamin B6, or pyridoxine;
- congenital heart defects and diseases of the cardiovascular system;
- development of brain defects (occur rarely, about 10% of all cases);
- Maternal use of alcohol, drugs, certain medications (withdrawal spasms) during pregnancy.
The risk group includes premature babies, small babies born as a result of an emergency caesarean section.
Earst of all, convulsions may occur, caused by birth trauma or asphyxia. The syndrome develops in the first eight hours of a baby's life. When blood sugar levels are low (hypoglycemic seizures), the symptom is accompanied by sweating, restless behavior, hyperactivity, andbreathing. Such convulsions appear in the first two days.
Fifth day cramps occur between the third and seventh days of an infant's life. What do seizures look like in a child? These are short-term twitches, shudders, head nods, twisting and bringing fingers together, a "spasm" of looking up, which can be repeated up to forty times a day. If the symptom is accompanied by jaundice, then we can talk about convulsions against the background of hemolytic disease.
Convulsions due to neonatal asphyxia
The most common cause of seizures in infants is suffocation, or asphyxia. The symptom is manifested as a result of circulatory disorders, due to a lack of oxygen in tissues and organs, an excess of carbon dioxide. In most cases, this phenomenon leads to pinpoint hemorrhages in the brain and edema. The newborn needs immediate medical attention, as a long stay in this state can cause brain atrophy and irreversible pathological changes.
Convulsions in children with oxygen starvation occur if childbirth proceeds with complications, for example, if placental abruption occurs, the umbilical cord wraps around the neck, the water leaves too early, the birth process is excessively delayed. Alarming symptoms in this case will stop almost immediately, as soon as the child is taken out of the state of oxygen starvation. The swelling of the brain in this case disappears, and the condition of the newborn gradually returns to normal.
Cramps due to birth trauma
Whydoes the child have seizures? With a birth injury, this happens due to hemorrhages in the brain. Usually they are local in nature, accompanied by spasms of the muscles of the face. Often in this case, there are cramps in the legs of the child. There may also be general weakness in the muscles, shaking of the whole body is possible. Usually, this causes cyanosis of the skin (especially the face), breathing becomes difficult, and vomiting may occur.
If you do not stop the internal bleeding in time, then convulsions may not be noticed immediately, but only on the fourth or fifth day after birth. This will be the result of an expanding hematoma. As a rule, such convulsions in a child pass without fever. They may appear later, for example, after two to three months. This happens due to the adhesive process, the formation of cysts, scarring. Seizure triggers can be vaccinations, injury, or illness.
During infectious diseases
Quite often there are convulsions in a child with a temperature. Moreover, not only children with birth trauma or respiratory failure suffer, but also completely he althy and full-term babies. This is due to the toxicity of the virus and the general weakening of the body against the backdrop of fever, the condition negatively affects the central nervous system.
Often, convulsions in a child at a high temperature appear against the background of the acute phase of SARS or influenza, with active rashes of measles, chicken pox and rubella. The tension of the whole body, which is accompanied by swelling of the brain, an increase in intracranial pressure canoccur against the background of encephalitis and other neuroinfections. As a rule, convulsions in a child with a high temperature disappear when the state of he alth returns to normal.
Other causes of seizures
It is not uncommon for small children to have seizures in response to a prophylactic vaccination. This is especially a problem for infants who have suffered asphyxia, emergency caesarean section, birth trauma, diathesis (exudative). For children who have a high degree of convulsive readiness, preventive vaccinations are contraindicated.
No less urgent problem that can cause seizures in a child's sleep or while awake are various metabolic disorders. At the same time, there is a lack of calcium, magnesium, potassium in the body, and convulsions are manifested by a distortion of the facial expression.
Thus, the most common causes of convulsions in children in infancy are birth trauma, asphyxia during childbirth, too long a birth process, early discharge of water, and so on. If the convulsive syndrome appeared on the background of viral or other diseases, but after the cure, the basis of the disease did not disappear, then it is imperative to show the child to the pediatrician in order to exclude the development of epilepsy.
Signs of convulsions at temperature
During convulsions, the child does not respond to the parents' words, actions, loses contact with the outside world, stops screaming and crying. Possible blue skin, difficulty or holding your breath.
Baby can throw back his head, then permanentthe tension of the whole body is gradually replaced by short-term twitches, they gradually fade. Limbs may twitch, eyes roll back, convulsions with sudden muscle relaxation, involuntary bowel movements and urination.
Such convulsions rarely last more than fifteen minutes. In some cases, the symptom may occur in series of one to two minutes, but goes away on its own. If a child has convulsions at a temperature, what should I do? The actions of parents should be consistent and calm. What exactly to do? Read below.
First aid for a child with convulsions
What help should parents provide to a child with convulsions? First of all, you need to call an ambulance. The child is laid on a flat surface on its side so that the head and chest are in line. You can not move the cervical spine. It is important to lay the baby so that he does not fall. There should be no objects around that can hurt you. It is necessary to free the chest and neck of the baby from tight clothing, to ensure free breathing.
It is necessary to ventilate the room, the optimum temperature is about 20 degrees Celsius. Do not forcibly restrain the child from involuntary movements, do not open his jaws, insert a finger, spoon or any other object into his mouth.
If a child has a seizure for the first time, do not refuse hospitalization. At a minimum, it is necessary to show the baby to the doctor as soon as possible after an attack, it is worth contacting not only a pediatrician, but also a neurologist. The specialist will offer a number of studies, including biochemical and clinical blood tests, EEG, to determine the causes of the convulsive syndrome.
Temperature spasm treatment
If convulsions at a temperature in a child occur rarely, last no more than 15 minutes, then no special treatment is needed. It is enough to cool the baby's body by any available means (selection with a weak vinegar solution, a cold towel on the forehead and in the armpits, inguinal folds, bends under the elbows and knees).
After the attack stops, you need to give an antipyretic. With frequent and prolonged convulsions, intravenous anticonvulsant drugs will be required, but the need for this will be determined by the doctor. Phenobarbital, Diazepam, or Lorazepam may also be prescribed.
A child with convulsions should not be left alone. During an attack, do not give any medicines, water, food to avoid suffocation.
Seizure relief
What to do with convulsions in a child? Ambulance doctors can administer intravenously a glucose solution (25%) at a dosage of 4 ml per kilogram of weight, vitamin B6, or pyridoxine (50 g), "Phenobarbital" intravenously (from 10 to 30 mg per kilogram of weight), magnesium solution (50%), 0.2 ml per kilogram, calcium gluconate solution (2 ml per kilogram of weight).
Epileptic seizures in children
In childhood, epilepsy is quite common, but its diagnosis is difficult. Children'sthe body has a high threshold for seizure activity, but most often seizures develop that are not actually associated with epilepsy. Due to these difficulties, doctors are in no hurry to diagnose babies with epilepsy.
The most common causes of this disease in preschool children are:
- Heredity. Scientists are increasingly expressing the opinion that it is not the disease itself that can be obtained from parents, but only a predisposition to it. Each person has a certain convulsive status inherent exclusively to him. The realization of predisposition depends on many factors.
- Disturbances in the development of the brain. CNS development disorders can be caused by infections, genetics, exposure of the expectant mother to harmful substances during pregnancy (alcohol, drugs, certain medications), her diseases.
- Various infectious diseases. The earlier the child had an infection with seizures, the more likely it is to develop epilepsy in the future. As a rule, encephalitis and meningitis become the causes. But with a predisposition to epilepsy, any disease can "start" the disease.
- Head injury. Characteristically, seizures in epilepsy do not appear immediately after the injury, but only after some time. This is a distant consequence of the action of the traumatic factor on the brain.
The onset of the disease can be skipped. Seizures at first may be rare and short-lived, the condition is accompanied by sleepwalking, the occurrenceunreasonable fears, depressed mood, bouts of pain in various organs, behavioral disorders. If these symptoms appear again and again, then you need to see a doctor.
Treatment of epileptic convulsive seizures is always selected taking into account the individual characteristics of the child. There are no general treatment regimens. For each child, not only the optimal regimen and dosage should be drawn up, but also the best combinations of drugs. There is no quick cure for epilepsy. Therapy is always very long, drugs should be discontinued slowly, switching to another drug should be done gradually.
Possible effects of seizures
In most cases, seizures that occur in infancy do not remain a trace when the baby grows up. In children under one year old, the brain recovers quite quickly, and its development has not yet been completed. But the more serious the convulsions (more often and longer the seizures), the stronger the oxygen starvation, that is, quite serious consequences can be expected. In this case, be sure to show the baby to the doctor.
If the matter concerns epilepsy, then complex treatment is necessary, a serious approach to the disease, constant monitoring by an epileptologist. Without containment of the disease as it progresses, each new seizure can reduce the intellectual abilities of the child, which can lead to serious consequences. Treatment, as mentioned above, should be comprehensive and individually selected.
