Convulsions in children are not uncommon. This is due to hereditary features of nerve cells, immaturity of the brain and 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 survive to cramps, children from emergency CS due to placental abruption, premature babies weighing less than 1.5 kg. Thus, approximately every 50th child suffers from the syndrome today, and more than half of all cases occur in the first three years of life.
Cramps: symptom description and types
Cramps are involuntary muscle contractions. Of course, experts know what to do in this case. But when this happens to the child, parents and adults who are close by can be confused. The sight 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 is a prolonged muscle tension or spasm. A child can throw his head back, strain and stretch his lower limbs, turn his palms outward, spread his arms. In some cases, characterized by difficulty breathing with cyanosis of the nasolabial triangle, redness of the face. Clonic - fast, usually 1-3 jerks per second.
By localization and prevalence, clonic convulsions 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 specific muscle or muscle group.
Fragmentary cramps are characterized by nodding of the head, limb flexion, eye symptoms, loss of consciousness or respiratory arrest (significant difficulty) may occur. Tonic-clonic differ in the alternation of contractions and increased muscle tone.
Epileptic seizures
Doctors divide all convulsions in children into epileptic and non-epileptic, moreover, the latter may eventually “develop” into the former. Only a specialist can diagnose “epilepsy” by carefully examining the child’s medical record. At the same time, they pay attention 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 adverse heredity, the central nervous system of the child is normal, there are no characteristic changes in the electroencephalogram, then the doctors refrain from an accurate diagnosis of “epilepsy”, considering the seizures to be non-epileptic.
Non-epileptic seizures
Such cramps in children occur relatively often. A seizure can cause many factors. As a rule, convulsive syndrome is observed in infants, but older children can also suffer from it, for example, at high temperature 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 convulsions);
- oxygen starvation, which leads to cerebral edema;
- low zinc content in the blood of a newborn (fifth day cramps);
- toxic effects of bilirubin on the central nervous system (hemolytic disease);
- impaired calcium metabolism (spasmophilia, or tetanic convulsions);
- metabolic imbalance of vitamin B6, or pyridoxine;
- congenital heart defects and diseases of the cardiovascular system;
- development of brain defects (rarely occur, approximately 10% of all cases);
- the use by the mother during pregnancy of alcohol, drugs, certain medications (withdrawal cramps).
The risk group includes premature babies, underweight, born as a result of emergency caesarean section.
The most common cramps can be caused by birth injury or asphyxiation. The syndrome develops in the first eight hours of an infant's life. With low sugar levels (hypoglycemic convulsions), the symptom is accompanied by sweating, restless behavior, hyperactivity and respiratory failure. Such convulsions appear in the first two days.
Fifth day cramps occur between the third and seventh days of a baby’s life. What do cramps look like in a child? These are short-term twitches, startles, nodding of the head, twisting and pinching of the fingers, "spasm" of looking upwards, 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.
Seizures with asphyxia of the newborn
The most common cause of seizures in infants is choking, or asphyxiation. 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 point hemorrhages in the brain and swelling. A newborn needs immediate medical attention, since a prolonged stay in this condition can cause brain atrophy and irreversible pathological changes.
Convulsions in children with oxygen starvation occur if childbirth occurs with complications, for example, if placental abruption occurs, the umbilical cord wraps around the neck, the water drains too early, and the birth process is excessively prolonged. The alarming symptoms in this case will stop almost immediately, as soon as the child is taken out of the state of oxygen starvation. In this case, cerebral edema passes, and the condition of the newborn gradually normalizes.
Birth injury cramps
Why does the child have cramps? With birth injury, this happens due to cerebral hemorrhages. Usually they are local in nature, accompanied by spasms of the muscles of the face. Often in this case, cramps occur in the legs of the child. General weakness in the muscles can also be observed, shaking of the whole body is possible. Usually, cyanosis of the skin (especially the face) appears, the breathing process is difficult, vomiting may occur.
If the opened internal bleeding is not stopped 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 increasing hematoma. As a rule, such cramps occur in a child without fever. They may appear later, for example, after two to three months. This happens due to adhesions, cyst formation, scarring. The factor provoking a seizure may be a preventive vaccination, injury or illness.
During infectious diseases
Quite often, a child has cramps at a temperature. Moreover, not only children with birth injury or respiratory failure suffer, but also completely healthy and full-term babies. This is due to the toxicity of the virus and the general weakening of the body against a background of fever, the condition negatively affects the central nervous system.
Often, cramps in a child at high temperature appear on the background of the acute phase of acute respiratory viral infections or influenza, with active rashes of measles, chickenpox and rubella. Tension of the whole body, which is accompanied by cerebral edema, increased intracranial pressure can occur against the background of encephalitis and other neuroinfections. As a rule, cramps in a child at high temperature go away with normalization of health.
Other causes of seizures
Often, cramps in young children can occur in response to a preventive vaccine. This is especially a problem for babies who have suffered asphyxiation, emergency cesarean section, birth injury, diathesis (exudative). For children who have a high degree of convulsive readiness, prophylactic vaccinations are contraindicated.
No less urgent problem, which can cause cramps in a child’s sleep or during wakefulness, are various metabolic disturbances. At the same time, the body has a lack of calcium, magnesium, potassium, and convulsions are manifested by a distortion of the facial expression.
Thus, the most common causes of seizures in infants are birth injuries, asphyxia during childbirth, too long a birth process, earlier discharge of water, and so on. If convulsive syndrome appeared against a background of viral or other diseases, but after the cure the basis of the disease did not disappear, then you need to show the child to a pediatrician to exclude the development of epilepsy.
Signs of seizures at temperature
During seizures, the child does not respond to the words of his parents, actions, loses contact with the outside world, stops shouting and crying. Blue skin, difficulty, or respiratory depression is possible.
A baby can throw its head back, then the constant tension of the whole body is gradually replaced by short-term twitches, they gradually fade. Limbs can twitch, roll up eyes, cramps with sudden muscle relaxation, involuntary bowel movements and urination are possible.
Such cramps rarely last more than fifteen minutes. In some cases, a symptom may occur in series of one to two minutes, but passes on its own. If a child cramps at a temperature, what should I do? Parents should be consistent and calm. What exactly to do? Read below.
First aid for cramps
What help should parents give in case of cramps? First of all, you need to call an ambulance. The child is laid on a flat surface on one 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 not be any objects around which can be injured. It is necessary to free the chest and neck of the baby from tight clothes, to ensure free breathing.
The room should be ventilated, the optimum temperature is about 20 degrees Celsius. No need to forcibly keep the child from involuntary movements, you can not open his jaw, insert a finger, a spoon or any other object into his mouth.
If the child's cramps begin for the first time, do not refuse hospitalization. At a minimum, it is necessary to show the baby as soon as possible after the attack to the doctor, it is worth contacting not only the pediatrician, but also the neuropathologist. The specialist will offer a number of studies, including biochemical and clinical blood tests, EEG, to determine the causes of convulsive syndrome.
Treatment for seizures at temperature
If seizures at a child’s temperature rarely occur, they last no more than 15 minutes, then no special treatment is necessary. It is enough to cool the baby's body by any available means (taking away 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, the administration of anticonvulsant drugs will be necessary intravenously, but the doctor will determine the need for this. Phenobarbital, Diazepam, or Lorazepam may also be prescribed.
A child with convulsions should not be left alone. During an attack, you should not give any medicine, water, food to avoid choking.
Relieving a seizure
What to do with cramps in a child? Ambulance doctors can administer intravenously a glucose solution (25%) at a dosage of 4 ml per kilogram of weight, vitamin B 6 , or pyridoxine (50 grams), Phenobarbital intravenously (from 10 to 30 mg per kilogram of weight), a solution of magnesium (50%) at 0.2 ml per kilogram, a solution of calcium gluconate (2 ml per kilogram of weight).
Epileptic seizures in children
In childhood, epilepsy is quite common, but its diagnosis is difficult. The children's body is characterized by an increased threshold for convulsive activity, but seizures that are not actually associated with epilepsy most often develop. Due to these difficulties, doctors are not in a hurry to diagnose epilepsy in babies.
The most common causes of this disease in preschool children are:
- Heredity. Scientists are increasingly expressing the view that it is not the disease itself that can be obtained from the parents, but only a predisposition to it. Each person has a specific convulsive status unique to him. The implementation of the predisposition depends on many factors.
- Brain developmental disorders. Disturbances in the development of the central nervous system can be caused by infections, genetics, exposure to the body of the future mother of harmful substances during pregnancy (alcohol, drugs, certain medications), its diseases.
- Various infectious diseases. The earlier the child suffered an infection with seizures, the greater the likelihood of developing epilepsy in the future. As a rule, encephalitis and meningitis become the causes. But with a predisposition to epilepsy, any disease can “trigger” a disease.
- Head injury. What is characteristic, convulsive seizures with epilepsy do not appear immediately after an injury, but only after some time. This is a long-term consequence of the action of a traumatic factor on the brain.
You can skip the onset of the disease. Seizures at first can be rare and short-lived, the condition is accompanied by sleepwalking, the occurrence of causeless fears, an oppressed mood, attacks of pain in various organs, and behavior 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. General treatment regimens do not exist. For each child, not only the optimal regimen should be compiled and the dosage prescribed, but also the best combination of drugs. There is no quick treatment for epilepsy. Therapy is always very long, the drugs must be withdrawn slowly, the transfer to another medicine should be carried out gradually.
Possible effects of seizures
In most cases, convulsions that occur in infancy do not leave a trace when the baby is growing up. In children up to a year, the brain is quite quickly restored, and its development is not yet over. But the more serious the seizures (more often and longer seizures), the stronger the oxygen starvation, that is, we can expect quite serious consequences. In this case, you must definitely show the baby to the doctor.
If it comes to epilepsy, then comprehensive treatment is needed, a serious approach to the disease, constant monitoring by an epileptologist. Without containing the disease during its progression, each new seizure can reduce the intellectual abilities of the child, which can lead to serious consequences. Treatment, as already mentioned above, should be comprehensive and individually selected.