Convulsions in a child are a rather dangerous symptom. Few of the parents know exactly what to do if a baby develops a convulsive syndrome. But it is the quality of first aid that in many cases determines the outcome of the situation. In this article, we will explain why babies and teens have muscle cramps and how parents can act during an attack.
What it is?
Convulsions medical science calls muscle contractions that are not subject to the will, which are involuntary or spontaneous spasms. Quite often, such contractions are very painful, painful and cause suffering to the child.
As a rule, convulsive syndrome occurs suddenly. Sometimes it covers the whole body, sometimes - its individual parts.
Muscle spasms are different. Their classification is wide enough. All seizures are divided into epileptic and non-epileptic seizures. The former are various manifestations of epilepsy, the latter can speak of other pathologies.
By their nature, seizures are:
Tonic. With them, muscle tension is long-term, prolonged.
Clonic. With them, episodes of tension are replaced by episodes of relaxation.
The most common among young patients are mixed - tonic-clonic seizures. In early childhood, spasms occur much more easily than in adults. This is due to the age-related characteristics of the functioning of the central nervous system in general and the brain in particular.
According to the prevalence, seizures are divided into several types:
Focal. They are small twitching of muscles in one or another part of the body. Often, these seizures accompany a calcium or magnesium deficiency.
Fragmented. These spasms affect individual parts of the body and are involuntary movements of the arm or leg, eye, head.
Myoclonic. This term denotes spasmodic contractions of individual muscle fibers.
Generalized. The most extensive of the muscle spasms. All muscle groups are affected.
The tendency to seizure is called convulsive readiness. The younger the child, the higher this readiness he has. The child can respond with muscle spasms to adverse external influences, to poisoning, to high temperatures.
Sometimes, seizures are symptoms of illness. Very often, children experience a single episode of convulsive syndrome. After that, the convulsions do not recur. But the child still requires very careful observation. Doctors found that most adults diagnosed with epilepsy had seizures during childhood. Whether there is a direct connection between childhood seizures and the subsequent development of epilepsy is not yet completely clear, but monitoring a baby who has survived one seizure should be continuous and close, just in case.
Symptoms and signs
Seizures are always the result of pathological disorders in the work of the brain. It is not difficult to recognize generalized seizures, in which the entire body of a child is shaken by convulsions. It is much more difficult to notice other forms of convulsive syndrome.
Fragmented seizures appear as a separate twitching of the muscles. Quite often, it persists even in a dream. Even loss of muscle tone, excessive relaxation, absent-minded gaze, indistinct mumbling, numbness are also forms of seizures.
With some illnesses, the child may pass out during a seizure. So, for example, febrile seizures occur. But with tetanus seizures, the child, on the contrary, maintains clarity of mind even with a strong generalized attack.
The development of an attack always occurs in a specific sequence. For different diseases and conditions, this sequence can be different. Sometimes it is she who allows you to establish the exact cause of muscle spasms.
A generalized seizure is characterized by a sudden onset. During convulsions, the child tightly clenches his jaw, can roll his eyes. Breathing becomes heavy or rapid, and may stop briefly. The skin changes color towards cyanosis - turn blue. In some cases, the sphincters relax and the child may pee or wet himself.
And although the convulsions look frightening and instill panic in parents, they do not carry great danger in themselves. The consequences are much more dangerous if convulsive syndrome is frequent. This affects the development of the brain, mental and intellectual abilities.
If emergency care is not provided correctly, a child in an attack may suffocate, choke on vomit, and get fractures.
Mechanism of occurrence
To understand what exactly is happening to the child, you need to clearly understand how a muscle spasm is born and developed. Muscle movements normally become possible only with the coordinated work of the brain and nerve fibers. The stability of this connection is ensured by a variety of substances - hormones, enzymes, trace elements. If at least one of the links in this process is disturbed, then the transmission of the nerve impulse is incorrect.
So, incorrect signals from the brain, overheated at high temperatures, are not "read" by muscle fibers and febrile seizures occur. And a lack of calcium or magnesium in the body makes it difficult for the transmission of impulses from brain cells to nerve fibers, resulting in muscle spasm again.
The nervous system of children is imperfect. This system is the most "loaded" in childhood, since it is the only one that is going through such rapid changes in the process of baby's growth.
That is why children often have night cramps. In a dream, blood circulation slows down, muscles relax, impulses pass with a great delay. Muscle spasm at night also occurs in children-athletes, whose muscles are under heavy load during the day.
When a "failure" occurs, the brain strives to restore the lost connection by all means. The cramp will last as long as it takes him. After the impulses begin to pass, muscle spasms and convulsions gradually recede. In this way, a seizure can begin suddenly, but the reverse development of an attack is always smooth, gradual.
Development reasons
The reasons that cause cramps in children are different. It should be noted that in about 25% of cases, doctors still fail to establish the true cause, if the attack was single and did not recur. Children often respond to fever with high fever with muscle spasms, spasms occur with severe poisoning, and some neurological problems can also cause increased spastic readiness.
Convulsions in children can occur against the background of dehydration, from severe stress. Many congenital and acquired pathologies of the central nervous system are accompanied by this unpleasant symptom. We will tell you about the most common reasons in more detail.
Epilepsy
With this chronic pathology, seizures are generalized with loss of consciousness. The attacks are multiple, repetitive. Symptoms depend on the location of the epileptic focus, in which part of the brain there is a violation. The onset of an attack is preceded by the impact of a certain factor. For example, in some adolescent girls, epileptic seizures occur only during menstruation, and in some young children, only at night or when falling asleep.
All the reasons why epilepsy develops in newborns and older children have not yet been studied, but among the identified, a hereditary factor occupies a special place - often children inherit the disease from their parents.
The likelihood of developing a disease in a child increases if the expectant mother, during the period of gestation, took medications without a doctor's recommendation and urgent need, used alcohol and drugs. The risk is increased in premature babies and toddlers with birth injuries. In preschoolers, the cause of the development of epilepsy can be a severe infection, the consequence of which was, in particular, complicated meningitis or encephalitis.
Convulsions in different forms of epilepsy manifest themselves in different ways. Their duration can be from 2 to 20 minutes. There may be short-term respiratory arrest, involuntary urination. If you wish, you can also recognize the first signs in a baby. The baby stops sucking and swallowing, looks at one point, does not react to sounds, light, parents. Quite often, before an attack, the baby's temperature rises, there is increased moodiness, refusal to eat. After an attack, one side of the body may be weaker than the other, for example, one arm or leg will move better than the other. This condition disappears in a few days.
Spasmophilia
This ailment can cause seizures in children aged six months to 2 years. At a later age, tetany (the second name for spasmophilia) does not occur. Convulsions with this ailment have metabolic causes. They are caused by a lack of calcium and magnesium in the body. This condition usually occurs with rickets. Spasmophilia is by no means a common cause, since it occurs in less than 4% of children prone to seizures.
The greatest number of seizures is observed precisely in children with rickets, as well as in premature babies with signs of rickets and rickets-like conditions. The disease is seasonal. Most of the time, the seizure cramps occur in the spring when the intensity of the sunlight gets higher.
Spasmophilia is most often manifested by laryngospasm, that is, the muscles of the larynx are cramped. This prevents the child from breathing and speaking normally. As a rule, the attack ends in 1-2 minutes, but there are situations when respiratory failure occurs. A certain form of the disease is characterized by the manifestation of tonic cramps of the hands and feet, facial muscles, as well as general eclampsia, when a cramps reduces large muscle groups with loss of consciousness.
The danger of spasmophilia is pretty ephemeral, since it has not been proven that it provokes the development of epilepsy at an older age, and respiratory arrest and bronchospasm, life-threatening, occur extremely rarely during an attack.
Tetanus
This acute illness is infectious in nature. The child's body, its central nervous system is affected by a very poisonous exotoxin, which is produced by tetanus bacillus - bacteria that can be active only in a space devoid of oxygen, but sufficiently warm and humid. Such an ideal environment for them is wounds, abrasions, burns and other damage to the integrity of the skin.
The risk of infection is higher in newborns (through an umbilical wound), in children from 3 to 7 years old, who fall and get injured more often than others, in children living in the village, since the bacillus is found in large quantities in the soil in areas where there are feces of cows and horses , people. Tetanus death rate is high, for example, newborns die in 95% of cases.
Mandatory vaccination (DPT vaccination) reduces the likelihood of infection, and the timely administration of tetanus toxoid after an injury on an emergency basis can further protect the child.
Tetanus seizures can be very severe, almost continuous, generalized. The first signs of the disease can be recognized by the characteristic tremors that occur in the area of the wound. They can be distinguished from ordinary flinches by their frequency and regularity. This sign is followed by trismus - the chewing muscles cramp, as a result of which the child's facial expression changes - the eyebrows "creep" up, the corners of the lips go down, it is very difficult to open or close the mouth.
At the next stage, the limbs and back, as well as the abdomen, begin to cramp. Muscles become tense, stiff, "stone". Sometimes in an attack the child literally freezes in incredible positions, more often horizontally, leaning only on two points - the back of the head and heels. At the same time, the back is arched. All this is accompanied by high fever, sweating, but the child with tetanus never loses consciousness.
Attacks can rarely be repeated, and can be almost continuous, they are often provoked by light, sounds, people's voices. Dangerous complications can develop as you recover. - ranging from pneumonia and auto-fractures to paralysis of the heart muscle, the development of acute respiratory failure.
Hysteria
A hysterical seizure differs from other causes of convulsive states in that it develops not due to viruses and bacteria, but exclusively against the background of a stressful situation. Children, due to their age, find it difficult to control their emotions, therefore, hysterical convulsions are not uncommon for them. Usually children from 2-3 years old to 6-7 years old suffer from them. This is the period of the most active emotional development. Often, the first attacks occur in the so-called "critical years" - 3-4 years, and then 6 years.
The starting mechanism of a convulsive attack is always a strong emotion - resentment, anger, fear, panic. Often, to start an attack, the presence of relatives is necessary. The child may fall, but he always retains consciousness. Convulsions are most often local in nature - the hands move, the toes are squeezed and unclenched, the head is thrown back.
The child does not pee, does not bite his tongue, and in general rarely receives any mechanical injuries during the attack.
At the time of the attack, the child responds quite adequately to pain. If he is easily pricked with a needle or pin in his hand, he will pull it back. The movements are complex movements - the toddler can cover his head with his hands, curl his knees and do it rhythmically with an obsessive identity. Grimaces appear on the face, uncontrolled flapping of the limbs is possible. The attacks are quite long - up to 10-20 minutes, in rare cases, the child can fight in a hysterical fit for several hours. Rather, he understands what he is doing, but physically cannot stop an already running process.
The attack ends abruptly. The kid abruptly calms down and behaves as if nothing had happened... He is not sleepy, as is the case after seizures in epilepsy or after febrile seizures, not apathetic. These cramps never occur during sleep.
Febrile
This type of seizures is characteristic only of children and only at a strictly defined age - up to 5-6 years. Muscle spasms develop against a background of high fever during any infectious or non-infectious disease. Children from 6 months to one and a half years old are most susceptible to such seizures. Under the same conditions, at the same temperature, muscle spasms develop only in 5% of children, but the probability of their recurrence with a subsequent illness with high fever is 30%.
Seizures can develop against the background of acute respiratory viral infections and flu, with teething of milk teeth, with severe allergies, and even with a reaction to the DPT vaccine.It is impossible to influence their development, neither antipyretic drugs nor constant temperature control reduce the likelihood of such an outcome.
Everything begins about a day after the establishment of a febrile state. Both simple convulsions, which are expressed by trembling of individual limbs, and complex, which cover large muscle groups, the child loses consciousness. Actually, this is the first sign of a febrile attack. First, it "brings" the legs, then the body and arms. The chin is thrown back due to the strong tension of the occipital muscle, the face tenses. The skin turns blue, sweating increases, and salivation is possible.
In an attack, short-term stops in breathing may occur... After passing the peak, symptoms develop in the opposite direction - the back and face are the first to relax, and the legs are the last to relax. After that, consciousness returns. The child is weak, after a seizure he really wants to sleep.
Traumatic brain injury
Convulsions after a skull injury or intracranial injury can develop both immediately and several days after the incident. By themselves, muscle spasms are not an obligatory consequence of traumatic brain injury, their nature and severity depend on what kind of injury is received and how serious the damage is. Parents should be alerted to the change in the child's behavior and condition - lethargy, apathy, severe headaches, nausea and vomiting, loss of consciousness.
At the first symptom of seizures (and they can be of any kind - from focal to generalized), you should immediately call an ambulance and provide emergency care yourself.
Organic lesions
Congenital organic lesions of the central nervous system - microfezaly, hydrocephalus, underdevelopment of the lobes of the brain, and so on can be accompanied by seizures. Doctors will definitely warn parents about such a probability, since most of such pathologies become apparent in the first hours and days after the birth of a child.
Often, seizures occur against the background of existing diseases of the musculoskeletal system (paralysis, cerebral palsy). During meningitis and enfezalitis, seizures are accompanied by numerous neurological symptoms. They start 1-2 days after the onset of the disease and usually have a frightening generalized character for adults.
Convulsions of various types and intensity, but usually generalized, accompany toxic lesions of the brain in case of poisoning. Quite often, the child loses consciousness in an attack. This is preceded by other signs of poisoning - vomiting, diarrhea.
First aid
The algorithm for providing emergency care is quite simple. Parents should first call an ambulance and record the time of the onset of the attack. You will need to gather all the will into a fist and, while waiting for doctors, notice all the details of what is happening with the child - what kind of convulsions are, how often they repeat, whether the baby reacts to external stimuli, is he conscious. All this information will be useful to the doctor to quickly make the right decision, to establish possible causes. If it is difficult to determine the nature of the seizures yourself, you can shoot what is happening on video and then show the doctor.
The child is placed on a firm and level surface in a universal "rescue" position: the position of the body is on its side so that the child does not choke on saliva or vomit. If the legs do not close, then you can leave everything as it is. A folded towel is placed under the head.
The child's mouth is cleaned of mucus with a handkerchief or tissue napkin. If the cause is not known for certain, then, just in case, you should take precautions that are important in case of an epileptic seizure. A wooden object (spoon or knife handle) is inserted between the child's teeth, be sure to wrap it with a cloth. You can simply tie a knot on a towel and insert it into your mouth. This is to protect the tip of the tongue from involuntary biting.
Be sure to open windows, balcony doors to provide fresh air. This is where the tactics of parents' actions in the event of seizures in a child is exhausted. The rest is up to the doctors.
What not to do:
Give your child a drink during a seizure.
You shouldn't try to give your baby any medication.
Force to unclench your teeth and shove an iron spoon into your mouth. This can lead to the fact that teeth break, and their fragments enter the respiratory organs.
Unclench the limbs, which are compressed by a spasm, as this can lead to fractures, muscle rupture and muscle tearing from bones.
Pouring or splashing cold water on the child, try to do artificial respiration, heart massage, and other resuscitation measures if breathing is preserved.
Treatment
The tactics of arresting an attack by a team of "ambulance" who arrived will depend on what kind of convulsions happened and the probable cause. Most often, for generalized, infantile childhood seizures, "Seduxen"... The dosage of this drug or "Relanium" for total muscle relaxation is calculated based on the age of the baby.
With affective-respiratory seizures, which are manifested in children by holding their breath, with febrile seizures of a simple type, the baby can be left at home. For other seizures - epilepsy, toxic convulsions, tetanus, urgent hospitalization is required.
Treatment usually requires the urgent administration of anticonvulsants, intravenous cleansing of the body with saline, mixtures of vitamin and mineral solutions. With tetanus, the child is injected with tetanus serum. In hysteria, the child is shown neurological and psychiatric assistance with the use of nootropic drugs and sedatives.
Usually, treatment is not limited to a hospital stay. The child is observed dispensary, sometimes anticonvulsants are prescribed for long periods of time.
After a history of seizures, the baby is shown taking multivitamins and microelements, walking in the fresh air, measures to strengthen immunity, good nutrition.
For information on what to do with convulsions in children, see the next video.
