Doctors make such a diagnosis as an example of 4% of children. Spasmophilia - a tendency to seizures is not characteristic of all babies, but only those who have clear signs of rickets. Why babies suffer from tetany and how to treat it, we will tell in this material.
What it is
Spasmophilia affects children from 5-6 months to 2 years. At an older age, the disease is not detected. Since this age ideally coincides with the age characteristics of another typical childhood disease - rickets, spasmophilia is considered a "companion". The more official name of the disease is "rickytogenic tetany".
The essence of the disease boils down to the fact that neuromuscular excitability increases, there is a tendency to convulsive syndrome and spasms. Sometimes the concept of "spasmophilia" sums up all children's convulsive states, but this is wrong.
True spasmophilia is a complex process that occurs against the background of improper mineral metabolism in the child's body.
A few decades ago, when artificial people were fed with cow's milk, the number of children suffering from rickets was ten times higher. With the spread of adapted milk formulas, in which, unlike cow and goat's milk, the amount of calcium and phosphorus, as well as vitamin D, is balanced, true rickets have become a rarity, which means that the number of children with spasmophilia has significantly decreased.
However, pediatricians in polyclinics continue to find signs of rickets in children. In most cases, it is a matter of overdiagnosis - the child does not have any rickets, besides, this diagnosis is not made based on the bald patches on the back of the head and sweating of the legs.
Many modern parents understand this, but the word "rickets" scares them and makes them doubt - and what if the doctor is right and if there are signs of rickets, then there may be other negative consequences, including tetany.
This forces mums and dads to carefully peer at their baby in search of certain deviations. Spasmophilia manifests itself in rare cases and for the most part the parents' anxieties are completely in vain. But if such a disease is found in a baby, then mom and dad need to be fully armed in order to be able to properly help the baby during a spastic attack.
In addition, spasmophilia, if it persists for a sufficiently long time, poses a danger to the development of the child, since his nervous system suffers, possibly a lag in mental development, in intellectual formation. In severe cases, an attack leads to cessation of breathing and death of the child.
Premature babies, as well as children with established signs of rickets, are more prone to the development of childhood rickets tetany. The greatest number of spastic attacks occurs at the beginning of spring, when solar activity increases. An increase in temperature, indigestion, and even prolonged crying can provoke an attack in a child with a tendency to tetany.
Causes
Against the background of a lack of vitamin D, the deficiency of which leads to rickets, the child's calcium and phosphorus metabolism is disturbed. Due to a lack of calcium and excessive losses of phosphorus in the baby's blood, the level of ionized calcium decreases.
The calcium content also decreases in the cerebrospinal fluid, but the potassium content increases in the body. Phosphorus accumulates in the kidneys, but they are not able to excrete it in full.
If the baby is sick with fever, if he cries for a long time (and this process ventilates the lungs), then an imbalance occurs in the body, the acid-base composition of the blood changes, and this is what causes a convulsive attack. In the spring, when the sun's rays, which, when in contact with the skin, contribute to the production of vitamin D, are many, a child with rickets quickly becomes oversaturated with this vitamin, the balance of minerals, alkalis and acids changes again, and this provokes a spastic attack.
Thus, the main reasons can be formulated more clearly and concisely:
- lack of vitamin D and impaired mineral metabolism (calcium and phosphorus, as well as magnesium and sodium);
- overdose of vitamins D2 and D3;
- the child has rickets in severe or moderate form.
Symptoms and characteristics
Spasmophilia in infants occurs in two variants - latent (passive) form and manifest (explicit). The disease always begins with an imperceptible, latent form, which can last for quite a long time - several months. If there are provoking factors (fever, any acute illness, etc.), the latent stage sometimes turns into a manifest one and a convulsive attack begins.
With a hidden form
It is quite difficult to identify any symptoms in latent rickytogenic tetany. This can be done only with the use of special skin-galvanic and mechanical tests. In general, spasmophilia will proceed with symptoms typical of rickets - the child will show excessive sweating, sleep poorly, he will be unnecessarily anxious and fearful. In blood tests, there will be a deficiency of calcium, vitamin D.
Here are some special "tests" showing muscle readiness for seizures, indicating the presence of latent rickytogenic childhood tetany:
- Trousseau's symptom. If the brachial ganglion is squeezed, then after a few minutes the hand of the upper limb will begin to contract like convulsions. This phenomenon is called carpopedic spasm, and for the characteristic arrangement of the fingers in a spasm, the limb itself is called the "palm of an obstetrician."
- Khvostek's symptom. If you lightly tap the fossae caninae with the tip of your finger ("goose foot" - the joint between the zygomatic arch and the corner of the mouth), then the entire half of the face, including the muscles of the mouth, eyelids and nose, will begin to contract convulsively.
- Maslov's phenomenon. If a child with spasmophilia is suddenly pricked, then he has a short-term cessation of breathing. Healthy children do not have this - they will cry, be indignant, but will not stop breathing.
There are other methods based on passing a weak current through the median nerve in the ulnar bend, as well as tapping the nerve coming out of the base of the fibula.
With a manifest form
The most common manifestation of the manifest form is laryngospasm - a sudden involuntary contraction of the muscles of the larynx. The spasm can be mild, or it can completely close the glottis, in both cases it is short-lived. With laryngospasm, the baby is very frightened, the skin becomes cyanotic sharply, the baby bulges his eyes and becomes abruptly covered with sweat. After a few seconds, the child takes a noisy breath, similar to the crowing of a rooster. Such an attack can last up to one and a half to two minutes, and can also be repeated several times during one day.
Karpopedalny spasm can continue with obvious spasmophilia for several hours, and may torment the child for several days. With it, the feet and hands are tonically reduced. Facial spasms are sometimes observed.
Sometimes involuntary muscles are exposed to spasms, which can lead to uncontrolled urination and bowel movements. The most dangerous is bronchospasm, in which respiratory failure develops.
Manifest spasmophilia in severe form can be manifested by eclampsia - a general attack of convulsive syndrome, in which the child loses consciousness. Less often, eclampsia occurs in the form of a short-term stupor, in which the child looks inhibited and pale. More often, contractions of the facial muscles begin, then other muscles, including the respiratory ones, are drawn into the process. The attack can last up to half an hour.
Despite the frightening manifestations, spasmophilia is rarely fatal. The death of a child is possible only with a general convulsive attack due to the development of acute respiratory failure or problems with cardiac activity.
Diagnostics
Problems with the diagnosis of an explicit form of spasmophilia usually do not arise. If rickets is confirmed by blood tests and X-rays, complaints of seizures or short-term loss of consciousness will be sufficient reason to give the child such a diagnosis.
To identify the latent form, you will have to apply special symptomatic "tests" described above.
They can be done by a pediatrician or pediatric neurologist. Suspicions with a positive reaction to this or that symptom must be confirmed or refuted by tests - a biochemical blood test will allow judging the amount of calcium and phosphorus, and CBS analysis will give an idea of the level of acid-base balance of the blood.
The child will be assigned an x-ray of the long bones to detect rickets, if this has not been done before. It is important for the doctor to distinguish spasmophilia from diseases similar in their manifestations to her - true convulsive syndrome, epilepsy, whooping cough and congenital stridor.
Urgent care
If the baby has laryngospasm, you need to sprinkle cold water on his face, open all windows or vents, and provide fresh air. Patting on the buttocks very effectively restores breathing, you can also shake the baby. If these measures turned out to be ineffective, and the child has not restored free breathing, he should be given artificial respiration, chest compressions (if necessary).
In case of a disease in the manifest stage, with eclampsia, the child should immediately enter the necessary anticonvulsants - a list of them will be prompted by the doctor if the tendency to seizures has been established earlier. Usually, emergency care includes the introduction of intramuscularly "Diazepam", the introduction of a rectal suppository "Phenobarbital". The ambulance doctors who have arrived, which should be called immediately, will certainly inject a solution of calcium gluconate intravenously, and a solution of sodium sulfate into the ass.
The algorithm for the actions of parents in a convulsive attack should be simple and clear: the child must be laid so that the upper body is raised, preferably on its side. Immediately call an ambulance, ensure the flow of fresh air. If the attack is not the first, then anticonvulsants, as a rule, are already ready in the home medicine cabinet and their dosage is already known to parents. If everything happened for the first time, you should not experiment and give any medications before the arrival of the ambulance team.
Treatment
A kid with spasmophilia definitely needs medical help. It is not worth hoping that everything will pass as you grow. Of course, it will pass, but with what consequences, even an experienced doctor will not say. The disease must be kept under control.
Conditions such as laryngospasm and eclampsia are urgently needed. If help fails, and cardiac or respiratory arrest occurs, resuscitation will be needed.
After the seizure is stopped, the child is usually taken to the hospital, where he is monitored for at least 24 hours, since seizures may recur.
Further therapy will be nutritional correction. Cow and goat milk is completely excluded from the diet, the child is transferred to breastfeeding or feeding with artificial milk adapted formulas. Vitamin D is prescribed in therapeutic doses. Fasting is recommended for 12 hours after the attack, the child is only given water to drink. Then feeding can be resumed, and after a year, children are given a carbohydrate diet, containing fruit purees, cereals.
As a mandatory treatment, it is recommended to take calcium preparations in a dosage established by a doctor based on blood tests.
The child definitely needs long walks in the fresh air, a strengthening massage. With obvious spasmophilia, all the same measures are recommended, and at the same time the use of anticonvulsants.
Many of them are prescription drugs, and therefore, along with the appointment, parents will receive a prescription for their purchase. It is important not to exceed the prescribed dosage. Most often, medication is taken for a rather long time, for example, barbiturates are prescribed in a course for six months.
It is important to understand that spasmophilia is not a sentence. After 2.5-3 years, there is no trace of the disease, everything goes along with rickets, the balance of calcium and phosphorus is restored. Fatalities are actually very rare, but this possibility cannot be ignored.
Prevention
In order to prevent a child from having such a diagnosis as spasmophilia, it is important not to allow the crumbs to create the prerequisites for the development of rickets. To do this, it is best to feed the baby with breast milk, and if this is not possible, then choose an exclusively adapted formula for nutrition, which will be recommended by the pediatrician.
Children born in late autumn and winter must be prescribed vitamin D for prophylactic purposes. For the rest of the children, especially those living in regions where the number of sunny days is small, an aqueous or oil solution of vitamin D is also prescribed in the winter and autumn.
Walking in the fresh air, especially in the sun, also promotes the production of this vitamin. Children of the first year of life are given a strengthening massage and, with the help of hardening and water procedures, they strengthen the baby's immunity. It is important to visit your pediatrician once a month so as not to miss the initial signs of rickets if they appear.
If there is rickets, then it is important to monitor the baby more closely in order to identify the latent form of spasmophilia in time. This will help the doctor adjust the baby's diet and lifestyle so that the likelihood of the onset of the manifest form is minimized. If, nevertheless, the disease happened and came to an obvious form, then it is important to follow all the doctor's recommendations and take the prescribed drugs. This will be an excellent prevention of recurrent seizures.
You will learn about the prevention of rickets in children from the following video.
