Seizures in children can be judged by signs such as short-term muscle contractions various groups skeletal or facial muscles. As a rule, these manifestations are accompanied by acute phases serious illnesses. Convulsions can be general and local, clonic or tonic. If you encounter this phenomenon for the first time, it is important not to get confused and follow a clearly defined algorithm of actions.
Most often, the onset of seizures is sudden, the child is excited, his movements become erratic, his head throws back, his jaws close. Then breathing stops, the skin turns blue, and the convulsions intensify. After a deep breath, breathing becomes “snoring”, noisy, cyanosis is replaced by pale skin. After a seizure, lethargy, confusion, or sleep occur.
Why does a child have seizures, and what symptoms are they characterized by? The main causes of seizures in a child are:
1) epilepsy:
Then the convulsions are reduced, breathing is restored, and involuntary urination and defecation often occur. 15-30 minutes after the attack, the child falls asleep, and when he wakes up, he does not remember what happened to him.
2) rapid rise body temperature during viral infections - short-term convulsions (last no more than 2-5 minutes), usually tonic-clonic. Characteristic symptom such convulsions in children – loss of consciousness;
3) spasmophilia - tonic spasms of the muscles of the face, feet, hands, loss of consciousness are typical for children from 3-4 months to 1.5 years;
4), encephalitis - seizures are accompanied by neurological symptoms.
Convulsions- sudden involuntary muscle contractions, often accompanied by loss of consciousness.
There are local and general convulsions. What are the types of seizures in children?
There are:
Seizures can occur due to diseases of the brain (abscesses, tumors, cerebral palsy, congenital anomalies etc.), epilepsy in response to various damaging factors (trauma, neuroinfections, fever, intoxication, vaccination, etc.).
First aid for seizures in children is to ensure patency respiratory tract: you need to free the child from restrictive clothing, clean the oral cavity from mucus, vomit, foreign bodies. To prevent injury to the tongue, it is allowed to bite solid object(pencil, spoon handle). Administer 0.5% relanium (0.1 ml/kg, but not more than 2 ml once) in an enema or intramuscularly; 25% solution of magnesium sulfate (0.2 ml/kg, but not more than 5.0 ml) intramuscularly; 20% sodium hydroxybutyrate (0.3-0.5 ml/kg) diluted through an enema.
When providing assistance for convulsions in a child, if breathing stops, switch to mechanical ventilation and do indirect massage hearts.
For convulsions against the background of a strong increase in body temperature, 50% analgin (0.1 ml/year of life) and 2.5% pipolphen (0.1 ml/year of life) are additionally administered intramuscularly.
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If a child begins to have seizures, it means a lesion has occurred. nervous system. Seizures are usually observed in children with epilepsy. This phenomenon in children can appear at different periods of life and depends on various reasons. Children are diagnosed with seizures more often than older children age category.
The progression of the disease can be triggered by causes, pathologies of the fetus in the womb, and several months after the birth of the baby. Premature babies are more likely to have seizures. At the first symptoms, visit immediately medical institution to prescribe the right treatment.
Children, especially premature babies, have a low threshold of excitability of the central nervous system, the brain is not mature enough, and there is a strong tendency to convulsive muscle contractions. Non-epileptic convulsive reactions occur frequently. Education convulsive reactions in infants it may be the result of trauma during childbirth, the manifestation of abnormalities in the central nervous system, or prematurity of the fetus. Moreover, seizures may be a consequence of unsuccessful vaccination.
Causes of seizures in a child:
Tonic convulsive manifestations (tonic seizures) – long contraction muscles of the arms and legs, in which there is freezing of the arms and legs in a bent or unbent position. During a tonic seizure, the baby’s body is stretched, the head is thrown back, and loss of consciousness occurs. Muscle contractions occur slowly and last a long time. The appearance of a tonic form signals overexcitation of brain structures.
Clonic convulsive manifestations - dynamic muscle contraction occurs, uncontrolled chaotic movement arms, legs and torso. Clonic seizures of the tonic-clonic type are often observed during sleep in the prone position. There is a combination of symptoms of a tonic and clonic attack.
Febrile convulsions in children - a form of the disease that progresses in children under 6 years of age. The reason is an increase in body temperature. Seizures occur that were not previously apparent. Important factor– genetic predisposition of the baby to convulsive phenomena. As a result of the febrile form of seizures, there is an external detachment from the world, loss of consciousness, the baby turns blue and holds his breath. Febrile convulsions in children are accompanied by disorientation; the patient does not understand anything and slowly comes to his senses.
Respiratory-affective convulsions - sudden manifestations arise as a result of the baby's experience of large quantity emotions. This form occurs in the age group from 6 months to 3 years, especially in premature infants; convulsions can occur during sleep in a prone position.
The reasons for the formation of epileptic seizures are the formation of strong neuronal discharges in the cerebral cortex. have following symptoms: the work of the arms and legs is disrupted, muscles contract, sensitivity is lost, thinking and thinking are upset mental function, loss of consciousness. Epileptic seizures– the most terrible, especially at night. The consequences are varied: injuries, bitten off tongue.
If your child starts having seizures, the symptoms are fairly easy to recognize: The head is thrown back, arms and legs are extended forward. The baby loses consciousness, clenches his teeth and rolls his eyes - everything happens involuntarily, often while sleeping on his stomach. Sometimes foam appears on the lips. The whole body is tense, twitching is observed in the arms and legs. The child's lips appear blue, and involuntary bowel movements may occur. After convulsive phenomena, the baby looks sleepy, tired, and cannot explain what happened.
Symptoms of a typical generalized seizure occur sharply, suddenly, and are possible while sleeping on the stomach. Signs: floating movement occurs eyeballs, loss of contact with the outside world.
Seizure time is up to 20 seconds. The pulse slows down, the baby may bite his tongue, breathing stops, and loss of consciousness occurs. Tonic attacks last no more than one minute and are replaced by restoration of consciousness. The consequences can be dire small child may cause injury to yourself.
Clonic seizures They begin by contracting the muscles of the face, then contracting the muscles of the arms and legs. Clonic seizures are characterized by noisy rapid breathing, loss of consciousness.
Clonic seizures vary in duration and are repeated. After the restoration of consciousness has occurred, the spasm of the arms, legs, and face has passed, and the baby falls asleep. Desirable urgent Care specialist and prescription of treatment, because clonic seizures are very dangerous. Delayed assistance can lead to death.
Tetanic attack characterized by the fact that it reduces the muscles of the arms and legs, the attack occurs with painful sensations. The likelihood of occurrence at night while sleeping on the stomach is high.
The spasm time is 10 – 15 seconds. The symptoms are pronounced, the cause is overexcitement during the day or high temperature during illness. Tetanic attacks are observed in children under 2 years of age, especially in premature infants.
During active growth, a newborn may experience leg cramps.. As soon as the first symptoms appear and you don’t know what to do, you need to seek help from a doctor. Urgent care is required and treatment is prescribed exclusively qualified specialists.
Different types of epileptic seizures have the following symptoms:
When diagnosing an attack, qualified specialists are primarily interested in hereditary factor, find out why the attack occurred, what ailments were previously suffered during the gestation period, whether there were pathologies during the period labor activity or childbirth. It is determined in what period and what provoked convulsive seizures, the amount of time between attacks.
To determine the cause of spasms, the child must undergo a detailed neurological and somatic examination. A general analysis of blood, urine and cerebrospinal fluid is prescribed.
Electroencephalography is also prescribed. Examination of the fundus of the eye is practiced, which makes it possible to detect certain pathologies in children. If necessary, small patients are prescribed to undergo computed tomography and spinal puncture.
As soon as the parents notice the beginning of the attack, emergency assistance is needed in the form of calling an ambulance. While waiting for the doctors, they begin active actions, don't panic. Help provided on time will save the child’s life.
When a spasm occurs during a period of nervous excitement of the baby, a calm environment is created. There is a reflex restoration of breathing. You need to sprinkle some water on the child, gently apply pressure to the root of the tongue using a spoon, and apply cotton wool with ammonia. Gently pat the cheeks, and after bringing them to their senses, a sedative is given. Valerian will be enough, dosage based on the child’s age: 1 drop for one year.
At febrile seizures In children, emergency measures are taken to help lower body temperature. The baby is given an antipyretic and can be rubbed with vinegar.
Keep an eye on the little patient until the convulsions have passed. If the attack does not go away, moreover, pallor occurs skin, blue lips - using vinegar is prohibited. The most dangerous attacks– at night, while sleeping on your stomach, since there may be no one nearby.
After rendering little patient first medical care hospitalization occurs in the neurological department of the hospital. Treatment is prescribed as soon as the diagnosis is confirmed. Doctors prescribe treatment for the baby in the form of anticonvulsant medications, massages and thermal procedures are prescribed.
Medications are prescribed to improve performance metabolic processes body. If seizures occur periodically, treatment is urgently needed. In the worst case, brain swelling will occur and breathing will be impaired. If the weather is hot, keep an eye on water balance baby, stay hydrated. To improve blood circulation, treatment is necessary in the form of alternating a hot compress with a cold one on the affected areas. You shouldn’t ignore the rise in temperature, you need to do something. If the temperature is high, give antipyretic syrups.
If it is impossible to diagnose the disease at the moment, treatment is carried out in the form of symptomatic therapy with the help of medications that help block convulsive paroxysm.
Treatment is aimed at restoring normal breathing and reducing the excitability of the central uneven system. What to do? It is impossible to stop an attack that has begun, shorten the duration of the attack, alleviate the symptoms - everything that can be done to help the child.
In children in early childhood convulsions are very common. Cramps are chaotic contractions of various muscle groups.
The appearance of seizures in older age is most often associated with diseases of the nervous system. It could be a brain tumor multiple sclerosis, autoimmune diseases. In early childhood, the appearance of seizures can also be associated with these diseases, but most often this is due to the immaturity of the nervous system.
If you imagine nerve ending in the form of an electrical wire, then you can easily understand the principle of transmission nerve impulse. In the center there is a nerve fiber through which the nerve impulse is transmitted, like electricity through a wire. On the outside, this nerve fiber is covered with an insulating substance - myelin. Myelin prevents the nerve impulse from leaving the nerve fiber. In young children, the nerve fiber is not completely covered with myelin, so it is possible for a nerve impulse to escape beyond the boundaries of the nerve fiber and excite nearby nerve fibers.
Very often, when the child’s body temperature rises during colds in children, the transmission of nerve impulses along fibers increases. These nerve impulses break through to the outer contour of the nerve fiber and begin to be transmitted to neighboring fibers. Chaotic irritation of the nerve fibers occurs, and because of this, the muscles begin to contract involuntarily - cramps appear. Such convulsions are called febrile, that is, they develop against the background of an increase in body temperature.
Another reason for the development of seizures is electrolyte disturbances. Electrolytes are involved in the transmission of nerve impulses. The main function in conducting the impulse belongs to calcium and sodium ions. When their concentration in the blood decreases, convulsions may occur. The appearance of seizures is also associated with metabolic disorders, in particular a decrease in blood glucose levels.
Sometimes children can experience convulsions against the background of psycho-emotional shock; in rare cases, children can independently provoke the appearance of convulsions in themselves and thus “blackmail” their parents into buying them something.
1. Infectious diseases. Meningitis, encephalitis, and brain abscesses lead to brain damage and disruption of nerve impulse transmission.
2. Maternal drug abuse during pregnancy. Narcotic substances disrupt the process of intrauterine brain formation, so children born to drug-addicted mothers may experience seizures.
3. Endocrine diseases. Diabetes mellitus, diseases thyroid gland, adrenal glands can cause seizures in a child at any age.
4. Burdened heredity. Some genetic diseases lead to disruption of brain development, as a result of which the development of convulsive syndrome in a child.
5. Tumor lesions of the brain cause disruption of nerve impulse transmission nerve fibers, which causes seizures in children.
6. Lack of calcium.
7. Misuse medicines. Some drugs, such as diuretics, cause a decrease in calcium in the blood, which causes seizures. The appearance of seizures is also observed with an overdose of vitamin D3 and the development of a condition such as spasmophilia.
8. A cramp may appear due to hypothermia (for example, a limb will cramp in cold water). But if this happens frequently, you need to see a doctor.
Seizures can be mistaken for an epileptic attack, so when diagnosing, it is necessary to keep this disease in mind.
Convulsions can be focal (involving one group of muscles on one half of the child’s body), multifocal (a group of muscles in one or the other half of the child’s body is affected) and generalized (against the background of twitching of individual muscle groups, loss of consciousness is observed, sometimes with cessation of breathing).
The risk of seizures in a child is associated with the possibility of respiratory arrest.
To diagnose seizures you must:
1. General blood test, general analysis urine, for children under 3 years of age, urine analysis according to Sulkovich to exclude spasmophilia.
2. Determination of the electrolyte composition of the blood. Special attention focuses on reducing calcium and magnesium levels in the blood.
3. Determination of blood glucose.
4. Determination of blood gas composition. Pay attention to the oxygen and carbon dioxide content.
5. Carrying out lumbar puncture with the study of cerebrospinal fluid with determination of the content of sugar, protein, electrolytes, cellular composition to exclude infectious damage to the brain.
6. Ultrasound examination brain for children with an open fontanelle, brain tomography for older children.
7. Electroencephalography to determine brain function and detect vascular disorders.
When convulsions appear, the child must be laid on a flat surface and try to protect him from foreign objects, since by making chaotic movements with his arms and legs, the child can injure himself. The child needs access to oxygen, so you cannot “huddle” over the child, hanging over him and making it difficult for him to get fresh air. If the child has a tight collar on his shirt, the top buttons must be undone. Under no circumstances should you try to insert it into a child’s mouth. foreign objects, especially sharp ones, as this can cause serious injury. It is necessary to urgently consult a doctor.
For treatment, it is necessary to determine the cause of the development of seizures and, if possible, eliminate it. At metabolic disorders carry out an intravenous infusion of glucose solution to correct electrolyte disturbances– solutions of calcium and magnesium
The main treatment is aimed at stopping seizures. Anticonvulsants are used to relieve seizures. Such drugs are phenobarbital and seduxen. Seduxen is administered at a dosage of 0.2-0.3 mg/kg intravenously and 0.5-1.0 mg/kg at intramuscular injection. Phenobarbital is prescribed at a dosage of 3-4 mg/kg intravenously.
If there is no effect from the treatment, it is recommended intravenous administration vitamin B6.
If there is no effect from the treatment within an hour, transfer of the child to artificial ventilation lungs with the prescription of muscle relaxants, since in this case respiratory arrest may develop.
To prevent the development of seizures it is necessary proper nutrition, normalization of sleep and wakefulness, moderate physical activity, prevention viral infections, hardening, vitamin therapy, applications medicines only under the supervision of a doctor.
If a child has febrile seizures that occur when the body temperature rises, the body temperature should not be allowed to rise. In this case, it is recommended to bring down even the temperature to 37.1° C.
Pediatrician Litashov M.V.
Seizures in children are not uncommon. This is due to hereditary characteristics nerve cells, immaturity of the brain and central nervous system. An important role was played by the increased number of successfully cared for children who in previous centuries simply did not live to see seizures, children from emergency CS due to placental abruption, premature babies weighing less than 1.5 kg. Thus, today approximately every 50th child suffers from the syndrome, and more than half of all cases occur in the first three years of life.
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 become confused. This spectacle is not for the faint of heart, so you need to know how you can help your baby. About first aid we'll talk further. Now let's look at the types of seizures in children.
Tonic is prolonged muscle tension or spasm. The child can throw back his head, strain and extend his lower limbs, turn his palms outward, and spread his arms. In some cases, difficulty breathing with cyanosis of the nasolabial triangle and redness of the face is characteristic. Clonic - fast, usually 1-3 twitches occur per second.
According to localization and distribution, clonic seizures can be focal, myoclonic, tonic-clonic or fragmentary. Focal ones are characterized by twitching of the arms and legs, parts of the face. Myoclonic are contractions of a specific muscle or group of muscles.
Fragmentary convulsions are characterized by nodding of the head, flexion of the limbs, eye symptoms, loss of consciousness or cessation (significant difficulty) of breathing may occur. Tonic-clonic are distinguished by alternating contractions and increased tone muscles.
Doctors divide all seizures in children into epileptic and non-epileptic, and the latter can “grow” into the former over time. Only a specialist can make a diagnosis of epilepsy after carefully studying the child’s medical record. At the same time, attention is paid not only to possible reasons seizure syndrome and risk factors, but also whether there is hereditary predisposition to seizures. If there is no unfavorable heredity, the child’s central nervous system is normal, there is no electroencephalogram characteristic changes, then doctors refrain from accurate diagnosis“epilepsy”, considering seizures to be non-epileptic.
Such seizures occur relatively often in children. A seizure can be caused by many factors. As a rule, convulsive syndrome is observed in infants, but older children can also suffer from it, for example, when high temperature And infectious diseases. Let us first consider the causes of seizures in a child in the first month of life:
The risk group includes premature babies born as a result of emergency caesarean section.
The first to occur are convulsions caused by birth trauma or asphyxia. The syndrome develops in the first eight hours of a baby's life. With low sugar levels (hypoglycemic cramps), the symptom is accompanied by sweating, restless behavior, hyperactivity and breathing problems. Such convulsions appear in the first two days.
Fifth day seizures occur between the third and seventh day of an infant's life. What do seizures look like in a child? These are short-term twitches, shudders, nods of the head, curling and clenching of fingers, 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 due to hemolytic disease.
The most common cause of seizures in children in infancy- suffocation or asphyxia. The symptom manifests itself as a result of circulatory disorders, due to a lack of oxygen in tissues and organs, and excess carbon dioxide. In most cases, this phenomenon leads to pinpoint hemorrhages in the brain and swelling. A newborn needs immediate medical attention, since prolonged stay in this state 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, water breaks too early, birth process overextends. Alarming symptoms in this case, they will stop almost immediately as soon as the child is removed from the state of oxygen starvation. In this case, cerebral edema goes away, and the newborn’s condition gradually normalizes.
Why does my child have seizures? With birth trauma, this happens due to hemorrhages in the brain. Usually they are local in nature, accompanied by spasms of the facial muscles. Often in this case, cramps occur in the child’s legs. There may also be general weakness in the muscles, and possible tremors of the whole body. Usually, this causes cyanosis of the skin (especially the face), difficulty breathing, and vomiting may occur.
If you don't stop what has opened in time internal bleeding, 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 occur in a child without fever. They may appear later, for example, after two to three months. This happens due to adhesive process, cyst formation, scarring. The triggering factor for a seizure may be a preventive vaccination, injury or disease.
Quite often, children experience convulsions with fever. Moreover, it is not only children with birth trauma or respiratory failure, but also completely healthy and full-term infants. This occurs due to the toxicity of the virus and the general weakening of the body against the background of fever; the condition negatively affects the central nervous system.
Often, convulsions in a child with a high temperature appear against the background of the acute phase of ARVI or influenza, with active measles rashes, chickenpox and rubella. Tension of the whole body, which is accompanied by swelling of the brain, increased intracranial pressure may occur against the background of encephalitis and other neuroinfections. As a rule, convulsions in a child at a high temperature go away when their health status returns to normal.
Often, seizures in young children may appear in response to a preventive vaccination. This is especially a problem for infants who have suffered asphyxia, emergency C-section, birth injuries, diathesis (exudative). For children who are different high degree convulsive readiness, conducting preventive vaccinations contraindicated.
No less actual problem, which can cause in a child or during wakefulness, are various disorders metabolic processes. At the same time, there is a lack of calcium, magnesium, potassium in the body, and convulsions are manifested by distortion of facial expression.
Thus, the most common reasons seizures in children infancy- these are birth injuries, asphyxia during childbirth, too long a labor process, earlier breaking of waters, and so on. If the convulsive syndrome appeared against the background of viral or other diseases, but after curing the underlying disease did not disappear, then it is necessary to show the child to a pediatrician to exclude the development of epilepsy.
During seizures, the child does not react to the words of the parents, actions, loses contact with the outside world, stops screaming and crying. You may experience blue skin, difficulty breathing, or holding your breath.
An infant may throw back his head, then the constant tension of the whole body is gradually replaced by short-term twitches, which gradually fade away. Limbs may twitch, eyes may roll, convulsions with sudden muscle relaxation, involuntary bowel movements and urination are possible.
Such convulsions rarely last more than fifteen minutes. In some cases, the symptom may occur in series of one or two minutes, but goes away on its own. If a child has seizures with a fever, what should you do? Parents' actions should be consistent and calm. What exactly should we do? Read below.
What help should parents provide to a child with seizures? First of all, you need to call an ambulance. The child is placed on a flat surface on his side so that his head and rib cage were on the same line. Cannot be moved cervical region spine. It is important to lay the baby down so that he does not fall. There should be no objects around that could cause injury. It is necessary to free the baby's chest and neck from tight clothing and ensure free breathing.
The room should be ventilated; the optimal temperature is approximately 20 degrees Celsius. There is no need to forcefully restrain your child from involuntary movements, you cannot unclench his jaws or insert a finger, spoon or any other object into his mouth.
If your child has seizures for the first time, you should not refuse hospitalization. At a minimum, it is necessary to show the baby to a 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 trials blood, EEG to determine the causes of seizures.
If convulsions at a child’s temperature occur rarely and last no more than 15 minutes, then no special treatment no need to carry out. It is enough to cool the baby’s body by any available means (sampling with a weak vinegar solution, a cold towel on the forehead and armpits, inguinal folds, bends under the elbows and knees).
After the attack stops, you need to give an antipyretic. For frequent and prolonged convulsions, administration will be required. anticonvulsants intravenously, but the need for this will be determined by the doctor. Phenobarbital, Diazepam or Lorazepam may also be prescribed.
A child with seizures should not be left alone. During an attack, you should not give any medications, water, or food to avoid suffocation.
What to do if a child has seizures? Emergency 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 (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).
Epilepsy is quite common in childhood, but its diagnosis is difficult. Children's body different increased threshold seizure activity, but most often develop seizures that are not actually associated with epilepsy. Due to these difficulties, doctors are in no hurry to diagnose children with epilepsy.
The most common causes of this disease in children preschool age are:
The onset of the disease can be missed. At first, seizures may be rare and short-lived; the condition is accompanied by sleepwalking, the occurrence of unreasonable fears, depressed mood, attacks of pain in various organs, and behavioral disorders. If these symptoms appear again and again, you should consult a doctor.
Treatment of epileptic seizures is always selected taking into account the individual characteristics of the child. General schemes there is no treatment. For each child, not only the optimal dosage regimen and dosage must be drawn up, but also the best combinations of medications. Fast treatment does not happen with epilepsy. Therapy is always very long, drugs need to be discontinued slowly, and transfer to another medicine should be done gradually.
In most cases, seizures that occur in infancy disappear when the baby grows up. In children under one year of age, the brain recovers quite quickly, and its development is not yet complete. But the more serious the seizures (more frequent and longer the seizures), the stronger the oxygen deprivation, that is, quite serious consequences can be expected. In this case, you should definitely show your baby to a doctor.
If it concerns epilepsy, then it is necessary complex treatment, a serious approach to the disease, constant monitoring by an epileptologist. Without containing the disease as it progresses, each new seizure may reduce intellectual abilities child, which can lead to serious consequences. Treatment, as mentioned above, must be comprehensive and individually selected.
