Forms of spasmophilia. Isolated spasms in a child

Spasmophilia (tetany) is a disease characterized by high neuromuscular excitability with the appearance of spasms of the facial muscles, muscles of the larynx and limbs.

The painful condition is most often observed in children in the first two years of life, mainly from 3 to 18 months. The same age range is prone to the development of rickets, with which tetany is associated with pathogenesis and etiology.

Among patients with spasmophilia, according to statistics, 4% of children suffer from or have suffered from rickets: more boys than girls. Previously, spasmophilia in children was considered a fairly common disease in pediatrics; today it is rare. The positive trend of the disease is directly related to the decrease in cases.

Rachitogenic spasmophilia is provoked by metabolic disorders (phosphorus- calcium metabolism). The disease occurs due to irrational feeding of the child and can be caused by both a deficiency and an excess of vitamin D:

Short stay of the child fresh air and poor quality nutrition. Hypocalcemia may occur due to a malfunction parathyroid glands, poor absorption of calcium by the body and its leaching in urine more than normal.
Taking “shock” doses of vitamin D higher than required or staying under the rays of the afternoon sun, rich in ultraviolet radiation, with large areas of exposed skin.

Symptoms

Latex

The course of the latex form of spasmophilia precedes the obvious one and can bother the child from a week to several months. Since the disease is associated with rickets, its manifestation has similar symptoms:

poor sleep;
rapid heartbeat;
increased sweating;
indigestion (constipation);
nervous hyperexcitability;
increased anxiety and fearfulness.

Confirmation of the latex form of spasmophilia is also indicated muscle twitching in the arms and legs, facial contractions of the facial muscles with a light tap on the cheek.

Manifest

Manifest spasmophilia in children manifests itself in the form of the following attacks:

Laryngospasm

Involuntary spasmodic contraction and blocking of the muscles of the larynx. The child quickly turns pale, begins to inhale heavily and exhale noisily. In acute cases, complete occlusion of the lumen of the larynx and bluish discoloration may be observed. skin, cold sweat and momentary loss consciousness. This is followed by a wheezing exhalation, noisy breathing, the patient calms down and goes to bed exhausted.

Corpopaedal spasm

Syndrome of tonic contraction of the muscles of the feet and hands, less commonly the face: during an attack, the child’s body is very tense, the arms are pressed to the body, the legs are bent - between each other. The attack begins unexpectedly, lasts a couple of seconds and also ends suddenly. After an attack, swelling of the hands and feet may occur.

Eclampsia

Brief loss of consciousness rapid rise blood pressure, transient paralysis – This is the rarest and most dangerous form of spasmophilia, in which in severe cases even emergency aid may not restore breathing and heart function.

A mild attack is characterized by cyanosis of the skin, intermittent breathing, spasms of the facial muscles and numbness of the child. During a prolonged attack (up to 30 minutes), convulsions cover the entire body, and the functioning of the central nervous system is disrupted. nervous activity, tongue biting, reflex urination and defecation.

If there is no immediate help and adequate treatment for spasmophilia, attacks may become more frequent. Very rarely, but still, long-term cessation of breathing with fatal.

Urgent Care

Symptoms of tetany in the form of acute development of an attack of convulsions with laryngospasm, loss of consciousness and respiratory arrest- That critical condition, in which emergency assistance must be provided.

Long-term causes disruption of the central nervous system nervous system and delayed psychotic development of the baby. If a child is affected by this strange disease, it will be useful for parents to know how emergency care is provided for tetany.

If symptoms of obvious spasmophilia are observed, immediate assistance is provided, and after the attack is stopped, the child is hospitalized.

To eliminate mild laryngospasm in a child sometimes standard generally accepted measures are enough, which can be carried out independently without a doctor:

lay the patient on a hard, flat surface and open the windows to ensure an influx of fresh air;
if the clothes are tight and restrict movement, unbutton them;
“shake” the child, change body position;
spray the baby cold water and let them smell the ammonia fumes;

Read also:

If you lose consciousness with respiratory arrest, call ambulance and carry out in parallel artificial respiration using the mouth-to-mouth or mouth-to-nose method.

Healthcare workers can administer 3–5 ml of a 10% solution to the patient intravenously under monitoring the heart rhythm, replenishing the deficiency of calcium ions. If first aid does not bring the desired results and there is a lack of breathing, tracheal intubation is used, and in case of cardiac arrest - indirect massage.

Treatment

The prognosis for the course of obvious spasmophilia in most cases depends on how timely and correctly emergency care was provided. An important role is played by preventive measures to prevent recurrent seizures.

When confirming the diagnosis of spasmophilia, doctors practice abstaining from food and water for half a day, then a carbohydrate diet and a 10% ammonium chloride solution orally. Parents are required to have a responsible attitude towards their child: they need to create quality food, take prescribed vitamins and protect the baby from colds.

Spasmophilia is quite dangerous pathology, which is accompanied by an increase in the excitability of neuromuscular fibers. Today the disease is extremely rare ( statistical research this is confirmed). But, given the fact that children in the first 2 years of life are susceptible to the disease, every parent should familiarize themselves with the basic information about the disorder.

What is pathology?

Spasmophilia is a rare but dangerous condition that is accompanied by muscle cramps caused by increased neuromuscular excitability. The pathology is associated with a violation of phosphorus-calcium metabolism. By the way, an excess of vitamin D in the body provokes such a disease. That is why in modern medicine Rickets and spasmophilia are closely related concepts.

Today, both pathologies are recorded very rarely. However, the possibility of their development cannot be excluded.

Spasmophilia: etiology and causes

First, it’s worth understanding the risk factors that can provoke the disease. Spasmophilia is a disease that mainly affects children aged three months to two years. There are several reasons for the development of pathology, the list of which is worth familiarizing yourself with:

excess vitamin D in the body, which is most often caused by an overdose of drugs intended for;
poor nutrition, in which the child’s body does not receive enough useful substances(as a rule, this is observed when artificial feeding);
excessive sun exposure to the skin (usually when radiation is prescribed as therapy);
Premature babies are more prone to this type of disease.

Extremely rare similar pathology develops in older children. The causes of spasmophilia in this case are as follows:

hemorrhages;
severe forms of infectious diseases;
tumors, including those that negatively affect the functioning of the thyroid gland;
surgical intervention in the thyroid gland area;

In adulthood, neuromuscular spasms develop against the background of strong nervous overstrain, pregnancy.

Rickets in children: symptoms and treatment

As already mentioned, these diseases are closely related. After all, both depend on the level of vitamin D in the body. Before considering the causes and symptoms of spasmophilia, it is worth familiarizing yourself with information about what constitutes rickets in children. Symptoms and treatment, causes and complications - these questions interest many parents.

This disease develops against the background of vitamin D deficiency and other metabolic disorders. The pathology primarily affects the nervous system and musculoskeletal system.

The disease develops if it enters the body along with food. Not sufficient quantity vitamin D. Since this substance is produced under the influence ultraviolet radiation on the skin, then risk factors include lack of sun exposure. Sometimes the disease develops against the background of certain diseases in which the absorption of vitamin D in the intestines is impaired.

Pathology usually develops in young children. First of all, the nervous system suffers from metabolic disorders. The child constantly cries and does not sleep well. Other symptoms include occipital baldness and excessive sweating.

Rickets is accompanied by muscle hypotonia. Baby teeth erupt later and in the wrong order. The fontanelle closes late. In the absence of treatment, the entire musculoskeletal system suffers - deformation of the pelvic bones, indentation or protrusion of the sternum is observed, the skull takes on a cubic shape.

Treatment boils down to eliminating vitamin D deficiency. For this purpose, children are prescribed appropriate medications, as well as frequent walks in sunny weather. Massage, physical therapy and physiotherapy help restore normal work muscles. If rickets was diagnosed on time and the child received necessary help, then the forecasts are quite favorable.

Forms of spasmophilia

Spasmophilia in children can have two forms.

Latent (or hidden). This form of pathology occurs almost unnoticed. The child looks quite healthy, eats and sleeps well. Nevertheless, you can notice signs of hyperexcitability - the baby reacts violently to any stimuli, flinches from sounds.
Explicit (manifest). A form of the disease characterized by obvious symptoms and pronounced impairments.

What symptoms are accompanied by spasmophilia?

What else should moms know? For example, what signs characterize spasmophilia. Symptoms may vary. Quite often, children experience laryngospasm - this is a powerful and sudden spasm of the muscles of the larynx. As a rule, an attack occurs during crying and looks like this:

Breathing is partially blocked, resulting in wheezing sounds in the child. The baby's skin turns pale.
In the most severe cases, the glottis is completely blocked, resulting in the patient being unable to breathe. The skin becomes bluish and cold sweat appears.
Often the child loses consciousness. The apnea may last for several seconds, followed by loud inhalation. As a rule, after an attack the little patient calms down. The attacks may recur periodically.

Carpopedal spasm and its features

A characteristic sign of spasmophilia is spasms of the muscles of the feet and hands. This condition is accompanied by the following symptoms:

cramps of the feet and hands, and the spasm can last from 2 hours to several days;
the baby pulls the shoulders towards the body and bends the upper limbs at the joints as much as possible;
the child’s fingers are clenched into a fist;
the toes also curl inward.

Of course, constant muscle tension negatively affects the child’s condition - he experiences discomfort and pain, which leads to problems with sleep, constant crying, and increased excitability. Prolonged spasm is often accompanied severe swelling hands or feet.

Isolated spasms in a child

Spasmophilia in children can be accompanied by strong contraction of almost any muscle. For example, muscle spasm leads to the sudden development of strabismus. If tension affects smooth muscles internal organs, then the child has problems with urination and defecation.

Very dangerous are the spasms of the so-called respiratory muscles, as this may cause breathing to stop. Occasionally, tension extends to the myocardium. The consequences in this case are extremely dangerous, because the baby may develop tachycardia, and sometimes even cardiac arrest.

Eclampsia: first signs

Most dangerous form spasmophilia is eclampsia. The clinical picture looks something like this:

First, small muscles appear, which are easy to notice, as uncharacteristic facial expressions appear on the child’s face.
The tension quickly spreads to the rest of the muscles - spasms of the muscles of the limbs are observed.
Later, breathing problems and laryngospasm appear. The child's skin becomes covered with sweat and acquires a pale, sometimes even bluish tint. The baby loses consciousness. There is involuntary urination or defecation. Foam appears on the child's lips.

Such an attack can last about several hours. The child must be taken to the hospital, as there is big risk cardiac or respiratory arrest.

Complications of the disease

Spasmophilia is dangerous illness, which should under no circumstances be ignored. The pathology is accompanied by a decrease in calcium levels in the body, which leads to dangerous complications. Severe cramps, breathing problems, problems at work cardiovascular system up to cardiac arrest - all this poses a threat to the child’s life.

Fortunately, in most cases, doctors are able to diagnose the disease in time and take the necessary measures - the prognosis for the child is favorable.

Diagnostic procedures

If you have any of the above symptoms, you should immediately take your child to the doctor. An obvious form of spasmophilia is easily diagnosed - the clinical picture is quite characteristic. But in case of illness, determining the presence of disorders is not so easy. Therefore, during a physical examination, doctors perform some tests.

Chvostek's sign. The doctor gently taps the area between the arch of the cheekbone and the corner of the mouth. In the presence of spasmophilia, a grimace appears on the face of a small patient, which is associated with spam of the facial muscles.
Rousseau's sign. On middle part An elastic tourniquet is applied to the baby's shoulder. If after a few minutes a spasm of the forearm appears, and then the hands are clamped, then this indicates a pre-convulsive state.
Lyust's symptom. Using a hammer or finger, the doctor lightly taps the shin (under the head tibia). With spasmophilia, bending of the toes and a sharp abduction of the limb are observed.
Maslov's symptom. A light injection in any area on the child's body, if available. of this disease leads to a short breath hold after inhalation.

In addition, it is mandatory biochemical analysis blood - during the study, a calcium deficiency is detected in the child’s body.

First aid rules for a child having a seizure

Regardless of the form and severity of the baby’s symptoms, it is necessary to urgently show a doctor. However, the child can be helped.

It is recommended to place the baby on something solid. You should not carry it in your arms, pressing it to yourself, as this only blocks access to air. It is better to remove clothes that restrict movement and open the window slightly, providing the child with a sufficient amount of oxygen.

If you lose consciousness, you can sprinkle cool water on your baby's face. If the attack is accompanied by impaired activity of the myocardium and respiratory muscles, it is recommended to perform a heart massage or use artificial respiration techniques.

Drug treatment of the disease

Often a child with a similar diagnosis is hospitalized. What therapy does spasmophilia require? Treatment includes several stages.

First of all, the baby is prescribed anticonvulsants, which relieve muscle spasms and prevent breathing and heart problems. As a rule, in this case, drugs such as Magnesium Sulfate are used. "Relanium", "Seduxen".
It is important to restore normal level calcium in the body. Therefore, the child is prescribed medications such as “Calcium chloride”, “Calcium gluconate”, “Ammonium chloride”.
Patients are sometimes given sleeping pills and sedatives.
After the attack has been relieved, the child is prescribed a 5% or 10% calcium chloride solution. Therapy lasts about 7-10 days.
Proper nutrition is also important for recovery. If we're talking about about infants, then in the first 8-12 hours after an attack a tea diet is recommended, after which the baby is again transferred to breast-feeding. The diet of the older child should be enriched with sour mixtures, cottage cheese, and kefir. If we are talking about school-age children, then their menu must include porridge, vegetable purees and fruit juices.

Are there preventative measures?

Of course, it is much easier to prevent the development of a particular disease than to try to get rid of it later. Prevention of spasmophilia includes several points. Firstly, it is necessary to monitor nutrition more carefully, especially when it comes to artificial feeding - it is important for parents to choose the right milk formula.

Secondly, do not forget that the disease is directly related to excess vitamin D in the body. Don’t refuse preventative treatment of this product. After all, its deficiency leads to the development of rickets. But during therapy it is important to adhere to the recommended dosages.

Special painful condition children early age(from 2 months to 2 years, more often from 3 to 9 months), associated with a violation mineral metabolism(calcium and phosphorus) and parathyroid hormone deficiency, expressed in increased neuromuscular excitability with a tendency to general or limited (local) tonic or clonic convulsions. It is observed more often in February - April, often in premature babies. With spasmophilia, serum calcium is reduced (less than 9 mg%). In particular, the content has been reduced ionized calcium. Serum phosphorus is usually increased, sometimes decreased. The level of alkaline phosphatase is sharply increased.

There are two forms of spasmophilia:

hidden (latent);

Symptoms of hidden spasmophilia

Facial nerve symptom (Chvostek) - repeated fast reduction facial muscles with short springy blows to the area of the facial nerve in the middle of the cheek. Trousseau's symptom is the rapid appearance of tonic convulsive contraction of the fingers in the form of an obstetrician's hand with moderate compression of the child's shoulder with the palm of the hand or an elastic bandage, as well as plantar flexion of the foot with compression of the calf muscle. Erb's symptom is a sharply increased galvanic neuromuscular excitability. It is tested on the median nerve in the elbow bend (when the cathode is opened, the fingers are flexed). Proofable at current levels below 5 mA. Changes in the child’s psyche - tearfulness, fearfulness, anxiety, worsening sleep and appetite.

Provoking moments: dyspepsia, improper feeding (excessive amount of cow's milk), infectious diseases, agitation, hot baths, mustard wraps how factors that irritate the autonomic nervous system create a predisposition to alkalosis, contribute to the mobilization of phosphorus, a decrease in serum calcium and the transition of latent spasmophilia to overt.

Symptoms of obvious spasmophilia

Laryngospasm (twitch of the glottis). The initial forms of laryngospasm manifest themselves in the form of a loud inhalation or inhalation with a choking sound with any excitement of the child, increased nervous excitability, timidity, or rolling up. Attacks of laryngospasm are characterized by:

a loud, sonorous groaning breath or a croaking breath with sudden stop breathing after unsuccessful attempts to take a breath;

sharp pallor with blue lips, a frightened look;

sharp motor restlessness child or freezing with head thrown back; sometimes the child’s whole body is tense;

tension of the large fontanelle in infants;

signs of the end of the attack: the appearance of several shallow breaths with a whistling tint (air penetration through a still narrowed glottis) and the establishment of normal breathing.

The number and intensity of seizures vary from single ones at large intervals to frequent - 20 or more per day. After severe seizures, the child becomes lethargic, drowsy, and sometimes an attack of laryngospasm can turn into general convulsions.

Less commonly observed are so-called carpopedal spasms - tonic spasms of the muscles of the hands and feet, lasting for hours and sometimes several days.

Bronchotetany is a particularly life-threatening spastic contraction of the bronchial muscles. Sometimes bronchoetania occurs as the first appearance of spasmophilia. It is observed mainly at 3-6 months of age. Its symptoms:

at normal temperature or with existing minor catarrhal symptoms of the upper respiratory tract sudden appearance shortness of breath with flaring of the wings of the nose;

spasmodic ringing cough;

difficult exhalation with groaning, cyanosis;

acute swelling of the lungs; hard breathing, areas with bronchial breathing and wheezing.

The most severe manifestations of overt spasmophilia are eclampsia - general clonic seizures with loss of consciousness.

Differential diagnosis

Laryngospasm must be differentiated from congenital stridor, foreign body aspiration and respiratory affective convulsions(see relevant sections).

Treatment

Emergency aid algorithm:

application of external irritations - spray with cold water, bring a cotton wool moistened to the nose ammonia;

spatula or index finger push the tongue forward or pull it out;

in case of a severe attack:

artificial respiration (with oxygen therapy),

intravenous slow administration of 3-5 ml of 10% calcium gluconate solution or 10% solution calcium chloride,

if ineffective, intracardiac injection of 2-4 ml of 10% calcium gluconate solution, indirect cardiac massage,

tracheotomy with controlled breathing as a last resort;

with repeated attacks of an enema with chloral hydrate, luminal in suppositories or in powders;

after the end of the attack of laryngospasm, the administration of calcium preparations orally is indicated: 10% calcium chloride solution, one dessert spoon, 6-8 times on the 1st day, with a dose reduction in subsequent days.

A diet with a sharp restriction of cow's milk in the first days. After saturating the body with calcium, prescribing a course of vitamin D2 ( alcohol solution) with continued use of calcium supplements.

Primary diffuse pulmonary fibrosis (Gamman-Rich syndrome)

Primary scarring process lung tissue, which initially occurs in the interalveolar septa with secondary change of the entire connective tissue framework of the lungs, resulting in alveolar capillary blockade with hypoxemia and hypoxia.

Symptoms:

attacks of shortness of breath lasting from an hour to a day, later transitioning to severe respiratory and cardiovascular failure;

cough, predominantly dry, whooping cough with sputum, sometimes containing streaks of blood, suffocating, accompanied by pain in the chest and throat;

cyanosis, persistent after several attacks;

increase in temperature;

headache;

hemoptysis;

physical data:

in the lungs there is a box-like tint of percussion sound, scattered dry and fine-bubbling wet rales, sometimes pleural friction noise,

decrease in cardiac dullness (relative and absolute), second tone on pulmonary artery strengthened,

sometimes slight hepatosplenomegaly;

X-ray findings: reticular pattern of pulmonary fields, “honeycomb” appearance, dilated roots, emphysema.

Differentiation with reticular diseases lung tissue(sarcoidosis, Christian-Schuller disease, collagenosis, miliary tuberculosis, idiopathic hemosiderosis, pneumoconiosis).

Treatment is often ineffective: inhalation of a 1-2% trypsin solution; corticosteroids in high doses; oxygen therapy (40-50% oxygen mixed with air); antibiotic therapy for the prevention of intercurrent diseases.

Idiopathic pulmonary hemosiderosis

In the lung tissue, hemosiderin is deposited and fibrosis develops. The vascular bed of the lesser circle narrows, forming hypertension and cor pulmonale.

Symptoms:

periodic crises with attacks of shortness of breath, severe pallor, often with icterus and increased temperature;

cough, hemoptysis;

pain in the chest, stomach;

severe anemia after crises with thrombocytosis, normal blood clotting, indirect bilirubinemia;

the presence of macrophages with hemosiderin in the sputum;

X-ray examinations, unstable multiple large and small lesions (consequence of massive hemorrhages), later compacted roots or fibrous changes;

progressive fibrosis in the lungs and symptoms of cardiovascular failure.

Treatment

Early recognition is necessary for timely active therapy: desensitizing therapy with corticosteroids - cortisone or prednisone, initially large doses; calcium supplements, vitamins C, P, B complex; antianemic treatment.

Congenital stridor

Congenital stridor is detected from the first days of life, gradually weakening by 6 months or ½-2, less often by 3 years. Its causes are anomalies in the development of the structure of the larynx (its deformation, the softness of the epiglottis, folded into a tube, causing the aryepiglottic folds to come together, when inhaling, they stick to the larynx and produce side effects of sound). Perhaps this underdevelopment of the larynx is associated with a delay in the development of innervation.

Symptoms:

a characteristic breath, accompanied by special sounds reminiscent of the clucking of a chicken, the purring of a cat or the cooing of a dove;

decreased stridor during sleep, increased when the child is excited, screaming, crying;

the general condition is not disturbed.

In acute respiratory disease congenital stridor may intensify and breathing becomes more difficult.

The diagnosis is established based on the main features: congenital inspiratory noise, decreasing during sleep, increasing when the child is excited, with a normal voice and wellness are saved. Recognition may be difficult if congenital stridor is layered with inflammatory phenomena larynx and trachea. Interviewing parents helps to establish the presence of stridor from the first days of life.

Congenital stridor must be differentiated:

with laryngospasm during spasmophilia, when respiratory arrest is noted. The phenomena of spasmophilia begin not at birth, but after 3 months. Outside of an attack, no adverse breathing sounds are observed;

with enlargement of the thymus gland. In this case, breathing is difficult, accompanied by collateral noise during inhalation and exhalation. When the head is tilted back, the noise intensifies. Percussion reveals dullness in the upper part of the sternum;

with tumor-like bronchial tuberculosis lymph nodes, which is characterized by expiratory shortness of breath that worsens during sleep, as well as a constant bitonic or whooping cough.

Treatment for congenital stridor is not required.

Shortness of breath in severe rickets

Severe form of rickets with deformation chest, kyphoscoliosis, softness, pliability of the ribs, hypotonia of the respiratory muscles and abdominal muscles, flatulence, highly elevated diaphragm causes:

disruption of normal gas exchange in the lungs with the surface, improper breathing and the appearance of poorly ventilated areas of the lungs, blockage of bronchioles with mucus with the appearance of atelectatic areas;

difficulty in blood circulation in the pulmonary circulation with congestion in the lungs;

frequent prolonged bronchitis, pre-pneumonic condition;

constant shortness of breath of an expiratory nature (“ chronic asthma rickets").

creation of proper hygiene regime;

correct mode nutrition, vitamins C and B complex;

antirachitic therapy ( ultraviolet irradiation) or a course of vitamin D2 with a prescription later fish oil, calcium supplements);

massage, therapeutic exercises.

Shortness of breath of a neurotic nature (a manifestation of obsessive syndrome)

Complaints of shortness of breath with a feeling of “lack” of air “heavy sighs” are observed in school age, less often, in children 5-6 years old who suffered from any acute respiratory or cardiovascular disease with unstable symptoms respiratory failure. None pathological abnormalities it is not detected in children from the lungs and heart. This obsessive syndrome with shortness of breath is observed in children with an unstable autonomic nervous system and is associated with the easy formation of conditioned reflexes at this age, especially with improper parental behavior.

the main thing is not to pay too much attention to these manifestations;

physical education (exercise, sports);

ingestion of a solution of glucose with sodium bromide, ascorbic acid and vitamin B.

Respiratory affective convulsions

Reflex inspiratory suspension of breathing is observed during respiratory affective convulsions. They are accompanied by asphyxia, anoxemia of the brain, sometimes with the addition of general convulsions. They occur in early childhood (from 6 months to 3-4 years). The reason is usually various emotional moments: anger, fear, force-feeding, unexpected joyful excitement.

Symptoms:

the child “goes crazy” from screaming;

initial cyanosis gives way to sudden pallor;

loss of consciousness with cessation of breathing and adynamia, sometimes short-term (up to V2 minutes) epileptiform general convulsions;

ending the seizure with a deep breath with the return of consciousness (sometimes after severe attacks the child falls asleep);

different frequency of seizures (several times a day or repetition at long intervals);

often revealed target setting seizures. This is how children achieve their desires and whims.

Differential diagnosis:

with foreign body aspiration. The main difference between Decnupa toral affective seizures is the recurrence of seizures;

with laryngospasm.

It should be noted that laryngospasm affects younger children. There are always signs of spasmophilia. Laryngospasm begins with a characteristic loud (sometimes groaning) inhalation. But if seizures of respiratory affective convulsions last more than 1 minute and not each of them is associated with affect, then another etiology of convulsions is likely: tracheal anomalies, compression of the trachea by an enlarged thymus gland or large blood vessels with their abnormal location.

Treatment

If the child is still conscious, unpleasant external irritations are used (sprayed with cold water, given ammonia to sniff). In case of loss of consciousness, artificial respiration should be used. For prevention, children suffering from affective respiratory convulsions are advised to take the correct regimen of calcium, bromine, and vitamin B supplements.

Spasmophilia is increased excitability of the nervous system, a predisposition to cramps of individual muscle groups or the whole body.

Most often this is a childhood disease, which affects children from 2 months to 2 years. Children who are bottle-fed or premature are affected. The disease often occurs in the spring, but is very rare in the summer. Spasmophilia affects children with signs of rickets. Spastic states and convulsions are observed, as a rule, in boys.

Spasmophilia manifests itself in the form of attacks of convulsions and laryngospasm (acute narrowing of the glottis), respiratory arrest, and loss of consciousness. IN bloodstream The level of vitamin D sharply rises, the level of magnesium, sodium, vitamins B1 and B6, and chlorides decreases. Urgent resuscitation measures are required. A long-term state of spasmophilia leads to damage to the nervous system, as well as developmental delays mental state child.

Reasons

The cause of spasmophilia is considered to be a failure of phosphorus-calcium metabolism. The calcium content in the blood decreases noticeably. At the same time, the phosphorus content increases. This may be influenced by the consumption of cow's milk with an increased concentration of phosphorus and insufficient removal of phosphorus by the kidneys.

Lack of calcium (hypocalcemia) leads to increased muscle and nervous excitability. With this condition, any irritant can cause the child seizure.

To the reasons causing development spasmophilia include:

Artificial feeding.
Unfavorable sanitary and hygienic environment in which the child has to be long period time.

Symptoms

Symptoms of spasmophilia are associated with the clinical course of the disease, which has 2 forms:

Explicit.
Hidden (latent).

The latent form always precedes the explicit form. This is why diagnosing the disease at the initial stage is difficult.

Outwardly this manifests itself in the appearance muscle cramps, all kinds of disorders of the functioning of the nervous system.

The latent form of the disease is characterized by following symptoms:

Convulsive contraction of the hands when squeezing the child’s shoulder (Trousseau’s symptom);
When you touch the cheekbones, an involuntary contraction of the muscles in the corners of the mouth and eyes is noticeable (Chvostek's symptom);
Slight flexion and rapid abduction of the foot to the side with gentle tapping (Lust's symptom);
Increased nervous excitability (Erb's symptom);
Stopping breathing due to painful stimulation (Maslov’s symptom);
Muscle contraction when exposed to median nerve elbow joint.

In addition, certain signs of rickets are often noticeable:

Increased sweating;
Digestive dysfunction;
Restless sleep.

Any symptom requires immediate consultation with a doctor.

Diagnostics

The diagnosis is made taking into account the following studies:

General and biochemical blood test;
Blood alkalosis (increased pH);
Analysis for hypocalcemia and hyperphosphatemia;
X-ray examination.

When making a diagnosis, the child’s age, type of feeding and time of year are taken into account.

Treatment

Treatment of spasmophilia is predominantly medicinal. In severe cases, the child must be hospitalized. Treatment directly depends on the manifestations of the disease and the general condition of the patient.

In case of severe laryngospasm (loss of consciousness, respiratory arrest), urgent resuscitation measures are required. With prolonged laryngospasm, asphyxia (suffocation) appears. To eliminate it, an oxygen mask and artificial respiration are indicated.

The child should be given drinks (tea, berry and fruit juices) often. Limit intake of cow's milk. Calcium preparations are required: calcium gluconate and calcium chloride solution 10%.

3 weeks after the seizures are relieved, antirachitic treatment is carried out. Limit or perform very carefully all procedures that are unpleasant for the child (injections, examination of the pharynx), which can cause an attack of laryngospasm. Very severe attacks may result in death. But this happens extremely rarely.

Anticonvulsants are prescribed to relieve spasms. Preference is given to seduxen. It acts instantly, but only for a short time. Gamma-hydroxybutyric acid is used. It is administered intravenously, intramuscularly or orally. Simultaneous administration of these drugs is allowed. Hydrochloride can be administered using an enema.

During an attack of laryngospasm you need:

Place the child on a flat and hard surface.
Unbutton your clothes and provide fresh air.
Sprinkle your face with cold water and ammonia to irritate the nasal mucosa.
Inject intravenously calcium gluconate or intramuscular relanium.

If the attack cannot be stopped, then an indirect massage of the heart muscle is performed.

Folk remedies

As an additional remedy can be given to a sick child:

Warm infusion of herbs chamomile, caraway, mint, taken in equal parts. The duration of treatment is 10 days.
Wild chicory. 1 tsp Add chicory roots to a glass of water, boil for 10 minutes, drink before meals.
Eucalyptus. Inhale eucalyptus decoction through your nose every day for at least 15 minutes. For bathing, add 20 grams of plant leaves per 10 liters of water.

Complications

With spasmophilia, the course of all diseases is significantly aggravated. Paralysis of the heart muscle is possible with prolonged illness.

Prevention

Prevention of spasmophilia is identical to the prevention of rickets and includes next row measures:

A balanced diet including cottage cheese, fermented milk products, meat, vegetables;
If breastfeeding is not possible, then the mixtures should contain calcium, phosphorus and magnesium;
For prevention, you need to take vitamin D. In the spring and summer months, the vitamin is not taken to avoid an overdose;
It is required to take calcium supplements and constantly monitor its content in the blood;
Shown preventive massage and daily walks in the fresh air;
Examination by a pediatrician - monthly, by a neurologist - once a quarter.

The prognosis for treatment of spasmophilia is favorable in most cases. With timely diagnostic activities and adequate treatment, there are no relapses, and harm to the child’s health is unlikely.

Spasmophilia in children is a disease associated with increased neuromuscular excitability. In this case, children suffer from spasms and convulsions, uncontrolled contractions of smooth and skeletal muscles, which can lead to respiratory arrest. The cause of this pathology is a failure of mineral metabolism in the child’s body. The disease may be associated with rickets. Most often, spasmophilia occurs in young children. At the same time, a lack of calcium and an excess of phosphates are detected in their blood. Treatment of the disease is aimed at normalizing mineral metabolism and combating.

During an attack of spasmophilia, it is important not to get confused and be able to carry out resuscitation measures and restore the baby’s breathing. General therapy consists of correcting the patient’s diet and increasing the amount of available calcium. Can also be used traditional treatment, which will reduce the manifestations of the disease and become an additional source of minerals.

Causes of the disease

The disease is typical for children aged from several months to two years and is associated with rickets. About 4% of children with rickets suffer from spasmophilia. The disease develops more often in boys.

Spasmophilia is a disorder of mineral metabolism, which is manifested by a decrease in calcium levels, an increase in phosphate levels and alkalization of the blood. At the same time, the metabolism of other minerals is disrupted in children. Their concentration of chlorine, sodium, magnesium decreases, and the potassium content increases. This disorder occurs in children with moderate or severe forms of rickets.

Possible causes of the disease:

An increase in phosphate content can occur when feeding a baby cow's milk rich in these salts.
This condition may be due to insufficient excretion of phosphate due to decreased kidney activity.
A deficiency of parathyroid hormone, the hormone of the parathyroid glands, leads to calcium metabolism disorders.

Clinical manifestations of spasmophilia appear in early spring. This is due to weather changes, an increase in the number of sunny days and more intense exposure to ultraviolet radiation on the skin. This leads to the synthesis of vitamin D, which is responsible for the absorption of calcium from the intestines and its deposition in the bones. If a child does not receive enough calcium through diet (which causes rickets), calcium for bones is taken from the blood serum. This leads to pathological decline concentration of this mineral. Calcium deficiency is manifested by increased neuromuscular excitability and the development of seizures.

Any irritant can trigger an attack. Spasm can develop due to:

strong emotions(positive and negative);
vomiting;
fever;
infectious process and other influences.

During breastfeeding, rickets and spasmophilia develop extremely rarely. Most patients are children who are bottle-fed. More often the disease develops in children from disadvantaged families with low level income. Also, the risk of spasmophilia is higher in premature babies.

Symptoms of the disease

Based on the nature of clinical manifestations, latent (hidden) and manifest (overt) forms of the disease are distinguished. As the child’s condition worsens, the latent form becomes overt.

Define latent spasmophilia is possible only with the help of special diagnostic procedures and tests, in response to which the child develops characteristic symptoms, for example, Khvostek’s, Trousseau’s, Maslov’s and others symptoms. With obvious spasmophilia, the symptoms of the disease appear during attacks.

On initial stage latent spasmophilia develops. The duration of the latent phase ranges from several weeks to several months. If there is no increase in the amount of available calcium, the latent form becomes overt.

Hidden spasmophilia accompanied by signs of rickets:

increased sweating;
rapid heartbeat;
worsening night sleep;
violations emotional background: anxiety, fearfulness, frequent crying;
disturbances of normal digestion.

Latent spasmophilia can be detected using a number of tests. In this case, the following symptoms of pathology appear:

Chvostek's sign: when tapping with a finger or a neurological hammer on the zygomatic arch or angle lower jaw The child experiences twitching in the corner of the mouth or eye.
Trousseau's sign: compression of the brachial neurovascular bundle leads to contraction of the hand muscles.
Lust's sign: Tapping the head of the fibula causes the muscles of the foot to contract, flexion and abduction of the sole.
Erb's sign: a weak electrical discharge in the elbow area causes the fingers to bend.
Maslov's symptom: an injection or other sharp, weak painful effect leads to a short-term cessation of breathing.

The principle of development of all these symptoms is the same: irritation of the nerves innervating certain muscles leads to contraction of these muscles. In healthy children, this contraction does not occur because the stimulation of the nerve is too weak to produce a response. And in children with spasmophilia, neuromuscular excitability is increased, and even slight stimulation of the nerve is enough to cause muscle contraction.

As calcium deficiency increases, the child's condition further deteriorates, and spasmophilia becomes apparent. Main sign this form of spasmophilia - . In this case, a spasm of the laryngeal muscles occurs with partial or complete closure of the airways.

Symptoms of laryngospasm:

pallor or bluishness of the skin;
wheezing;
possible complete cessation of breathing;
short-term loss of consciousness;
short-term cessation of breathing during night sleep (apnea).

The spasm is short-lived and lasts a few seconds, after which the muscles relax, the child takes a deep breath and calms down. The symptoms go away. In rare severe cases, the spasm does not go away on its own, and this can cause the child to completely stop breathing and die. Laryngospasm can occur several times a day. This condition can be provoked by crying, screaming, vomiting, but it can develop without visible reasons.

Another sign of the disease is carpopedal spasm– contraction of the muscles of the child’s feet and hands. Such a tonic spasm can last for several hours or even days.

Spasms can also affect other muscle groups:

when the eye muscles are damaged, the child develops strabismus;
spasm masticatory muscles manifested by clenching of the jaws and stiffness of the neck;
spasm smooth muscle leads to disruption of the processes of urination and defecation;
Rarely, a spasm of the heart muscle occurs, which leads to cardiac arrest.

In severe cases of the disease, the child develops eclampsia. This is a generalized seizure. At the beginning of the attack, facial muscles twitch, then convulsions occur skeletal muscles, laryngospasm occurs with partial or complete cessation of breathing. The child loses consciousness. Smooth muscles are also involved in the process, and the baby has spontaneous bowel movements and urination. The duration of such an attack can be from several minutes to several hours.

Laryngospasm and eclampsia most often develop in children under six months of age. In older children, the main clinical manifestation The disease is caused by carpopedal spasm.

Treatment of spasmophilia

During an attack, the baby may experience a spasm of the larynx with respiratory arrest and loss of consciousness. It is very important that parents are ready to provide first aid to the baby before the specialist arrives. Any delay is dangerous, because a long (more than 3-5 minutes) stay in this state can lead to irreversible brain damage and death of the baby.

Emergency help to relieve spasm:

The child’s face should be sprayed with cool water;
the baby needs to be shaken;
in some cases, patting the buttocks helps;
you need to press on the root of the tongue;
It will be useful to provide access to fresh air.

If these actions do not bring results, and the child has stopped breathing and heartbeat, resuscitation measures are necessary: chest compressions and artificial respiration.
Treatment of spasmophilia involves correcting the child’s nutrition. With food, the baby should receive a sufficient amount of available calcium. For infants the best option There will be breastfeeding. But as the baby grows, the calcium in breast milk becomes insufficient, and the mother needs to start introducing complementary foods.

Complementary foods are introduced starting from the child's six months, gradually, one new product at a time, carefully monitoring the baby's reaction. Porridge and puree of boiled vegetables and fruits are suitable for complementary feeding.
Also to reduce the manifestations of spasmophilia as additional funds can be used folk recipes. Such decoctions can be given to children after the first year of life.

A series. Steam 1 tsp in 200 ml of boiling water. dried herb successions, leave in a water bath for 15 minutes, then cool and filter. Give the baby 1 tbsp. l. of this drug three times a day.
Mint. Steam 1 tsp in a glass of boiling water. mint, leave for half an hour, then filter. Give the baby 1 tsp. infusion 4 times a day.
Walnut. An infusion of the leaves of this plant is prepared. In 200 ml of boiling water, steam 1 tsp. crushed leaves, leave for 1 hour, then filter. Give the child 1 tsp. three times a day.

Prognosis and prevention

The prognosis for most children is favorable. If spasmophilia is detected in a timely manner and parents correct calcium deficiency, all symptoms of the disease disappear completely. Death occurs in extremely rare cases from respiratory or cardiac arrest during an attack if qualified first aid is not provided.

However, with prolonged laryngospasm or eclampsia, the baby may experience disruption of the central nervous system and mental retardation due to a lack of oxygen supply to the body.

Breastfeeding is key for prevention. Rickets and spasmophilia extremely rarely develop in such children, since mother's milk is balanced in its mineral composition and is a sufficient source of calcium for infants. Substitutes mother's milk, especially cow's milk, are often unsuitable for feeding babies because they mineral composition does not meet needs child's body. Also, to prevent calcium deficiency, it is important to introduce complementary foods to the child in a timely manner (from six months). Fruit and vegetable purees and cereals are suitable for complementary feeding.

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