Child 1 year cramps what to do. Clonic convulsions

Some children have a special reaction to fever - convulsions. Unprepared parents who find themselves in a similar situation may become confused and even panic. Why does a child have convulsions and how to act correctly in critical circumstances? We will look at the causes of spasms in a baby and give step-by-step instructions for moms and dads who had to deal with this phenomenon.

Some children react to high temperatures with seizures.

Causes of seizures

Experts to this day have not been able to give an exact answer to the question of what is the cause of spasms. One of the hypothesized factors is the imperfection of the nervous system, the other is a genetic predisposition. According to some studies, seizures are more common in children whose parents showed similar symptoms in infancy. Also at risk are babies in whom one of the relatives suffers from epileptic seizures.

A decrease in calcium levels in the blood can also lead to spasms. In this case, accompanying phenomena are also possible - apnea, bloating. A good doctor, after conducting a series of tests, will be able to immediately suspect a lack of calcium in the blood of a small patient. To confirm the diagnosis, you will need to do a blood test.

Seizures in newborns

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Separately, it is worth mentioning such a phenomenon as convulsions in newborns. They do not necessarily occur as a reaction to a fever:

• Spasms on the background of birth trauma may indicate hypoxic damage to brain tissue. Such convulsions develop in the first eight hours of a newborn's life.
• Hypoglycemic spasms. They can occur against the background of a low level of glucose in the blood of an infant. As a rule, this phenomenon can be observed in the first 48 hours after the birth of the baby.
• withdrawal syndrome. Mothers who took alcohol or drugs during pregnancy have children who are accustomed to regular doses of the drug. After the birth, the baby stops receiving the toxin, which can cause him to “break”.

There are other causes of seizures in newborns. However, they are most often the result of serious diseases that are diagnosed during pregnancy or at the time of the birth of the baby.

Symptoms: general and individual

Each child may experience seizures differently, but there are common points for everyone. As a rule, febrile seizures have standard features:

• during spasms, the baby does not respond to external stimuli;
• convulsions can provoke a discoloration of the skin - pallor or even a slight bluing is possible;
• most often, muscle spasms last 5 to 15 minutes.

However, in reality, seizures can look different in each case. Often they have a different character:

• Tonic - the child stretches out to the string, throws back his head, the whole body twitches. These seizures are more common. As a rule, in this case, the child stretches his legs, presses his hands to his chest, throws his head back. The twitches are fading in nature and gradually disappear.
• Atonic - in this case, all muscles relax, even the sphincter. In addition, the baby may urinate. This type of seizure is much less common.
• Local - the muscles of the limbs tense and twitch, or only one part of the body.

With tonic convulsions, the child stretches into a string and strains all the muscles

Diagnosis and consequences

Experts believe that febrile convulsions in children under six years of age will not affect their health in the future. Most often, the child outgrows this nuisance and by the school age already tolerates high temperatures without any problems. According to neurologists, the children's brain has a high potential and quickly recovers from oxygen starvation, which provokes convulsions.

However, convulsions can transform into epilepsy, which happens only in two cases out of a hundred. It is imperative that a child prone to convulsions be seen by a neurologist. The doctor will give recommendations to parents and help stop the development of undesirable consequences. Moreover, even if the doctor is sure that febrile convulsions are taking place, it is better if the child undergoes a series of examinations. It usually includes:

• a general blood test, for calcium and glucose;
• general urinalysis;
• computed tomography of the brain;
• analysis of feces for worm eggs.

Sometimes additional examinations are required - electroencephalography of the brain or specific tests. Also, the pediatrician may recommend consulting a vascular surgeon. All this will give a complete picture of the disease and help the doctor exclude the possibility of any serious disorders.

What should be feared?

Convulsions due to fever are most likely febrile and do not require treatment. There are other, not so harmless causes of convulsions during a fever:

• Infections that affect the brain - such as tetanus. Today, this disease is very rare, since most children are vaccinated.
• Drug poisoning. If a child has swallowed something from a home medicine cabinet - antidepressants or antipsychotics, the medicine may well give out a similar reaction.
• Poisoning by mushrooms or plants.
• Dehydration due to prolonged diarrhea, vomiting.

Most often, seizures are febrile and resolve on their own after a decrease in temperature.

If convulsions occur without being accompanied by a high temperature, there is a possibility that epilepsy is manifested in this way (see also:). This disease has several forms and is not always diagnosed during the initial examination. Epilepsy attacks can be short-term, during which the baby's gaze stops and movement is inhibited. In other cases, the attack is accompanied by convulsions, foam at the mouth, and even swallowing of the tongue. People with epilepsy are under the care of a doctor. To reduce the number of seizures, they must take special medications.

How can you tell a febrile seizure from an epileptic seizure? For a number of reasons, this is quite difficult to do when it comes to a preschooler. However, there are several signs that may indicate the presence of epilepsy. Recall that the listed features are not the only and sufficient condition for making a diagnosis:

• stereotyping - seizures are associated with a certain time of day, they are the same in duration;
• the child may urinate during an attack;
• after the seizure, the baby falls asleep.

How to help?

As soon as the parents have determined that the child has started febrile convulsions, you need to act immediately. The right decision is to call an ambulance. However, until the doctor is nearby, it is important not to aggravate the situation. You won’t be able to stop the process, but parents are quite capable of trying to avoid the consequences:

• It is necessary that the baby lies on his back on something hard, and not on a soft feather bed. Make sure that the head is in line with the body, and a folded blanket lies under the neck.
• Try to cool the patient in order to bring down the temperature a little (more in the article:). Open a window or window, unbutton the clothes around the baby's neck and chest.
• Control breathing - if the baby holds his breath and exhale, artificial respiration is allowed, but only after an attack.
• Make sure that the child does not choke on vomit. If the baby has a gag reflex, it is worth turning it on its side.
• Remove toys and other objects that the child can catch on and get hurt.

As a rule, after five minutes (sometimes a little more), the spasms stop and the child comes to his senses. Now you can bring down the temperature with the help of medicines so that the convulsions do not recur. You can give an antipyretic syrup or use suppositories.

What can not be done?

Under no circumstances should you panic. Mom should act calmly and deliberately. It should be understood that convulsions at a temperature are a fairly common phenomenon, the doctor will quickly provide the child with the necessary assistance. The main thing is to wait for the doctor and make sure that the child is in the correct position. Do not make unnecessary noise, and also turn on bright lights. It is also not necessary to transfer the patient, it is better to try to arrange a comfortable place where he was caught by a seizure.

You can not try to open the baby's teeth with a spoon or other object, and also try to immobilize him. Some parents try to pour medicine into their mouths to bring down the temperature - this is strictly prohibited. The child may choke on the liquid. In this situation, it is recommended to use rectal suppositories to lower the temperature. In this case, it is still better to wait for the end of convulsions and only after that give medication.

For convulsions, it is better to use antipyretic candles.

Prevention of seizures

It is difficult to avoid a repetition of the situation when the baby has febrile convulsions. There is a high probability that such a nuisance will not happen again. Usually, only one in three children have seizures again, but some have to put up with them. You can only try to avoid too high a temperature by knocking it down in time. It is even better to act in a complex way - to strengthen the child's immunity so that he gets sick as little as possible, and his body can easily cope with all kinds of respiratory infections.

Cramps are muscle contractions that cause aching and sharp pain. Actually, convulsions are a process of muscle contraction that occurs involuntarily. Accompanied by pain and a number of recurring attacks within a short time. Tonic and clonic seizures often occur in children, are found in representatives of any age.

To determine the cause, it is recommended to consult a doctor. The doctor will conduct an examination, as a result of the diagnosis, an accurate one will be revealed. Children are more sensitive, mainly at an early age, if appropriate symptoms are detected, it is necessary to provide timely assistance, consult a doctor.

Mixed, or tonic-clonic, type of seizures is known. There are convulsions due to disruption of the central nervous system. These two types of seizures are accompanied by epileptic seizures, distinguished by characteristics.

Spasms appear as a result of all kinds of harmful effects on the body. Impacts and cause muscle contraction. If the contractions occur in a short period of time, this paroxysmal appearance is called tonic convulsions.

With the clonic type of seizures, the muscles spasm involuntarily, presenting smooth muscle contractions, in contrast to tonic ones that occur sharper. Tonic spasms usually spread to the arms and other parts of the body, including the legs, face. In such conditions, the patient experiences loss of consciousness.

It is impossible to allow the tongue to fall on the palate when giving first aid. The patient is able to choke on foam, which becomes dangerous for his condition. Even death is possible.

Convulsive syndromes in children. Tonic and clonic seizures in childhood

Pathology, manifested in convulsive states, occurs in 2-3% of children. In a child, convulsions are more active due to the immature state of the child's body, the immature state of the cerebral cortex. Cerebral edema causes the manifestation of convulsive conditions in children, the tendency of the child's body to be affected is higher than in adults.

The causes of the appearance of convulsive conditions in children depend on age, for each age category, peculiar types of spasms are characteristic. often occur in connection with asphyxia, cerebral hemorrhage and other causes. Among the reasons are high vascular permeability and hydrophilicity of the brain.

If a violation of the water balance of the body or an overdose of drugs was found in children, it is quite possible that these facts can be included in the causes of convulsive conditions.
A number of causes of seizures in children are known:

• Convulsions arising from trauma and various infectious diseases, epileptic and encephalitic reactions.
• Epilepsy syndrome on the background of the inflammatory process.
• Epilepsy attacks that occur against the background of disorders of the central nervous system.

The intensity of convulsions, the time of their course depends on the strength of the expression of the epileptic seizure. Asphyxia is characterized by a lack of oxygen in the blood and tissues. Carbon dioxide accumulates there, respiratory and metabolic acidosis develops. There is a violation of blood circulation, an increase in vascular permeability. Intracranial disorders are considered the main symptom of seizures in children.

Convulsive syndrome is inevitable when it comes to dehydration and lack of water balance in the child's body. The convulsive syndrome is manifested as a result of disruption of the brain, leading to intracranial disorders, cerebral edema and neuroinfections.

Symptoms of convulsive conditions in children

A wide variety of clinical manifestations of convulsive syndromes in a child has been described. There are convulsive states according to the time duration, forms of manifestation. Clonic and tonic contractions are the most common types, most often found in children.

Symptoms of clonic seizures:

• Twitching of the muscles in the face, passing to the rest of the body and limbs.
• Noisy, hoarse breathing and foaming at the mouth and on the lips.
• Paleness of the skin.
• Disorders of the heart.

The clonic type of seizures is long in duration. In selected cases, it can be fatal. If a corresponding disease is detected, you should immediately consult a doctor, be able to properly provide first aid, following the steps, without violating them.

Tonic convulsions in a child are prolonged muscle contractions, characterized by a slow onset and a sharp manifestation.

With clonic disorders, situations are possible:

• Loss of contact of the child with the environment.
• Muddy and floating look.
• Throwing back of the head, bending of the arms in the hands and elbows, elongation of the legs, closeness of the jaws.
• Slow breathing and heart rate.
• The child is able to bite his tongue.

The described phase of the convulsive state is considered tonic-clonic, lasts no more than a minute. A convulsive attack does not occur spontaneously, it depends on the cause that directly affects its development. If convulsive conditions occur on the basis of brain injuries, they are considered tonic-clonic type.

Convulsive conditions in most patients are of a general nature: foam appears in the mouth, almost always the patient loses consciousness. The syndrome of convulsions in children is clearly manifested, starting from the age of three. In young children, manifestations of a tonic character, clonic type develop - they come already in older periods.

Focal seizures - a type of seizures, typical for older children. Separate forms of such states are combined into status ones, leading to extremely serious consequences. The disease is unstable, the patient has excruciating convulsions. In some cases, these forms of seizures lead to paralysis or death. A sick child needs to be immediately provided with the necessary treatment, a young sensitive organism perceives diseases faster than a mature adult. The child's body is often unable to cope on its own with a number of diseases, having a weak immune system, which is not always able to protect against the disease.

The form of children's that occurs in children from an early age is known. Spasms are observed in a child from several months to five years. Febrile convulsions are divided into certain types - they distinguish typical and atypical forms of contractions. There are simple and complex.

Complex convulsions, or atypical ones, last up to 15 minutes, accompanied by a temperature of up to 39 degrees. Simple spasms are accompanied by short attacks, body temperature is not lower than 39 degrees. Complex forms of febrile seizures can last for a day, it is shown to immediately consult a doctor. It is forbidden to leave a sick child in such a state. It is not difficult to identify the causes of the appearance of convulsive conditions in a child.

How to help children with seizures

Children need help in several ways.

• Be sure to maintain the basic important functions of the body.
• Administer anticonvulsant therapy.

In convulsive states of any level, make sure that the child has an open airway. It is desirable to maintain the process of blood circulation in a stable state. In the event of violations or complications, timely therapy is required.

If prescribed medications do not work, phenobarbital is prescribed as an additional treatment. Seizures, accompanied by seizures of epilepsy, sometimes lead to serious complications. Seizures are distinguished by different forms - from relatively mild and short-term to severe, prolonged.

Convulsive seizures are relatively common lesions of the nervous system in children. Baby seizures can occur in a baby at different periods of his life, and they are associated with different reasons.

Seizures may be associated with the influence of harmful factors, which can occur both during the period of intrauterine development of the fetus, and during. Such factors can affect the baby after birth, in the first months of his life. Seizures are much more common in children than seizures in adults.

Causes of seizures in children

Due to the fact that the brain in children at an early age is not yet mature enough, they have a low threshold of excitability of the central nervous system and, accordingly, a tendency to convulsive reactions. In young children, there is a high permeability of the walls of blood vessels, so cerebral edema under the influence of harmful factors (toxic effects, infections, etc.) develops very quickly. They are accompanied by a convulsive reaction.

Seizures in children are usually classified into non-epileptic And epileptic . It happens that the first eventually develop into the second. But one can talk about epilepsy in a child only if the doctor confirms the diagnosis after a detailed examination and study of the medical history.

Non-epileptic seizures the child may appear relatively often. Convulsions in newborns can occur due to asphyxia, injuries received during childbirth, with the manifestation of defects in the central nervous system, diseases of the cardiovascular system, etc.

In addition, seizures in children can be a consequence vaccination , intoxication of the body, infectious diseases, as well as metabolic disorders. Therefore, when convulsions appear, it is necessary to immediately conduct a comprehensive examination of the child and find out what reasons led to this phenomenon.

The most common causes of seizures in children are the following situations. Convulsions in children immediately after birth may develop due to asphyxia. Due to suffocation, blood circulation is disturbed, develops cerebral edema, and hemorrhages appear in it. In such a situation, the baby needs to be provided with timely professional assistance, because with prolonged asphyxia, the tissues are scarred, and brain atrophy.

Often, convulsions due to this cause develop during complicated childbirth, when there is an entanglement of the umbilical cord around the neck, premature discharge of amniotic fluid, placental abruption. As soon as the child is taken out of this state, the convulsions stop, and the baby's condition returns to normal.

Convulsions are also accompanied by intracranial injuries received during childbirth. Most often, such seizures in children occur local , that is, there are facial cramps, or cramps in the legs in children. Sometimes these children have muscle weakness, and in severe cases, general convulsions of the whole body. If an infant who has just been born has intracranial bleeding, and assistance is not provided to him in time, then convulsions appear about 4 days after birth. Sometimes seizures occur later, a few months after the birth of the child. The reasons for this phenomenon are damage to brain tissue due to scarring. In this case, convulsions in infants may occur due to vaccination, infection, trauma.

The impetus for a seizure in this case can be an injury, a preventive vaccination or an infection. Convulsions can be observed if the child has a congenital defect in the development of the central nervous system.

With the development of infectious diseases, convulsions can occur both in children who have suffered injuries during childbirth, and in perfectly healthy babies. A toxic virus that attacks the child's body negatively affects his nervous system. As a result, the symptoms of the disease are manifested, among other things, by convulsions.

Very often, convulsions occur in children under one year old in the acute phase or. If the child has chicken pox , then convulsions may appear at the peak of the rash. With neuroinfections, convulsions in children occur due to an increase. At the same time, the whole body is tensed. After adequate treatment of diseases is carried out, and the temperature returns to normal, convulsions stop.

Sometimes the occurrence of seizures in children can be associated with a response to management. The risk of seizures is especially high in children who have a high degree of convulsive readiness. Therefore, the parents of such children must know how first aid is provided for convulsions. To do this, you can not only familiarize yourself with the relevant rules, but also watch the video. But if the child has previously suffered asphyxia, birth trauma, or exudative diathesis , then he most likely will not be given preventive vaccinations.

Seizures in children can also occur due to disturbances in metabolic processes. As a result, the body is deficient in certain minerals ( magnesium , potassium , calcium ).

But if daytime and nighttime cramps in children develop for no apparent reason, then parents should definitely consult a doctor to rule out development.

Types of seizures

Given the nature of muscle contractions, are determined tonic And clonic convulsions . tonic convulsions in children, these are relatively long muscle contractions, as a result of which the limbs are frozen in the position of flexion or extension. In this case, the child's body is stretched, and the head leans towards the chest or throws back. For clonic seizures are characterized by dynamic contractions of the flexor and extensor muscles. As a result, rapid involuntary movements of the trunk, arms, legs are noted. Often also occurs tonic-clonic convulsions, when there are two phases in an attack. If you determine the completeness of the involvement of skeletal muscles, then local (partial ) And are common (generalized ) convulsions.

Febrile convulsions in children develop in children under the age of six. They occur at high temperatures. We can talk about febrile convulsions if we are talking about the occurrence of convulsive seizures in children who have not had seizures before. Such convulsions are associated with the immaturity of the nervous system and occur against a background of high temperature. One of the important factors in this case is the genetic predisposition to seizures. With febrile convulsions, the child is completely removed from the outside world, he can turn blue, hold his breath. Sometimes such convulsions occur in series, but they rarely last more than 15 minutes. Treatment of this condition is carried out only with the participation of a doctor. When they appear, it is important to provide the correct first aid.

Respiratory-affective convulsions develop in a child as a result of very strong emotions. This is a kind of hysterical reaction to an emotional shock. Such convulsive seizures are observed in children during the period of life from 6 months to 3 years.

Symptoms

For seizures in a child throws back the head, limbs stretch forward. Most often the baby loses consciousness He clenched his teeth and rolled his eyes. In some cases, foam appears on the lips. The body is tense, but the limbs may twitch, or they completely open and freeze. The baby may have blue lips, involuntary urination or loss of feces also occurs.

After an attack, the child becomes lethargic, drowsy, he often does not remember what happened to him, he may not be able to navigate in space.

Diagnostics

Thus, when evaluating convulsive seizures, the doctor necessarily takes into account information about heredity, the health of the parents, about the diseases suffered during pregnancy by the mother of the baby, about pathologies during childbirth. The collection of anamnesis involves determining the nature and characteristics of convulsive seizures. In particular, it is important to determine when the seizures occurred, how the seizure started, how often the seizures recur, and other important points.

In the process of diagnosis, the doctor receives important data during electroencephalography. Also practiced is the study of the fundus, which allows you to detect some pathologies in children. If necessary, also assigned CT scan , pneumoencephalography , angiography , spinal tap and etc.

First aid for seizures

If the parents notice that the child is starting to have convulsions, then the first thing to do in this case is to call an ambulance. During the waiting period for doctors, it is necessary to act actively. First of all, the baby needs to be rid of tight clothes and put him on his side. The child should lie on a flat and hard surface. If the baby is lying on his back, then turn his head to the side. During convulsions, it is necessary to ensure the patency of the airways. First you need to clear the mouth of mucus. To prevent biting his tongue and allow air to enter, he needs to put something between his teeth. It can be a handkerchief or a folded piece of cloth. If a child puts something hard in his mouth, he can break his teeth. In order for the room to have fresh air, you should immediately open the window.

With convulsions that occur during crying, it is important to create the most calm environment around the crying child. If a convulsive seizure is noted with a strong crying of the child, then he needs reflexively restore breathing . You can sprinkle the baby with water, press on the root of the tongue with a spoon, let him breathe with ammonia. You can also pat your child on the cheeks. After that, it is recommended to give a sedative. You can use the usual tincture of valerian at the rate of 1 drop per 1 year of the baby's life. Sometimes, with strong tension and lack of breathing, the baby has to do artificial respiration . But it should be done only after the end of the attack, since this method is not practiced during the attack.

If a child has febrile convulsions, then measures must be taken to lower the body temperature. The baby needs to be given an antipyretic (,), undress him, make a wrap with vinegar, or try to bring down the body temperature by other methods. Until the convulsions are over, the baby must be constantly monitored. You can give him water only after the convulsions have ended.

If, at high temperature and convulsions, pale skin, blue lips and nails, chills, cold feet and palms are observed, then we are talking about pale fever . In this case, it is impossible to cool the child's body. It needs to be warmed up and given an injection or at a dose of 1 mg per 1 kg of weight in order to expand the vessels.

Children who are prone to febrile seizures , no need to take to the bath, let out on the street during the hot period of the day. A child who is prone to convulsions with an increase in body temperature should not be left alone if her growth is noted.

After the baby was given first aid, he was hospitalized in the neurological department of the hospital.

Treatment of seizures is carried out only after the diagnosis is established and, above all, consists in the treatment of the underlying disease. In the process of treatment, anticonvulsants are used, thermal procedures, massage are prescribed. It is also practiced to use antipyretic drugs , dehydrating agents , as well as drugs that improve metabolic processes in the body.

Thoughts will be filled with memories of terrible pictures of convulsions in patients with epilepsy. But the stress will pass, everything will fall into place. As soon as the baby becomes easier, it will be possible to calmly understand the reasons for what happened.

The mechanism of occurrence and causes

Cramps are involuntary muscle contractions that occur under the influence of too much excitation of the neurons of the motor part of the brain. They mostly appear in children under the age of 3 years. With age, their frequency decreases. Seizure activity remains only in 2-3% of children diagnosed with epilepsy or organic damage to the central nervous system.

A favorable condition for the occurrence of spasms is the unformed central nervous system of babies. Unpreparedness for full functioning after birth is common to all babies. However, hypoxia during fetal development, intoxication and infectious diseases of the expectant mother lead to the fact that the unformed structure of the brain and its functions in the newborn will be more noticeable. Asphyxia, CNS damage, hemorrhages that occurred during childbirth also have a negative impact on the infant's readiness for independent living. Most of the problems are corrected in the first year of life under the influence of drug therapy, physiotherapy.

The main causes of involuntary muscle spasms are:

1. Traumatic brain injury.
2. Intoxication of various types.
3. Vaccination.
4. Epilepsy. The disease is mainly hereditary. It is believed to be passed down through generations to children of the same sex.
5. Inflammatory infectious diseases of the brain, for example, meningitis, encephalitis.
6. Neoplasms.
7. Congenital and acquired pathologies of the cardiovascular and endocrine systems.
8. Heat. The threshold of response to hyperthermia in different children is different and depends, among other things, on the formation of the central nervous system.
9. Imbalance of vitamins and minerals.

Kinds

Seizures in children are classified according to several criteria:

• distribution area;
• the nature of the stress;
• flow features;
• causes of occurrence.

Classification by area of ​​distribution

Depending on the area of ​​distribution, they speak of partial and generalized convulsions. Partial (local) arise when the electrical activity of a certain area of ​​the cerebral cortex increases. They manifest as twitching of individual muscles of the foot, arms, tongue, including during sleep.

Generalized convulsions take over the whole body. A characteristic feature is the tension of the body in a string. At the same time, the head is thrown back, the legs are unbent, the arms are bent to the chest, the teeth are clenched, the pupils do not react to light, the skin turns pale, turns blue. In most cases, loss of consciousness occurs. This is characteristic of epileptic seizures, hysteria, tetanus, acute intoxication or infection, circulatory disorders of the brain.

Before an attack, hallucinations may occur, and an inarticulate scream immediately precedes convulsions. With epilepsy, there are several seizures in a row. One attack lasts up to 20 seconds.

Classification by the nature of stress

Depending on the nature of the manifestation, they speak of clonic, tonic and atonic convulsions. Clonic spasm is pulsating in nature, the muscles contract and then relax. The chaotic movement of the limbs is characteristic. The baby may wake up and cry. Tonic convulsions are characterized by strong, prolonged muscle tension. The limbs seem to freeze for an indefinite time. Appear slowly. The kid doesn't make a sound. There are also tonic-clonic convulsions.

Atonic seizures can be attributed to the same group. They are characterized by the absence of tension. There is a rapid relaxation of all muscles. Involuntary defecation or urination is possible. Often the cause of atonic spasms is Lennox-Gastaut syndrome, which manifests itself in children aged 1 to 8 years.

Classification by flow features

Depending on the characteristics of the development of seizures, they speak of myoclonic, flexor, infantile spasms and absences.

And instantly capture one or more muscles. They don't cause pain. From the side, they resemble tics or twitches. The main causes are metabolic disorders, brain pathologies. The attack lasts for 10-15 seconds.

Infantile convulsions during sleep in a child aged 6-12 months. Occur during sleep or after waking up due to sudden movements and when feeding. Manifested by a cry, like a grimace, rolling the eyes, increasing the size of the pupils. It is believed that convulsions in children of this type are evidence of mental retardation. They can also be the initial symptom of paralysis, microcephaly, or strabismus.

Flexor convulsions are typical for children under 4 years of age. There is an unrelated flexion or extension of the body, neck, limbs, repeated several times. Duration - from a few seconds to half an hour. For a short time, loss of consciousness is possible. The causes of occurrence are unknown.

In children aged 4 to 14 years, an absence develops, characterized by a stoppage of gaze, a lack of response to external stimuli, and immobilization. In some cases, there are involuntary chewing movements, smacking. At the heart of this are stress, fatigue, traumatic brain injuries, brain infections. According to the EEG, electrical activity increases in the occipital region.

Classification by cause

Most often, febrile, epileptic and respiratory-affective convulsions are isolated in children.

With the greatest frequency of manifestation at the age of 6 to 18 months. Having happened once, convulsions at a temperature appear in 30% of children. Pathology covers both single muscles and separate groups. Perhaps facial tension, tilting of the chin. The skin turns blue, the baby sweats a lot. At some point, loss of consciousness and respiratory arrest may be noted. Then comes relaxation.

Without fever, seizures occur in a child due to epilepsy. In this case, the attack is generalized.

Respiratory-affective arise due to an excess of emotions in children from six months to 3 years. characteristic of premature babies.

Symptoms

The main signs of seizure activity are:

• involuntary movements;
• cyanosis of the skin;
• limb tension;
• tightly clenched teeth;
• foaming;
• involuntary urination;
• eye rolling.

Diagnostics

Even after a single attack, it is important to diagnose and understand the question of why convulsions arose. This will avoid relapse, prescribe treatment and just calm down. Seizures can occur not only at temperature, epilepsy. In infants, they may be the first signs of cerebral palsy or mental retardation.

After recovery, the pediatrician gives a referral for tests and a visit to a neuropathologist or endocrinologist. Analyzes include a general picture of urine, blood and biochemistry. In most cases, you will need to do an electrocardiogram and consult a cardiologist.

The pediatrician and neurologist will collect the seizure history by asking questions about the following:

• heredity;
• what could be the cause of the attack;
• features of pregnancy and childbirth;
• features of the first year of life;
• attack duration;
• symptoms;
• the nature of the seizures;
• how many times the spasms recurred;
• Was there a loss of consciousness?

In some cases, the neurologist will send for the so-called lumbar puncture - a sample of cerebrospinal fluid. An electroencephalogram is mandatory. If neoplasms or vascular disorders are suspected, the doctor gives directions for an MRI or computed tomography. You may need to check the fundus and consult an ophthalmologist.

Convulsions at a temperature also require diagnosis, despite the fact that the cause of their occurrence seems clear. Only 5% of young children with hyperthermia have convulsive attacks, so it is better to make sure that the child does not have any organic pathologies.

When the first signs of convulsions occur in children, regardless of their cause, emergency care is required. Often parents have no idea what to do with seizures in a child.

With convulsive activity of any etiology, all dangerous objects that can lead to injury to the patient are removed. If the attack occurs indoors, open a window for ventilation. The temperature in the room should not exceed 21 °C. Adults, whether they are parents, educators or teachers, should always be near the patient until the moment of the complete end of the attack and the return of consciousness.

In all cases, when joining the convulsions of stopping or holding the breath, it must be remembered that during an attack it is impossible to make artificial respiration. The muscles of the respiratory tract are tense and do not allow air to pass through. You have to wait until the end of the attack. Waking up, disturbing the patient is not recommended.

As a first aid for convulsions in children, they are laid on a hard surface, the whole body or only the head is turned on its side, outer clothing is removed or loosened. In no case do not give a drink. As soon as the convulsions go away, saliva and vomit are removed from the mouth.

If a seizure begins in a child diagnosed with epilepsy, one must be prepared for the fact that spasms will cover the entire body. They will be joined by loss of consciousness, and, possibly, a second attack will occur. After the baby is laid down, a towel roll is placed under the neck, a corner of the towel is pushed between the molars. In no case should a metal object be placed in the mouth, it can damage the teeth, the remains of which will fall into the larynx. Any drugs are administered intramuscularly and only by a doctor.

If convulsions occur in children at a high temperature, they are undressed, wiped with alcohol, covered with a towel dipped in water. During an attack, it is unacceptable to give drugs orally. The muscles are compressed, the baby will not swallow it anyway, but it will be able to choke on it at the end of the attack. If it is necessary to urgently take measures to reduce the temperature, put rectal suppositories with paracetamol.

Treatment

Treatment tactics depend on the nature and causes of the disease.

In case of convulsions at a temperature or convulsions of an affective-respiratory nature, children are usually not hospitalized, treatment continues at home. After the attack caused by the high temperature has ended, the children are re-cooled by wiping the body with a solution of vinegar, vodka, or applying a damp towel to the forehead. If after the end of the convulsions the temperature does not subside, the baby is given an antipyretic - Paracetamol or Efferalgan. With the repetition of seizures or their duration for more than 15 minutes, the doctor prescribes anticonvulsants - Diazepam or Phenobarbital. You cannot start giving them on your own.

With epilepsy, tetanus or intoxication, treatment in a hospital is indicated. Introduced drugs aimed at eliminating seizures, vitamins.

Urgent hospitalization is also required for newborns. In the intensive care unit, the baby will be constantly monitored.

Even if the convulsive episode recurs only once, children are registered and observed for 12 months.

Consequences

The occurrence of convulsive syndrome in newborns, especially premature ones, can lead to death. It is noted that with unidentified causes of repeated attacks, such children develop encephalopathy or ischemic stroke. Often death is possible with meningococcal infection.

Metabolic seizures and febrile seizures are usually treatable. The latter pass without leaving a trace, especially in infants. But if attacks occur in older children, appear repeatedly, then there is a risk of oxygen starvation, mental retardation and gross damage to all areas of the personality.

It is important to remember that the onset of an attack is accompanied by impaired coordination of movements and loss of consciousness. When falling on asphalt, hard surfaces, sharp objects, you can get injured, including craniocerebral. First aid should include safety measures for the victim.

Children prone to epilepsy should not be left alone at night. During a night's rest, when no one is watching the child, it is possible to fall out of bed, pinching and biting off the tongue.

Prevention

If seizure activity is hereditary or associated with organic brain damage, preventive measures will only help reduce the frequency and, possibly, intensity of seizures. It is impossible to exclude relapses.

You need to think about the prevention of any possible diseases of the baby when he is still in the stomach of the expectant mother. Her lifestyle, well-being, health, nutrition affect whether the organs of the fetus will form correctly and whether they will work correctly.

To the born baby should be increased attention. It is unacceptable to use alcohol, drugs during lactation. The procedures and treatment prescribed by a pediatrician, a neurologist, must be performed very accurately, without amateur performance. The central nervous system is very sensitive. Ignoring the symptoms of diseases, non-compliance with the dosage of drugs, self-administration of treatment will lead to a deterioration in the condition and the emergence of new pathologies.

As soon as possible, physical activity should be started with the baby. Every day, do a set of exercises appropriate for your age. Massage once every six months.

Walking in the fresh air has a positive effect on the development of the baby and strengthening his health.

It is important to include foods containing potassium and magnesium in the menu:

• vegetables;
• dairy products;
• porridge from cereals;
• nuts;
• legumes;
• seaweed;
• bananas.

Useful for older children are foot baths with sea salt, light massage, contrast showers.

You need to choose comfortable orthopedic shoes.

In most cases, seizures in children disappear after 4-5 years. However, when convulsions occur, especially involving the whole body, it is important to find out their causes. Only this will allow you to prescribe the right treatment. To prevent the occurrence of seizures, it is important to engage in prevention.

Seizures in children are a series of sudden involuntary contractions of the skeletal muscles, often accompanied by impaired consciousness. Seizures in children are the body's response to external or internal stimuli.

Convulsions in children most often occur in severe infectious diseases (toxic forms of influenza, severe intestinal infections, neuroinfections, etc.).

Why are seizures more common in children than in adults?

Seizures are much more common in children than in adults. The reason for this is the age-related anatomical and physiological features of the children's nervous system.

The smaller the baby, the richer his brain is in water. In young children, the ventricles of the brain are relatively wider than in adults. The frontal lobes and cerebellum are less developed. The gray matter of the brain is worse differentiated from the white. The processes of neurons are shorter, nerve cells interact with each other worse, nerve fibers actually do not have myelin sheaths. The brain in children is more intensively supplied with blood than in adults, but the reverse flow of blood is reduced, since diploic veins form only when the fontanelles close. As a result, favorable conditions are created for the accumulation of toxic substances.

Children have a relatively high permeability of the blood-brain barrier, which regulates the flow of substances from the blood to the cerebrospinal fluid and vice versa. The spinal cord in children develops faster, relatively more mature than the brain. Cervical and lumbar thickening in the spinal cord are determined by the age of 3 years. The medulla oblongata in children enters the foramen magnum at an angle, which, with the development of cerebral edema, leads to a rapid wedging of the brain stem into the foramen magnum.

The spinal cord in young children is longer (relatively) than in adults. The volume of cerebrospinal fluid is less, its pressure is lower. Cerebrospinal fluid contains more protein and less sugar. In children, the brain's need for oxygen is much higher than in adults. For the children's central nervous system, imperfection and incompleteness of all mechanisms of central regulation are typical.

Seizures in children Causes

• In young children, the cause of seizures may be an increase in body temperature to febrile numbers (38C and above). Febrile seizures occur at least once in a lifetime in 5% of children. Violation of the electrolyte balance in the body (changes in the level of potassium, sodium, calcium, phosphorus in the blood, cerebrospinal fluid, etc.) Decreased blood glucose levels.
• In the neonatal period, convulsions can be provoked by hypoxic-ischemic damage to the central nervous system. Neonatal seizures occur in 0.1-1.6% of newborns.
• In children of any age and adults, the cause of seizures can be a traumatic brain injury, a volumetric process in the brain (tumors, aneurysms, hemorrhages).
• Seizures at any age can be caused by epilepsy. Epilepsy is registered in 0.5-0.75% of children. But the debut of epilepsy in 75% of patients with epilepsy occurs in childhood.

The prevalence of seizures is

• Partial or focal.
• Generalized (convulsive seizure).

According to the type of skeletal contractions, convulsions are

• Clonic.
• Tonic.
• Atonic.
• Clonic-tonic;

Convulsions in children are divided into non-epileptic and epileptic.

Non-epileptic seizures in children

1. Seizures as a response of the brain to various harmful agents and stimuli(this may be an increase in body temperature, neuroinfection, trauma, a pathological reaction to vaccination, intoxication, metabolic disorders). Such convulsions occur in children up to 4 years of age.

• Febrile convulsions (with an increase in body temperature).
• Intoxication (for burns, gastrointestinal infections).
• Hypoxic (for respiratory diseases, asphyxia, etc.).
• Affective-respiratory attacks.
• Exchange (for conditions such as spasmophilia, hypervitaminosis D, rickets, hypoglycemia, hypo- and hyperkalemia).
• Vegetative-vascular crises with loss of consciousness and convulsions (various syncope - heart rhythm disturbances, etc.) and others.

2. Symptomatic convulsions in diseases of the brain

• Tumor.
• Abscess.
• Inflammation of the meninges.
• Hemorrhage.
• Brain injury.
• Stroke.
• Aneurysm etc.

Epileptic seizures or seizures in epilepsy

The most severe manifestation of seizures is status epilepticus, in which consciousness, the work of the cardiovascular and respiratory systems are disturbed.

If convulsions continue for more than 5 minutes in a row or a series of convulsive seizures is observed for a short time, between which the functions of the nervous system are not fully restored, this condition is called status epilepticus.

Status epilepticus is characterized by recurrent convulsions between which consciousness is not fully restored, breathing is disturbed during seizures, and cerebral edema develops. If, after a convulsive seizure, a violation of consciousness increases and paresis and paralysis appear, these are prognostically unfavorable symptoms.

Status epilepticus (ES) may be precipitated by withdrawal of anticonvulsants or by acute illness.

In children, status epilepticus is less common than in adults. Status epilepticus may be a manifestation of epilepsy or be symptomatic of other diseases of the central nervous system. Status epilepticus is a condition that is extremely life-threatening for a child and requires emergency medical attention.

How to distinguish between different types of seizures in children?

There are separate articles about x and x. Read about other types of seizures in children below.

Seizures in children with spasmophilia

This is a type of metabolic cramp. They are characterized

• The presence of distinct symptoms of rickets from the musculoskeletal system.
• Convulsions begin with a short-term cessation of breathing, which lasts seconds, then the child takes a deep sonorous breath - and the pathological symptoms regress, and the initial state of the child is restored.
• For an attack with spasmophilia, cyanosis of the nasolabial triangle is typical.
• Convulsions with spasmophilia are generalized, clonic.
• An attack can cause a sharp irritant - a loud knock, a call, a scream, etc.
• During the day, seizures can happen several times.
• Body temperature before, during and after an attack is normal.
• There are no focal signs on neurological examination.
• There are no symptoms of inflammatory somatic diseases.
• There are specific symptoms of convulsive readiness characteristic of spasmophilia:
  Chvostek's symptom- when tapping on the zygomatic arch, the facial muscles on the same side contract;
  Trousseau's sign- when the muscles of the upper third of the shoulder are compressed, a characteristic spasm of the fingers of the hand, called the obstetrician's hand, occurs;
  Lust's symptom- when the muscles of the lower leg are compressed in the upper third, dorsiflexion, abduction and rotation of the foot occur simultaneously;
  Maslov's symptom- Suspension of breathing on inspiration with pain irritation.

Exchange cramps

Blood glucose disorders - hyperglycemia, hypoglycemia, electrolyte metabolism disorders: sodium, potassium, can lead to impaired consciousness, and be accompanied by convulsions.

Cardiac syncope

Cardiac syncope occurs due to cardiac arrhythmias, paroxysmal tachycardia, and congenital heart defects. Their manifestations may be loss of consciousness, and sometimes convulsions, due to the developed hypoxia of the brain. These are life-threatening conditions and require emergency assistance from an anesthesiologist-resuscitator!

Children with epilepsy, acute situational convulsions, as well as convulsions against the background of somatic diseases, including cardiogenic ones, children with endocrine diseases need careful monitoring and adequate treatment.

To distinguish epilepsy from other conditions accompanied by convulsions and loss of consciousness, there is a table.

Differential diagnosis of epilepsy with syncope and conversion seizures (Mukhin K.Yu., 2001)

sign	Pathological condition
	Epilepsy	Syncope	Conversion states (hysterical neurosis)
Age of patients	Any	More often teenage	Not typical for young children
Body position at the onset of an attack	Any	vertical	Any
Anticipation of an attack	Aura	Swoon	non-specific
Attack kinematics	Stereotypical, synchronized movements	limp; possible isolated clonic twitches	Chaotic artsy asynchronous movements; opisthotonus
The presence of automatisms	Characteristically	Can not be	Can not be
Consciousness during an attack	Turned off, changed or saved	Always off	Saved, rarely modified
Urination during an attack	characteristic	Extremely rare	Extremely rare
Time of onset of seizures	Any	In wakefulness	Usually awake
Seizure provocation	Hyperventilation, photostimulation	Stuffiness, fear, prolonged vertical position	Psychogenic factors
Intelligence	Often reduced	Norm	Norm
Electroencephalogram	epiactivity	Norm	Norm

Convulsions in children What to do?

Before the arrival of the ambulance, the room should be ventilated. To prevent head injury, lay the child on its side. Fix language. To measure the temperature.

For the doctor, the following will be important

• If a child is seen by a neurologist with epilepsy, what anticonvulsants does he receive.
• How long ago did the seizures start?
• Possible provoking factor (injuries, severe dehydration, discontinuation of anticonvulsants, etc.).
• How long did the convulsive attack last and how did it proceed before the child was examined by a doctor (whether the child lost consciousness, was there vomiting, what did the convulsions look like, etc.).
• How often have you had seizures lately?
• What did the parents do with the child before the doctor arrived, what medicines were given.

Children need to be hospitalized

• Up to 1 year.
• With first-time seizures.
• With convulsions, the cause of which is not established.
• With febrile convulsions on the background of neurological diseases (cerebral palsy, neurodegenerative diseases of the central nervous system, etc.).
• With convulsions on the background of infectious diseases.

The plan for examining a child with any convulsions is similar to that for febrile convulsions.

Forecasts favorable with typical febrile convulsions, with affective-respiratory attacks.

Unfavorable forecasts for later quality of life if the child has frequent epileptic seizures or status epilepticus with encephalopathy. The prognosis depends on the cause of the seizures.

Dispensary observation

All children after any seizures are observed by a neurologist, with the obligatory EEG (electroencephalography). According to the indications, anticonvulsant drugs are prescribed. It is necessary to prevent provoking factors and stresses.

It's all about seizures in children. Stay healthy!