forms of spasmophilia. Isolated spasms in a child

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

A painful condition is most often observed in babies of 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 babies suffering from or have had 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 a metabolic disorder (phosphorus- calcium metabolism). The disease occurs due to irrational feeding of the child and can be caused by both deficiency and excess of vitamin D:

Small stay of the child on fresh air and poor quality food. Hypocalcemia may occur due to malfunction parathyroid glands, poor absorption of calcium by the body and its leaching with urine is more than normal.
Higher doses of vitamin D than required or exposure to ultraviolet-rich afternoon sun with large areas of exposed skin.

Symptoms

Latex

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

bad sleep;
cardiopalmus;
increased sweating;
indigestion (constipation);
nervous hyperexcitability;
exacerbated anxiety and fearfulness.

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

Manifesto

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

laryngospasm

Involuntary convulsive contraction and blockage of the muscles of the larynx. The child quickly turns pale, begins to breathe heavily hoarsely and exhale noisily. In acute cases, there may be a complete overlap of the lumen of the larynx, bluish staining skin, cold sweat compartment and momentary loss consciousness. This is followed by a whistling exhalation, noisy breathing, the patient calms down and goes to bed exhausted.

Corpopedal spasm

Syndrome of tonic contraction of the muscles of the feet and hands, less often the face: during an attack, the child's body is very tense, the arms are pressed to the body, the bent legs are between each other. The attack starts unexpectedly, lasts a couple of seconds and also ends abruptly. After an attack, swelling of the hands and feet is possible.

Eclampsia

Brief loss of consciousness rapid rise blood pressure, transient paralysis this is the least common most dangerous form of spasmophilia, in which in severe cases even an emergency ambulance may not restore breathing and heart function.

An easy course of an attack is characterized by a manifestation of cyanosis of the skin, intermittent breathing, convulsions of the muscles of the face and numbness of the child. With a protracted (up to 30 minutes attack), convulsions cover the entire body, there is a violation of the functioning of the central nervous activity, tongue biting, reflex urination and emptying.

If there is no immediate help and adequate treatment for spasmophilia, attacks may become more frequent. Very rarely, but still, prolonged pauses in breathing with lethal outcome.

Urgent Care

Tetany symptoms in the form of an acute development of an attack of convulsions with laryngospasm, loss of consciousness and respiratory arrest- That critical condition for which immediate assistance should be provided.

Prolonged contribute to disruption of the central nervous system and delayed psychotic development of the child. If a child is struck by this strange disease, it will be useful for parents to know how emergency care is provided for tetany.

If symptoms of apparent spasmophilia are observed, help is urgently provided, and after the attack is stopped, the child is hospitalized.

To eliminate mild laryngospasm in a child sometimes there are enough standard generally accepted measures that you can carry out on your own without a doctor:

lay the patient on a hard, flat surface and open the windows to ensure the flow of fresh air;
if the clothes are narrow and restrict movement, unfasten them;
"shake" the child, change the position of the body;
splash the baby cold water and give a sniff of ammonia vapor;

Read also:

In case of loss of consciousness with respiratory arrest, call ambulance and run in parallel artificial respiration mouth-to-mouth or mouth-to-nose method.

Health workers can administer to the patient intravenously under the supervision of the heart rhythm 3–5 ml of a 10% solution replenishing the deficiency of calcium ions. If first aid does not bring the desired results and there is no breathing, tracheal intubation is used, and in case of cardiac arrest - indirect massage.

Treatment

The prognosis of the course of overt 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 abstinence from food and water for half a day, after - a carbohydrate diet and 10% ammonium chloride solution inside. Parents are required to have a responsible attitude towards the child: it is necessary to create quality food, take the 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. To date, the disease is extremely rare ( statistical studies confirm this). But, given the fact that children of the first 2 years of life are affected by the disease, each parent should familiarize himself with the basic information about the violation.

What is pathology?

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

To date, both pathologies are recorded very rarely. However, the possibility of their development is not excluded.

Spasmophilia: etiology and causes

To begin with, it is worth understanding the risk factors that can provoke the disease. Spasmophilia is a disease that predominantly affects children between the ages of three months and two years. There are several reasons for the development of pathology, the list of which is worth reading:

an excess of vitamin D in the body, which is most often provoked by an overdose of drugs intended for;
malnutrition in which the child's body receives insufficient useful substances(as a rule, this is observed with artificial feeding);
excessive exposure to the sun on the skin (usually if radiation is prescribed as a therapy);
premature babies are more prone to this kind of disease.

Rarely 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 adversely affect the functioning of the thyroid gland;
surgical intervention in the thyroid gland;

In adulthood, neuromuscular spasms develop against the background of strong nerve strain, 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, you should familiarize yourself with the information about what constitutes rickets in children. Symptoms and treatment, causes and complications - these questions are of interest to many parents.

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

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

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

Rickets is accompanied by muscle hypotension. Milk teeth erupt later and in the wrong order. The spring closes late. In the absence of treatment, the entire musculoskeletal system suffers - there is a deformation of the pelvic bones, indentation or protrusion of the sternum, the skull acquires a cubic shape.

Treatment is reduced to eliminating vitamin D deficiency. For this purpose, appropriate drugs are prescribed for babies, as well as frequent walks in sunny weather. Massage, physiotherapy exercises and physiotherapy help to restore normal work muscles. If rickets was diagnosed on time, and the child received needed help, the forecasts are quite favorable.

Forms of spasmophilia

Spasmophilia in children can take two forms.

Latent (or hidden). This form of pathology proceeds almost imperceptibly. The child looks quite healthy, eats and sleeps well. Nevertheless, you can notice signs of hyperexcitability - the baby reacts violently to any stimuli, shudders from sounds.
Explicit (manifest). The form of the disease, which is characterized by obvious symptoms and severe violations.

What are the symptoms of spasmophilia?

What else do moms need to know? For example, what are the signs of spasmophilia. Symptoms may vary. Quite often, laryngospasm is observed in children - 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, as a result of which whistling breaths are heard in the child. The baby's skin turns pale.
In the most severe cases, the glottis is blocked completely, as a result of which the patient cannot breathe. The skin becomes bluish, cold sweat appears.
Often the child loses consciousness. Apnea can last for several seconds, after which there is a loud breath. As a rule, after an attack, a small patient calms down. Seizures may recur periodically.

Carpopedal spasm and its features

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

it reduces the feet and hands, and the spasm can last from 2 hours to several days;
the baby pulls his shoulders to the body and flexes the upper limbs in the joints as much as possible;
the child's fingers are clenched into a fist;
toes are also pressed 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 a strong contraction of almost any muscle. For example, muscle spasm leads to the sudden development of strabismus. If tension covers smooth muscles internal organs, then the child has problems with urination and defecation.

Very dangerous are the spasm of the so-called respiratory muscles as this can lead to respiratory arrest. 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: the 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 mimic 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.
In the future, there are problems with breathing, laryngospasm. The skin of the child is covered with sweat and becomes pale, sometimes even bluish. The kid loses consciousness. There is involuntary urination or defecation. Foam appears on the child's lips.

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

Complications in the disease

Spasmophilia is dangerous disease which should never be ignored. Pathology is accompanied by a decrease in the level of calcium in the body, which leads to dangerous complications. Severe convulsions, breathing problems, problems at work of cardio-vascular system up to cardiac arrest - all this poses a threat to the life of the child.

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

Diagnostic procedures

In the presence of the above symptoms, you should immediately show the child to the doctor. An explicit form of spasmophilia is easily diagnosed - the clinical picture is quite characteristic. But with a disease, determining the presence of violations is not so simple. Therefore, during the physical examination, doctors do some tests.

Chvostek's symptom. 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 a spam of facial muscles.
Symptom Rousseau. On middle part an elastic tourniquet is applied to the baby's shoulders. If after a few minutes a spasm of the forearm appears, and then the hands are clamped, then this indicates a preconvulsive condition.
Symptom of Lust. With a hammer or finger, the doctor lightly beats on the lower leg (under the head tibia). With spasmophilia, bending of the toes and a sharp retraction of the limb are observed.
Maslov's symptom. A light injection in any area on the child's body, if available this disease leads to a short delay in breathing after inhalation.

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

First aid rules for an attack in a child

Regardless of the form and severity of the baby's symptoms, it is urgent to see a doctor. However, the child can be helped.

The baby is recommended to put on something solid. You should not wear it in your arms, pressing it to you, as this only blocks access to air. It is better to take off clothing that restricts movement and open the window slightly, providing the child with enough oxygen.

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

Medical 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 assigned anticonvulsants, which relieve muscle spasms, prevent the occurrence of problems with breathing and heart. 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 removed, the child is prescribed a 5% or 10% solution of calcium chloride. Therapy lasts about 7-10 days.
Proper nutrition is also important for recovery. If we are talking about babies, then in the first 8-12 hours after the attack, a tea diet is recommended, after which the baby is again transferred to breast-feeding. The diet of an older child should be enriched with sour mixtures, cottage cheese, kefir. If we are talking about school-age children, then their menu must contain cereals, vegetable purees and fruit juices.

Are there preventive measures?

Of course, it is much easier to prevent the development of a 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 an excess of vitamin D in the body. Don't give up prophylaxis this tool. After all, its deficiency leads to the development of rickets. But during therapy, it is important to adhere to the recommended dosages.

special disease state 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 calcine is lowered (less than 9 mg%). In particular, reduced content ionized calcium. Serum phosphorus is usually elevated, sometimes reduced. Sharply increased level of alkaline phosphatase.

There are two forms of spasmophilia:

hidden (latent);

Symptoms of latent spasmophilia

Symptom of the facial nerve (Chvostek) - repeated rapid contraction facial muscles with short springy blows to the region of the facial nerve in the middle of the cheek. Trousseau's symptom - the rapid appearance of tonic convulsive reduction of the fingers in the form of an obstetrician's hand with moderate squeezing of the child's shoulder with a palm or an elastic bandage, as well as plantar flexion of the foot during compression of the leg 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 bent). Evidence for currents below 5 mA. Changes in the child's psyche - tearfulness, fearfulness, anxiety, deterioration of sleep and appetite.

Provocative moments: dyspepsia, improper feeding (excessive cow's milk), infectious diseases, agitation, hot baths, mustard wraps as 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 explicit.

Symptoms of overt spasmophilia

Laryngospasm (glottic spasm). The initial forms of laryngospasm are manifested in the form of a sonorous breath or a breath with a choking sound with any excitation of the child, increased nervous excitability, fearfulness, rolling up. Attacks of laryngospasm characterize:

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

sharp pallor with blue lips, frightened look;

sharp restlessness a child or freezing with the head thrown back; sometimes the whole body of the child is tense;

tension of the large fontanel in infants;

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

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

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

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

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

spastic ringing cough;

expiration difficult with groaning, cyanosis;

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

The most severe manifestation of overt spasmophilia is eclampsia - common clonic convulsions 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 Algorithm:

the use of external irritations - sprinkle with cold water, bring a cotton swab moistened with ammonia;

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

for a severe attack:

artificial respiration (with oxygen therapy),

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

with ineffectiveness intracardiac injection of 2-4 ml of 10% calcium gluconate solution, chest compressions,

as an extreme measure tracheotomy with controlled breathing;

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

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

Diet with a sharp restriction of cow's milk in the early days. After saturation of the body with calcium, the appointment of a course of vitamin D2 ( alcohol solution) with continued intake of calcium supplements.

Primary diffuse pulmonary fibrosis (Gammann-Rich syndrome)

Primary scarring process lung tissue, flowing first in the interalveolar septa with secondary change 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 with a transition later to severe respiratory and cardiovascular insufficiency;

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

cyanosis, persistent after several attacks;

temperature increase;

headache;

hemoptysis;

physical details:

in the lungs, a boxed shade of percussion sound, scattered dry and finely bubbling wet rales, sometimes a pleural rub,

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

sometimes a small hepatosplenomegaly;

X-ray data: mesh pattern of lung fields, honeycomb appearance, dilated roots, emphysema.

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

Treatment is often ineffective: inhalation of 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, fibrosis develops. The vascular bed of the small circle narrows, its hypertension and cor pulmonale are formed.

Symptoms:

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

cough, hemoptysis;

pain in the chest, abdomen;

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

the presence in the sputum of macrophages with hemosiderin;

x-ray studies, unstable multiple large and small foci (a consequence of massive hemorrhages), later compacted roots or fibrous changes;

progressive fibrosis in the lungs and phenomena of insufficiency of the cardiovascular system.

Treatment

Early recognition required for timely active therapy: corticosteroid desensitization therapy with cortisone or prednisone, initially large doses; calcium preparations, vitamins C, P, complex B; 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. The reasons for it are anomalies in the development of the structure of the larynx (its deformation, the softness of the epiglottis folded with a pipe, which is why the scoop-epiglottic folds come together, stick to the larynx when inhaled and give side sound phenomena). Perhaps the indicated 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;

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

the general condition is not disturbed.

With acute respiratory disease congenital stridor may increase and breathing becomes difficult.

The diagnosis is established by the main features: congenital inspiratory noise, decreasing during sleep, increasing with the excitement of the child, with a normal voice and good health are saved. Recognition may be difficult if congenital stridor is superimposed inflammatory phenomena larynx and trachea. Questioning parents helps to establish the presence of stridor from the first days of life.

Congenital stridor has to be differentiated:

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

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

with tumor-like bronchial tuberculosis lymph nodes, which is characterized by expiratory dyspnea with increased sleep, as well as a persistent bitonic or whooping cough.

Treatment for congenital stridor is not required.

Shortness of breath with severe rickets

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

violation of normal gas exchange in the lungs with superficial, wrong breathing and the appearance of poorly ventilated areas of the lungs, blockage of bronchioles with mucus with the appearance of atelectatic areas;

difficulty of blood circulation in a small circle with congestion in the lungs;

frequent protracted bronchitis, prepneumonic condition;

persistent expiratory dyspnea (" chronic asthma rickets").

creation of the correct hygienic regimen;

correct mode nutrition, vitamins C and complex B;

anti-rachitic therapy ( ultraviolet irradiation) or a course of vitamin D2 with an appointment later fish oil, calcium preparations);

massage, therapeutic gymnastics.

Shortness of breath of a neurotic nature (manifestation of an 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 had any acute respiratory or cardiovascular disease with unstable symptoms respiratory failure. None pathological abnormalities from lungs and heart at children it is not found out. This obsessive syndrome with shortness of breath is noted in children with an unstable autonomic nervous system and is associated with the easy formation of conditioned reflexes at this age, especially when the parents misbehave.

the main thing is not to fix undue attention on these manifestations;

physical education (exercises, sports);

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

Respiratory affective convulsions

Reflex inspiratory cessation of breathing is observed with 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 excitement.

Symptoms:

the child “goes in” from crying;

initial cyanosis is replaced by a sharp blanching;

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

the end of 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 recurrence at large intervals);

often revealed target setting seizures. By this, children achieve the fulfillment of their desires, whims.

Differential Diagnosis:

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

with laryngospasm.

It should be noted that children of an earlier age are affected by laryngospasm. There are always signs of spasmophilia. Laryngospasm begins with a characteristic loud (sometimes groaning) breath. 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 seizures is likely: tracheal anomalies, squeezing 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, allowed to smell ammonia). In case of loss of consciousness, artificial respiration should be applied. For prevention, children suffering from respiratory affective convulsions are shown the correct regimen with the appointment of calcium, bromine, vitamin B.

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

Most often it is a childhood disease that affects children from 2 months to 2 years. Children who are bottle-fed or premature get sick. The disease often occurs in the spring, in the summer it is very rare. 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 seizures and laryngospasm (acute narrowing of the glottis), respiratory arrest, loss of consciousness. IN bloodstream the level of vitamin D rises sharply, the level of magnesium, sodium, vitamins B1 and B6, and chlorides decreases. Urgent resuscitation is required. A prolonged state of spasmophilia leads to damage to the functioning of the nervous system, as well as developmental delay mental state child.

Causes

The cause of spasmophilia is considered to be a failure of phosphorus-calcium metabolism. The calcium content in the blood is markedly reduced. The phosphorus content rises at the same time. This may be influenced by the use of cow's milk with an overestimated concentration of phosphorus and insufficient removal of phosphorus by the kidneys.

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

To the reasons causing development spasmophilia include:

Artificial feeding.
Unfavorable sanitary and hygienic environment in which the child has to be a 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. That is why it is difficult to diagnose the disease at an early stage.

Outwardly, this is manifested 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 the following symptoms:

Convulsive contraction of the hands when squeezing the child's shoulder (Trousseau's symptom);
When touching 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 to the side of the foot with weak tapping (Lust's symptom);
Increased nervous excitability (Erb's symptom);
Stopping breathing with pain irritation (Maslov's symptom);
Muscle contraction when exposed to median nerve elbow joint.

In addition, certain signs of rickets are often noticeable:

increased sweating;
Disruption of the digestive function;
Restless sleep.

Any symptom requires immediate medical attention.

Diagnostics

The diagnosis is made based on 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 age of the child, the type of feeding and the time of year are taken into account.

Treatment

Treatment of spasmophilia is predominantly medical. In severe cases, hospitalization of the child is required. Treatment directly depends on the manifestations of the disease and the general condition of the patient.

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

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

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

To relieve spasm, anticonvulsants are prescribed. Preference is given to seduxen. It works instantly, but for a short time. Gamma-hydroxybutyric acid is used. It is administered intravenously, intramuscularly, or orally. Simultaneous administration of these drugs is allowed. With the help of an enema, the introduction of hydrochloride is allowed.

With an attack of laryngospasm, you need:

Lay the child on a flat and firm surface.
Unfasten clothes, provide fresh air.
Sprinkle your face with cold water, ammonia, cause irritation of the nasal mucosa.
Enter calcium gluconate intravenously or intramuscularly Relanium.

If the attack could not 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, cumin, mint, taken in equal parts. Duration of treatment - 10 days.
Chicory wild. 1 tsp chicory roots pour a glass of water, boil for 10 minutes, drink before meals.
Eucalyptus. Inhale a decoction of eucalyptus through the nose every day for at least 15 minutes. For bathing, add 20 grams of plant leaves to 10 liters of water.

Complications

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

Prevention

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

Balanced diet with the inclusion of cottage cheese, fermented milk products, meat, vegetables;
If breastfeeding is not possible, formulas should contain calcium, phosphorus and magnesium;
For prevention, vitamin D is required. In the spring and summer months, vitamin D is not taken to avoid 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 - 1 time per quarter.

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

Spasmophilia in children is a disease associated with increased neuromuscular excitability. At the same time, children suffer from spasms and convulsions, uncontrolled contractions of smooth and skeletal muscles, which can lead to respiratory arrest. The reason for 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, they have a lack of calcium and an excess of phosphates in their blood. Treatment of the disease is aimed at normalizing mineral metabolism and fighting.

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 in correcting the nutrition of the patient and increasing the amount of available calcium. You can also apply folk 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 babies aged from several months to two years and is associated with rickets. About 4% of children with rickets suffer from spasmophilia. The disease often develops in boys.

Spasmophilia is a violation of mineral metabolism, which is manifested by a decrease in the level of calcium, an increase in the content of phosphates and alkalization of the blood. At the same time, the metabolism of other minerals is disturbed in children. Their concentration of chlorine, sodium, magnesium decreases, and the content of potassium increases. Such a violation occurs in children with moderate or severe rickets.

Possible causes of the disease:

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

Clinical manifestations of spasmophilia appear in early spring. This is due to weather changes, an increase in the number of sunny days and a more intense effect of 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 the child receives insufficient amounts of calcium from the diet (which causes rickets), calcium for bones is taken from the blood serum. This leads to pathological decrease concentration of this mineral. Calcium deficiency is manifested by an increase in neuromuscular excitability and the development of seizures.

Any stimulus can provoke an attack. Spasm may develop due to:

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

With 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

According to the nature of clinical manifestations, latent (hidden) and manifest (explicit) forms of the disease are distinguished. With the deterioration of the child's condition, the latent form turns into an explicit one.

Define latent spasmophilia possible only with the help of special diagnostic procedures and tests, in response to which the child develops characteristic symptoms, for example, the symptom of Khvostek, Trousseau, Maslova and others. 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 at the same time there is no increase in the amount of available calcium, the latent form becomes explicit.

Latent spasmophilia accompanied by signs of rickets:

excessive sweating;
cardiopalmus;
deterioration of night sleep;
violations emotional background: anxiety, fearfulness, frequent crying;
disorders of normal digestion.

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

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

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

As calcium deficiency increases, the child's condition worsens further, and spasmophilia becomes apparent. main feature this form of spasmophilia -. In this case, a spasm of the muscles of the larynx occurs with partial or complete overlap of the airways.

Symptoms of laryngospasm:

pallor or cyanosis of the skin;
wheezing;
complete cessation of breathing is possible;
short-term loss of consciousness;
short-term cessation of breathing during a night's 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 complete respiratory arrest and death of the child. Laryngospasm can develop several times a day. Crying, screaming, vomiting can provoke this condition, but it can develop without visible reasons.

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

Spasms can also affect other muscle groups:

with damage to the eye muscles, the child develops strabismus;
spasm chewing muscles manifested by compression of the jaws and rigidity of the neck;
spasm smooth muscle leads to disruption of the processes of urination and defecation;
rarely there is a spasm of the heart muscle, which leads to cardiac arrest.

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

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

Treatment of spasmophilia

During an attack, the baby may have 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 arrival of a specialist. Any delay is dangerous, because a long (more than 3-5 minutes) being in this state can lead to irreversible brain damage and death of the baby.

First Aid to Relieve Spasm:

the child's face should be sprinkled with cool water;
the baby needs to be shaken;
in some cases, patting on the buttocks helps;
you need to click on the root of the language;
it will be useful to provide access to fresh air.

If these actions have not brought results, and the child has stopped breathing and palpitations, resuscitation is necessary: chest compressions and artificial respiration.
Treatment of spasmophilia is a correction of 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, calcium in the mother's milk becomes insufficient, and the mother needs to start introducing complementary foods.

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

Series. In 200 ml of boiling water, steam 1 tsp. dried herb series, insist on a water bath for 15 minutes, then cool and filter. Give the baby 1 tbsp. l. this drug three times a day.
Mint. In a glass of boiling water, steam 1 tsp. mint, insist half an hour, then filter. Give the baby 1 tsp. infusion 4 times a day.
Walnut. Prepare an infusion of the leaves of this plant. In 200 ml of boiling water, steam 1 tsp. crushed leaves, insist 1 hour, then filter. Give the child 1 tsp. three times a day.

Forecast 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 completely disappear. Death occurs in exceptionally rare cases from respiratory or cardiac arrest during an attack, if qualified first aid is not provided to him.

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

For prevention, breastfeeding is key. Rickets and spasmophilia 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 a lack of calcium, it is important to introduce complementary foods to the child in a timely manner (from six months). Fruit and vegetable purees, cereals are suitable for complementary foods.

Write in the comments about your experience in the treatment of diseases, help other readers of the site!
Share the material on social networks and help your friends and family!