What is the cause of seizures in children: classification, diagnostic measures, methods of treatment
- 1 The mechanism of occurrence and causes
- 2 Kinds
- 3 Symptoms
- 4 Diagnostics
- 5 First aid
- 6 Treatment
- 7 Effects
- 8 Prevention
Thoughts filled with memories of the terrible pictures of convulsions patients with epilepsy. But stress will pass, everything will fall into place. As soon as the baby becomes easier, you can safely understand the causes of the incident.
The mechanism of occurrence and causes
Spasms are involuntary contractions of muscles that occur under the influence of too much excitation of neurons in the motor part of the brain. They mainly appear in children under the age of 3 years. With age, their frequency decreases. Convulsive activity remains only in 2-3% of children diagnosed with epilepsy or an organic lesion of the central nervous system.
A favorable condition for the occurrence of spasms is the unformed central nervous system of babies. The inability to fully function after birth is characteristic of all babies. However, hypoxia during prenatal 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, damage to the central nervous system, 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:
- Traumatic brain injury.
- Intoxication of various types.
- Epilepsy. The disease is mainly hereditary. It is believed that it is transmitted through the generation of children of the same sex.
- Inflammatory infectious diseases of the brain, for example, meningitis, encephalitis.
- Congenital and acquired pathologies of the cardiovascular and endocrine systems.
- Heat. The threshold for hyperthermia is different in different children and depends, among other things, on the formation of the central nervous system.
- Imbalance of vitamins and minerals.
Seizures in children are classified according to several criteria:
- area of distribution;
- nature of stress;
- flow characteristics;
Depending on the area of distribution, they speak of partial and generalized convulsions. Partial (local) occur when the electrical activity of a specific area of the cerebral cortex increases. Manifested as twitching of individual muscles of the foot, hands, tongue, including in sleep.
Generalized convulsions seize the whole body. A characteristic feature is the tension of the body in the 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 typical of epileptic seizures, hysteria, tetanus, acute intoxication or infection, circulatory disorders of the brain.
Before an attack, the appearance of hallucinations is possible, immediately convulsions are preceded by inarticulate cry. When epilepsy occurs several attacks in a row. One attack lasts up to 20 seconds.
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. Characteristic chaotic movement of limbs. Baby can wake up and cry. For tonic convulsions is characterized by strong, prolonged muscular tension. Limbs seem to freeze indefinitely. Appear slowly. Baby does not make a sound. Tonic-clonic convulsions are also distinguished.
This group of seizures can be attributed to atonic. They are characterized by the absence of voltage. There is a rapid relaxation of all muscles. Involuntary defecation or urination is possible. Often the cause of atonic spasms is Lennox-Gastaut syndrome, manifested in children aged 1 to 8 years.
Classification by flow characteristics
Depending on the characteristics of the development of seizures, they speak of myoclonic, flexor, infantile spasms and absans.
Myoclonic convulsions occur in infants and instantly capture one or more muscles. Do not cause pain. From the side they look like tics or twitches. The main reasons are metabolic disorders, brain pathologies. The attack lasts for 10-15 seconds.
Infantile convulsions during sleep in a child aged 6-12 months. Arise in a dream or after awakening due to sudden movements and during feeding. They show up as a scream, like a grimace, rolling eyes, increasing pupil size. It is believed that seizures in children of this type are evidence of mental retardation. They can also be the initial symptom of paralysis, microcephaly or strabismus.
Flexor spasms are typical for children under 4 years. There is an unconnected flexion or extension of the body, neck, limbs, which is repeated several times. Duration – from a few seconds to half an hour. For a short time, loss of consciousness is possible. The causes are unknown.
In children between the ages of 4 and 14 years, an abscess develops, characterized by a stopping look, lack of response to external stimuli, and immobilization. In some cases, involuntary chewing movements, smacking. The basis of this – stress, fatigue, head injuries, brain infections. According to EEG, electrical activity increases in the occipital region.
Classification by cause
Most often in children emit febrile, epileptic and respiratory-affective convulsions.
Febrile seizures in a child occur up to 6 years old with the highest frequency of manifestation between the ages of 6 and 18 months. Occurring once, convulsions appear in 30% of children at a temperature. Pathology covers both single muscles and individual groups. Possible face strain, drooping chin. The skin is blue, baby sweats heavily. At some instant, loss of consciousness and cessation of breathing may be noted. This is followed by relaxation.
Without fever, cramps occur in a child due to epilepsy. In this case, the attack is generalized.
Respiratory-affective occur due to an overabundance of emotions in children from six months to 3 years. Characteristic for premature babies.
The main signs of convulsive activity are:
- involuntary movements;
- cyanosis of the skin;
- limb tension;
- tightly clenched teeth;
- involuntary urination;
- rolling eyes.
Even after a single attack, it is important to diagnose and figure out the question of why convulsions have arisen. This will avoid recurrence, prescribe treatment and just calm down. Seizures can occur not only at a temperature, epilepsy. In infants, they may be the first signs of cerebral palsy or mental retardation.
After recovery, the pediatrician gives directions to tests and visits 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.
A pediatrician and a neuropathologist will collect a history of an attack by asking questions about the following:
- what could cause an attack;
- features of pregnancy and childbirth;
- features of the first year of life;
- attack duration;
- the nature of the cramps;
- how many times spasms repeated;
- whether there was a loss of consciousness.
In some cases, the neurologist will send a so-called lumbar puncture – a sample of cerebrospinal fluid. An electroencephalogram is required. If you suspect a neoplasm or vascular disorders, the doctor gives directions to an ultrasound of the brain and neck, MRI or computed tomography. You may need to check the fundus and oculist consultation.
Convulsions at temperature also require diagnostics, despite the fact that the cause of their appearance seems clear. Only 5% of young children with hyperthermia develop convulsive seizures, so it is best to make sure that the child has no organic pathologies.
At occurrence of the first signs of seizures in children, regardless of their cause, emergency care is required. Often parents do not have any idea what to do in case of convulsions in a child.
In case of convulsive activity of any etiology, all dangerous objects that may lead to injury of the patient are removed. If the attack occurs in the room, open the window for ventilation. The temperature in the room should be no higher than 21 ° C. Adults, whether parents, caregivers or teachers, should always be with the patient until the moment the seizure is complete and consciousness returns.
In all cases, when joining convulsions to stop or hold your breath, you need to remember that during an attack it is impossible to perform artificial respiration. The muscles of the respiratory tract are strained and do not let the air through. We must wait for the end of the attack. It is not recommended to wake up the patient.
As a first aid for convulsions in children, they are placed on a hard surface, the whole body is turned on its side or only the head, the outer clothing is removed or loosened. In no case do not give a drink. As soon as the convulsions are gone, saliva and vomit are removed from the mouth.
If the seizure begins in a child diagnosed with epilepsy, you must be prepared for the fact that the spasms will cover the whole body. Loss of consciousness will join them, and perhaps a second attack will occur. After the baby is laid, a roll of towel is placed under the neck, and a corner of the towel is inserted between the molars. In no case can a metal object be placed in the mouth, it can damage the teeth, the remnants of which will fall into the larynx. Any medications are injected intramuscularly and only by a doctor.
When cramps occur in children at high temperatures, they are undressed, rubbed with alcohol, covered with a towel dipped in water. During an attack, it is unacceptable to give medication orally. The muscles are compressed, the baby will not swallow him anyway, but he will be able to choke on him at the end of the attack. If it is necessary to take urgent measures to reduce the temperature, put rectal suppositories with paracetamol.
Therapeutic tactics depend on the nature and causes of the disease.
In the case of convulsions at temperature or convulsions, the affective and respiratory nature of children is usually not hospitalized, treatment continues at home. After the seizure caused by fever is over, the children are re-cooled by wiping the body with a solution of vinegar, vodka or applying a damp towel to the forehead. If the temperature does not subside after the completion of seizures, the child is given antipyretic – Paracetamol or Efferalgan. When a seizure recurs or lasts more than 15 minutes, anticonvulsants are prescribed by the doctor — Diazepam or Phenobarbital. You cannot start giving them yourself.
In epilepsy, tetanus, or intoxication, hospital treatment is indicated. Introduced drugs aimed at eliminating seizures, vitamins.
Urgent hospitalization is also required for newborns. The baby will be monitored at the intensive care unit.
Even if the convulsive episode was repeated only once, children are registered and monitored for 12 months.
The onset of convulsive syndrome in newborns, especially premature babies, can lead to death. It is noted that for unspecified causes of recurrent seizures, these children develop encephalopathy or ischemic stroke. Often death is possible with meningococcal infection.
Seizures due to metabolic disorders and febrile seizures are usually treatable. The last pass, leaving no trace, especially in infants. But if seizures occur in older children, appear more than once, 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 appearance of an attack is accompanied by a violation of coordination of movements and loss of consciousness. If you fall on the asphalt, hard surfaces, sharp objects you can get injured, including craniocerebral. First aid should include safety measures for the victim.
Children prone to epilepsy, it is better not to leave alone at night. During the night time when no one is watching the child, it is possible to fall off the bed, pinching and biting the tongue.
If the convulsive activity is hereditary or is associated with organic brain damage, preventive measures will only help reduce the frequency and, possibly, the intensity of the attacks. Eliminate relapses impossible.
It is necessary to think about the prevention of any possible diseases of the baby, when he is still in the belly of the future mother. Her lifestyle, well-being, health, nutrition influence whether the organs of the fetus are formed correctly and whether they will work properly.
To the born baby should be increased attention. The use of alcohol, drugs during lactation is unacceptable. Procedures and treatment prescribed by a pediatrician, a neuropathologist, must be performed very accurately, without amateur performance. The central nervous system is very sensitive. Ignoring the symptoms of diseases, failure to comply with the dosage of drugs, self-prescription of treatment will lead to a deterioration of the condition and the emergence of new pathologies.
As soon as it is possible, you need to start engaging in physical activity with the baby. Every day, do a set of exercises that are age appropriate. Every six months to massage.
Walking in the fresh air has a positive effect on the development of the baby and strengthening its health.
It is important to include in the menu products containing potassium and magnesium:
- dairy products;
- cereal cereals;
- sea kale;
Useful for older children foot bath with sea salt, light massage, douche.
With leg cramps, you need to find comfortable orthopedic shoes.
In most cases, convulsions in children go away after 4-5 years. However, in the event of convulsions, especially exciting the whole body, it is important to find out their causes. Only this will allow you to prescribe the correct treatment. To prevent the occurrence of seizures, it is important to engage in prevention.