Causes of cramps in a child with and without fever, how to treat febrile convulsions?

Cramps in a child – a sight not for the faint of heart. Of course,
The specialist in this situation knows what to do. But how not
get confused and not panic to parents or adults who
appeared near the child at a similar moment? How dangerous are
convulsions in children and how to behave as correctly as possible so as not to
harm the baby?

Types of cramps

Cramps are involuntary muscle contractions that can
grab individual muscle fibers or muscles or
spread to multiple muscle groups. Cramps in children
There are several types.

  • Tonic convulsions – prolonged muscle tension or spasm.
    With этом ребенок принимает разгибательную позу, запрокидывает
    head, stretches and strains the legs, spreads his arms and turns
    palm out. Sometimes characterized by respiratory failure by type
    stops, which is accompanied by cyanosis of the nasolabial triangle,
    limbs, reddening of the skin of the face.
  • Clonic convulsions – quick change of tension and relaxation
    muscles (approximately 1-3 twitches per second).

By распространенности выделяют следующие клонические
судороги:  фокальные, мультифокальные и генерализованные.

  • Фокальные  – подергивания отдельных частей лица, рук, ног
    (for example, convulsions in sleep with magnesium loss).
  • Myoclonic – contractions and twitches in the muscle or group
    muscle
  • Тонико-клонические  характеризуются чередованием
    clonic muscle contractions and their increased tone.
  • Фрагментарные  – это глазные симптомы, двигательные
    equivalents (limb bending, head nodding), tripping
    consciousness or respiratory arrest (apnea).

What are febrile seizures?

Febrile convulsions develop in children with convulsive readiness.
against a rise in body temperature. This kind of cramps
diagnosed in children under six years of age against a fever if
previously they had no cramps. Usually such attacks develop,
if the heat crosses the 38 degree mark.

Byскольку примерно у каждого третьего ребенка фебрильные
convulsions may occur again during the following episodes
temperature, in children, once suffered such an attack,
It is advisable to bring down the temperature, starting with 37.5 degrees.

Febrile seizures are not epilepsy and do not require special
treatment, they should be distinguished from epileptic seizures. Epilepsy
может возникнуть в любом возрасте, фебрильные же судороги  —
up to 6 years on the background of high temperature.

Byчему они возникают при температуре?

Withчины их возникновения до конца не изучены, но большинство
scientists are unanimous that this is caused by the prevalence in the brain
brain kids excitation processes over inhibition, which leads to
the occurrence of pathological impulses in the nerve cells.
SARS, any
infectious disease or vaccination. Availability is assumed
hereditary location to febrile convulsions.

Byскольку после 6 лет нервная система становится более зрелой,
febrile seizures should not be if seizures occur in
A child older than 6 years old is an epilepsy, an infection or a tumor.

Withзнаки судорог у ребенка при температуре

Usually during convulsions the baby does not respond to actions and words.
parents, loses contact with others, stops crying,
possible blue skin and breath. Febrile seizures
similar to epileptic and may be of the following types:

  • тонические с drooping head, напряжением тела, которые
    change to clonic rhythmic twitchings that
    gradually fade out;
  • focal with twitching arms or legs, rolling eyes;
  • atonic with sudden muscle relaxation, involuntary
    urination and defecation.

Such seizures rarely last over 15 minutes, sometimes they can
occur in series of 1-2 minutes, but they pass by themselves. ABOUT
Help your child with such convulsions read below.

What to do if a child has convulsions for the first time

If the child has seizures for the first time, do not give up.
proposed hospitalization or at least after an attack
show your child to a pediatrician and a neurologist. The child will be offered a number
research, including: clinical and biochemical
blood tests, EEG (electroencephalography).

Why are seizures today a frequent occurrence in children?

Unfortunately, the number of children willing to respond with a convulsive fit
on a variety of situations grows from year to year.

  • this is not only due to inherited features of the exchange
    substances of nerve cells and their convulsive readiness
  • the immaturity of the nervous system of young children, but also
  • with the number of successfully nursed newborns who
    “Wild” environment of past centuries simply did not live up to convulsive
    debuts
  • most of the premature babies with
    weighing up to one and a half kilogram
  • children with hemorrhages in different parts of the brain
  • children from emergency caesarean sections for detachment
    placenta
  • severe placental insufficiency with oxygen
    fasting
  • with other factors leading to pathologically flowing
    pregnancy (intrauterine infection), birth injury, in which
    children are born with severe CNS damage.

Thus, today every person suffers from convulsive syndrome.
Fiftieth child, 60% of all cases of primary development of seizures
fall into the first three years of life. But pure convulsions
can not be considered. This is not a separate disease, but a complex
symptoms that can develop with a variety of
diseases.

Causes of cramps in infants and newborns

In the first month of their life, a child in some cases is very
unstable system that can respond with convulsions to different
trouble

Convulsions in the background of birth injury

ABOUTни возникают в результате гипоксических повреждения тканей
brain, hemorrhage or shock waves of cerebrospinal fluid.
Develop in the first eight hours of a baby’s life. For hemorrhages
in the cerebral ventricles are characterized by tonic convulsions, with
hemorrhages in the subarachnoid space are clonic. For
brain hematomas or hemorrhages under the dura mater
develop generalized tonic or clonic
convulsions.

Hypoglycemic convulsions

Such convulsions appear in the first two days against the background of a very
low blood sugar (less than 1.1 mmol per liter). With
initial manifestations are characterized by hyperactivity, sweating,
anxiety, breathing problems. The stronger the hypoglycemia, the
тяжелее генерализованные тонические convulsions. To such states
lead to metabolic disorders of the infant, galactosemia,
hormonal disorders, birth asphyxia, prematurity, low weight
at birth.

Anoxic convulsive syndrome

This syndrome is a consequence of deep oxygen
starvation of the brain in children with asphyxia, which leads to edema
the brain. ABOUTбычно развиваются тонико-клонические convulsions. First phase
– тоническая, сменяющаяся  остановкой глазных яблок, задержкой
breathing. Withступ длится несколько минут и сменяется вялостью и
crying child. Seizures appear directly on the day.
childbirth. If a similar condition develops in children older than a month,
it is worth suspecting the infectious process and being alert to
development of epilepsy.

Fifth day cramps

ABOUTни возникают между третьим и седьмым днем жизни младенца,
проявляются как кратковременные (до трех minutes) клонические
twitching, the frequency of which reaches forty times a day. These
disorders associated with low blood levels in the newborn
zinc.

Convulsions on the background of hemolytic disease of the newborn

Such convulsions are caused by a toxic effect on the central
bilirubin nervous system. These генерализованные тонические
seizures develop during the first week of the child and
accompanied by jaundice, depression of reflexes, drowsiness,
impaired sucking. With развитии ядерной желтухи поражаются
подкорковые структуры the brain. Byявляются навязчивые непроизвольные
movement, delayed motor and mental development
baby

Spasmophilia (tetanic convulsions)

This is the result of calcium metabolism disorders. Early version
appears on the third day from birth, later – after the fifth
days. Characterized by spasm of gaze up, tonic hand cramps and
legs (curling and rolling fingers). Following this may
develop tonic phase with loss of consciousness.

Pyridoxine-dependent

This is a consequence of a violation of the metabolism of vitamin B6. ABOUTни характерны для
первых трех суток жизни baby Manifest as
common muscle twitches, nods of the head,
jerks.

Spasms against the background of malformations of the brain

ABOUTни достаточно редки (около 10 % всех случаев судорог
новорожденных), и возникают в первые сутки после childbirth. Also
A rare option is the family nature of the syndrome with convulsions.
up to 20 times a day, which begin to appear in the second week
of life.

Withdrawal syndromes

This cramps in children born to mothers who suffer
alcoholism or drug addiction, who used drugs during
of pregnancy. Byдобные состояния могут быть и у младенцев, чьи
mothers used barbiturates.

Primary Convulsive Syndrome is Epilepsy

With этом существует наследственная предрасположенность к
convulsions, because a certain type of exchange in the nerve cells is inherited
brain cells, which reduces their threshold of excitability. This is true
called, convulsive readiness of the brain, which when
adverse events can be realized in convulsive
seizure.

Epilepsy affects from 1 to 5% of children, while the disease
first appears in childhood in 70% of all ill adults. Byмимо
seizures epilepsy can manifest itself as autonomic, mental or
sensitive disorders. For эпилепсии нетипичны
cramps at night.

There are epilepsy with focal or generalized
cramps.

  • Simple focal seizures are the cramps of individual muscular.
    groups without loss of consciousness, difficult – convulsions with loss
    of consciousness.
  • Generalized seizures may be accompanied by clonic,
    tonic-clonic, atonic or myoclonic convulsions
    or minor seizures (absans).
  • Epileptic status – prolonged epiphristos (order half an hour)
    or a series of convulsions with loss of consciousness. He can be provoked
    electrolyte disorders, infections, medication. Often
    epistatus – the debut of a brain tumor.

How does a typical epileptic seizure occur?

The onset of an epileptic seizure is an aura:

  • visuals
  • auditory
  • olfactory or sensitive impressions that take
    the nature of exaggerated and intrusive

In addition to the aura, you may experience headache, irritability,
feeling of fear.

With a generalized attack

The child suddenly loses consciousness and with a shriek or groan
is falling. The tonic phase with muscle tension lasts a few seconds:
Causes of cramps in a child with and without fever, how to treat febrile convulsions?

  • drooping head
  • stretching the legs
  • throwing up arms

At this time there may be a stop of breath or a bite of the tongue.
due to compression of the jaws. The pupils of the child dilate, can freeze
sight.

In the phase of clonic convulsions are noted:

  • short-term jerking of various muscle groups (up to two
    minutes)
  • noisy breathing
  • there may be involuntary urination or a bowel movement
  • frothiness from mouth

After convulsions, relaxation begins, and the child falls asleep. By
When awakening, as a rule, the child does not remember the event of an attack.

Focal seizures

They give jerking of individual muscles, taste, tactile,
visuals, auditory расстройства. They can be accompanied
headache or abdominal pain, palpitations or sweating,
mental disabilities.

Minor seizure

This is a consciousness shutdown (lasting up to 20 seconds), stopping
movements and speech, fading eyes. Byсле окончания приступа
the child does not remember his circumstances. Sometimes abscesses are followed
simple or even complex motor activity (twitching
muscle, monosyllabic movements or even imitation of meaningful
activities).

Secondary seizures develop against a background of various injuries.
neurocyte

  • Withdrawal syndrome is usually characteristic when used in children
    barbiturates.
  • Spasmophilia for vitamin D overdose or hypoparathyroidism
    have a clinic similar to tetany in newborns.
  • Traumatic brain injuries resulting in massive hemorrhage
    in different parts of the brain can leads to cramps.
  • Cramps in diabetes – the result of a drop in sugar
    blood.
  • Brain tumors often manifest for the first time convulsive syndrome in
    secondary vascular epilepsy program.

Neuroinfection

Meningitis, arachnoiditis on the background of meningococcal, staphylococcal
infections, flu, botulism can give seizures. Most
a typical example of tetanic convulsions with a fatal outcome is
tetanus, which, although infrequently occurs, can carry
a child’s life that doesn’t make sense of DPT vaccination.

West syndrome (infantile seizures)

These are myoclonic seizures that may be on the background.
epilepsy or more often on the background of growth and developmental disorders of the cortex
brain in children from three to eight months of life. This type
convulsions caused by post-partum asphyxia or severe
hypoxia, cerebral palsy, abnormalities in exchange
substances, increased intracranial pressure. With this attacks
convulsions appear with lightning speed and are often combined with delays in
mental development. Typical limb flexion (leg cramps in
child) and the spine, followed by muscular
relaxation (described by West) or extensor cramps.
It is noted that convulsions follow a series and more often appear in
morning hours

Poisoning drugs, mushrooms, plants

  • ABOUTтравление лекарственными средствами –  антидепрссантами
    (amitriptyline, azafen), strychnine, isoniazid,
    ethylene glycol, anticholinergics (cyclodol, dimedrol, atropine),
    neuroleptics (haloperidol, triftazinom);
  • Mushrooms: toadstools, pale toadstool;
  • Plants: bleached, raven eye, dope.

Dehydration or blood loss

Hypovolemia or decrease in circulating blood volume on the background
dehydration (frequent diarrhea and vomiting, improper drinking regimen)
or blood loss leads to oxygen starvation of nerve cells
brain and can cause cramps.

With blood loss or dehydration, night cramps are very typical.
against the background of an imbalance of magnesium and calcium ions.

First aid for convulsions in a child

  • Call an ambulance
  • Lay the child on a hard, flat surface on its side so that
    so that the head and chest were on the same line, and lift the head
    end using a rolled blanket. At the same time it is impossible to displace the cervical
    the spine section and it is important to put the child so that he is from nowhere
    did not fall.
  • Remove around the child all the items that he can
    get hurt.
  • Release the neck and chest from tight clothes to make
    breathing free.
  • Ventilate the room, the air temperature should not be higher
    20 C.
  • Do not hold the child with force from involuntary movements, not
    open his jaws, do not pour liquids into his mouth, do not insert
    spoon, finger, etc.!

Treatment of seizures

Emergency care for convulsions of newborns

  • Внутривенное введение  25% раствора глюкозы (4мл на кг
    weight).
  • Vitamin B6 (pyridoxine) 50 mg intravenously.
  • 10% раствор глюконата кальция до 10 мл (2 мл на кг weight).
  • 50% раствор магния  0,2 мл на кг.
  • Phenobarbital (10-30 mg per kg of body weight) intravenously slowly.
  • Phenytoin 20 mg per kg intravenously.

How to treat cramps at a child’s temperature

If the cramps are rare and the duration of not more than 15 minutes
no treatment is needed.

  • The child should be cooled by any safe physical
    ways: rubbing with a weak solution of vinegar or
    alcohol solution (since the skin of the baby is actively absorbed
    substances, be careful), or put a cold on the forehead,
    cold wet towel on the armpits, popliteal and
    elbow folds, inguinal folds.
  • Byсле остановки приступа следует дать жаропонижающее средство –
    paracetamol, candles – tsifekon, efferalgan, panadol).
  • With longer and frequent convulsions you may need
    intravenous administration of anticonvulsant drugs, the need for
    this determines the doctor.
  • The doctor may also prescribe – Diazepam (0.5 mg per kg of body weight) or
    Phenobarbital (10 мг на кг) или Лоразепам (0,05 мг на кг).

Since the onset of febrile seizures, leave the baby alone
supervision cannot be, also during an attack it is impossible to give drugs
or water to avoid aspiration.

Stopping an epileptic seizure

  • 0.5% solution of diazepam (0.3 mg per kg in children from 3 years and 0.5 mg
    per kg in children under 3 years old) or midazolam (0.2 mg per kg). With
    no effect – sodium thiopental (5-10t mg per kg)
    intravenously.

Emergency care for status epilepticus

  • Early stage (5-10 minutes from the start of status): diazepam
    или  мидазолам или вальпроевую кислоту.
  • Установившийся эпистатус (10-30 minutes): внутривенно вальпроевая
    acid 15-30 mg per kg, then at a dose of 5 mg per kg per hour.
  • Stage of refractory status (up to an hour): propofol 2 mg per kg,
    sodium thiopental 5 mg per kg, midazolam 100-200 mg per kg
    intravenously.
  • Superstable epistatus (longer than a day): drugs of the third
    stages plus pyridoxine 30 mg per kg intravenously, dexamethasone,
    naloxone for suspected addiction. With необходимости
    artificial ventilation of the lungs.

Sequelae

In most cases of febrile convulsions in a child in the future
no trace of them will remain. Kids up to a year possessing high
potential to restore the brain, whose development
not finished yet, come out of frequent convulsive seizures with less
cerebral deficiency than older children. The more seizures than
они продолжительнее, чем глубже кислородное голодание neurocyte,
the more serious the consequences.

Если  дело касается первичной или вторичной эпилепсии, то
A serious approach to the problem, a comprehensive treatment is very important here.
and observation by an epileptologist. Without the containment of epilepsy and with her
progression each new seizure will carry away
child’s intellectual abilities that can lead to
loss of his capabilities and mental abilities.

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