Convulsions in a child without fever. What to do with convulsions in a child to alleviate the condition of the baby before the doctor arrives? How to help children with seizures

More than anything, parents worry about their children - if the baby has convulsions, it causes them to panic. Febrile seizures look terrible, but they do not pose a particular danger, but almost imperceptible seizures are harbingers of serious illness. Why do convulsions occur, how dangerous are they, what symptoms do they manifest and how to help without harming the baby?

What are seizures?

Convulsions in a child - involuntary movements of the body, limbs, head, accompanied by respiratory failure, rolling eyes, changes in heart rate, disorders of consciousness, up to its loss. They arise due to overexcitation of the central nervous system of children, excessive activity brain cells and are expressed in the fact that neurons send impulses to perform involuntary movements.

Convulsions in newborns are quite common, occurring at a frequency of 10 cases for every 1000 babies. They can appear both in a dream and during wakefulness. If you do not provide timely assistance little child, serious consequences are possible.

Recognizing seizures in children is not easy. Usually they shoot a video and show it to the doctor, but this does not apply to severe attacks, which cannot be identified. Standard generalized seizure in an infant (eg, sharp rise temperature) usually has the following manifestations:

tonic phase: sudden onset with motor excitation and various disturbances of consciousness, rolling or incomprehensible movements eyeballs, tilting the head, the body is stretched, the baby stops breathing, the skin turns pale or becomes cyanotic, bradycardia occurs;
clonic moments: breathing and facial expressions appear, convulsive movements of the trunk and limbs, vomiting is possible, as well as involuntary urination and bowel emptying;
ending: consciousness is gradually restored, everything returns to normal.

Why does muscle contraction?

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With seizures in children, there is an effect on the brain, the neurons of which send signals about movement, which leads to muscle contraction.

Depending on the type of seizure, muscle may freeze for a while in tension or it alternates with weakening, which causes convulsive movements. If it reduces muscles without a seizure due to spasm - the reason is in the local effect on the muscle area annoying factor(hypothermia, overpressure).

Causes of seizures in children

Seizures can occur both immediately after the birth of a child, and in an older baby. Reasons for these seizures:

How to distinguish cramps from spasms?

Spasms are involuntary tonic contractions of striated or smooth muscles. Small children do not bright signs by which spasms can be distinguished from various options tonic convulsions. In fact, these concepts are so confused that they are often used as synonyms, but they are not. Understanding what exactly the problem is with the baby is difficult, but possible. Here are the main differences:

Types of seizures

Seizures are:

Localized and generalized (focal and partial). The former affect a specific muscle or group of them, the latter cover the entire body of the child.
Clonic, tonic and tonic-clonic. Some resemble convulsions, as tension quickly alternates with muscle relaxation, others are longer, for example, a cramp can “pull out” the child’s body, which will remain in a frozen state for several seconds or minutes, while the head is tilted or thrown back. The child cannot make a sound. When weaving types of seizures and transitions from one to another, they are called tonic-clonic.
Epileptic and non-epileptic. The first are caused by epilepsy, with them the work of the limbs is disrupted, the muscles are paralyzed, sensitivity is lost, the mental and mental activity loss of consciousness occurs. Non-epileptic seizures include seizures caused by various effects on brain cells. They arise due to an imperfect nervous system and disappear by the age of 4.

There are no convulsions, but the child constantly pulls his leg - what should I do?

A situation where a child may twitch a leg or arm without convulsions occurs in such cases:

Tremor. It is manifested by the fact that in a dream the child begins to pull the leg or handle. It arises due to the immaturity of the nervous system of the child. Most often occurs at night, immediately after falling asleep and before waking up.
Hypertonicity. Both limbs can twitch, or individually, depending on where the muscle tone is higher.
Intestinal colic. Unpleasant sensations or pain in the tummy can provoke this kind of movement in the baby.
Overexcitation. Big emotional load, even positive, affects the fragile psyche of the child and can cause spontaneous movements of the limbs.
Tight swaddling. Due to the lack of blood circulation, the "staleness" of the muscles due to stiffness and limited mobility, the baby, having gained freedom, will twitch the legs or the leg that is more swollen.

If twitches are frequent, paroxysmal in nature, accompanied by crying, nervousness, capriciousness, it is advisable to seek advice from a neurologist. This will help eliminate the possibility of developing serious violations.

When does a child's condition become dangerous?

In most cases, seizures are benign and practically harmless. However, pathological convulsions occur, in which the danger lies not in the manifestation itself, but in the disease that caused them. Seizure syndrome can be epilepsy, edema or brain tumor, damage to brain cells due to infectious diseases. The child must be shown to a neurologist or called ambulance.

First aid

If a cramp has begun, before the doctor arrives, you need to help the child:

unbutton clothes or take them off if it restricts the baby's breathing;
turn the child or his head on his side (to avoid falling of the tongue and to facilitate the release of vomit);
insert a flagellum from a handkerchief between the teeth so as not to bite the tongue;
if the attack occurred at a high temperature, give an antipyretic, cool the child's skin with compresses or rubdowns;
ventilate the room or bring the child to the window to increase the supply of oxygen.

In the event of seizures in the baby, you should not refuse hospitalization. If it is not possible to go to the hospital with the child, urgently you need to show it to a pediatrician and a neurologist.

The doctor will prescribe a series of studies and tests to prevent the possibility pathological conditions organism.

Diagnosis and treatment

To diagnose seizures, the following examinations are prescribed:

interviewing parents for the presence of a hereditary factor, previous diseases child and problems in carrying it;
analyze the cause of occurrence, the time between seizures;
examinations are carried out for the presence of neurological and somatic diseases;
analyzes of urine, blood and cerebrospinal fluid are taken;
prescribe electroencephalography, computed tomography;
the fundus is examined;
other research methods.

The main treatment should be aimed at eliminating the disease that caused the seizures. To do this, you need to contact a specialist.

He will choose the tactics of treatment and write out suitable medications against seizures. The following groups of medicines are most commonly used:

anticonvulsants (depending on the underlying cause of seizures, prescribe iminostilbenes, valproates, barbiturates, succiminides, or benzodiazepines);
neuroleptics ("Aminosin", "Magafen", "Thorazine");
carbamazepine, lamotrigine, valproic acid;
nootropics ("Phenibut", "Piracetam", "Glycine") (we recommend reading:);
sedatives(valerian, Novo-Passit, Persen) (we recommend reading:);
B vitamins.

The anticonvulsant drug is chosen by the doctor taking into account that it must be hypoallergenic, not addictive and not suppress the psyche. Concomitant medicines are used only as prescribed by a specialist.

Do I need to change my baby's lifestyle?

To prevent seizures, it is important to change the features of a child's life:

observe sleep and wakefulness, while sleep should be at least 10 hours a day;
exclude stressful situations, to teach the child to calmly respond to problems or quarrels with peers;
provide a regular balanced diet;
in case of allergies, avoid irritants;
exclude the possibility of passive smoking;
limit the computer and TV to an hour a day and only in the middle of the day;
before going to bed, find a quiet activity for the child: modeling, drawing, reading;
make baths with soothing decoctions of lemon balm, motherwort, lavender;
give the baby a light relaxing massage;
provide a comfortable temperature - 18 - 21 ° C;
if you have night fears, get a night light.

Preventive actions

To prevent possible seizures, you should:

during pregnancy, use a complex of all essential vitamins and microelements, as well as to exclude all factors that can lead to problems in the baby;
conduct examinations by a neurologist at least once a year;
timely give antipyretics.

If the baby has already had seizures:

adjust the child's lifestyle so as to exclude their recurrence;
monitor their course (they became prolonged, the attacks became more frequent, accompanied by dizziness, vomiting);
in case of any changes, immediately contact a neurologist;
keep antipyretics and anticonvulsants nearby.

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 supposed to provide timely help, see 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 convulsions 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 seizures 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 children have a disorder water balance organism or an overdose of drugs, 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:

Seizures due to 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

Described a wide variety clinical manifestations convulsive syndromes in a child. 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 manifestation clonic seizures:

Twitching of the muscles in the face, passing to the rest of the body and limbs.
noisy, hoarse breathing and the appearance of foam from 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 states in most patients have general character: 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 severe 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 provided immediately necessary treatment, a young sensitive organism perceives diseases faster than a mature adult. Children's body often unable to cope on their own with a number of diseases, having weak immunity not always able to protect against 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 seizures are divided into certain types- distinguish typical and atypical forms abbreviations. 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 free Airways. 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 the prescribed medicines do not work, as additional treatment phenobarbital is given. Seizures accompanied by seizures of epilepsy sometimes lead to serious complications. Seizures secrete different forms- from relatively mild and short-term to severe, long-term.

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

Types of seizures

Cramps are involuntary muscle contractions that can involve individual muscle fibers or muscles, or spread over multiple muscle groups. Convulsions in children are of several types.

tonic convulsions- protracted muscle tension or spasm. In this case, the child takes an extensor posture, throws back his head, stretches and strains his legs, spreads his arms and turns his palms outward. Sometimes a violation of breathing is characteristic by the type of its stop, which is accompanied by cyanosis of the nasolabial triangle, extremities, reddening of the skin of the face.
Clonic convulsions- a quick change in tension and muscle relaxation (about 1-3 twitches per second).

According to the prevalence, the following clonic convulsions are distinguished: focal, multifocal and generalized.

Focal - twitching of certain parts of the face, arms, legs (for example, convulsions in sleep with magnesium losses).
Myoclonic - contractions and twitches in a muscle or group of muscles.
Tonic-clonic characterized by alternating clonic muscle contractions and their increased tone.
Fragmentary - these are eye symptoms, motor equivalents (flexion of the limbs, nodding of the head), or respiratory arrest (apnea).

What are febrile seizures?

Febrile convulsions develop in children with convulsive readiness against the background of an increase in body temperature. This type of seizure is diagnosed in children younger than six years of age with a fever, if they have not previously had seizures. Usually, such attacks develop if the high temperature crosses the mark of 38 degrees.

Since about one in three children may have a febrile seizure during subsequent episodes of fever, in children who have had such a seizure once, it is advisable to bring down the temperature, starting from 37.5 degrees.

Febrile seizures are not epilepsy and do not require special treatment, they should be distinguished from epileptic seizures. Epilepsy can occur at any age, febrile convulsions - up to 6 years on the background high temperature.

Why do they occur at temperature?

The reasons for their occurrence are not fully understood, but most scientists are unanimous in the opinion that this is caused by the predominance of excitation over inhibition processes in the brain of babies, which leads to the appearance of pathological impulses in nerve cells. SARS, any infectious disease or vaccination can provoke such a reaction of the body. It is assumed that there is a hereditary predisposition to febrile convulsions.

Since the nervous system becomes more mature after 6 years, febrile seizures should not occur if seizures occur in a child older than 6 years - this is epilepsy, infection or tumor.

Signs of seizures in a child with a temperature

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

tonic with head tilting, body tension, which change to clonic rhythmic twitches, which gradually fade;
focal with twitching of arms or legs, rolling eyes;
atonic with sudden relaxation of the muscles, involuntary urination and defecation.

Such convulsions rarely last more than 15 minutes, sometimes they can occur in series of 1-2 minutes, but they pass on their own. Read about helping a child with such convulsions below.

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

If a child has a seizure for the first time, do not refuse the proposed hospitalization, or at least after the seizure, show the child to a pediatrician and a neurologist. The child will be offered a number of studies, including: clinical and biochemical research blood, EEG (electroencephalography).

Why are seizures so common in children today?

Unfortunately, the number of children who are ready to respond with a convulsive seizure to the most different situations is growing year by year.

this is due not only to the inherited characteristics of metabolism nerve cells and their convulsive readiness
immaturity of the nervous system of young children, but also
with the number of successfully nursed newborns who, in the “wild” environment of past centuries, simply did not live up to convulsive debuts
here it is worth including most deeply with a mass of up to one and a half kilograms
children with hemorrhages in different parts of the brain
children from emergency caesarean sections about placental abruption
severe placental insufficiency with oxygen starvation
with other factors leading to a pathological pregnancy (), in which children are born with severe damage to the central nervous system.

Thus, today every fiftieth child suffers from convulsive syndrome, 60% of all cases of primary development of convulsions occur in the first three years of life. But in pure form convulsions cannot be considered. This is not a single disease, but a complex of symptoms that can develop with a variety of diseases.

Causes of seizures in infants and newborns

In the first month of his life, a child in some cases is a very unstable system, which can respond with convulsions to various troubles.

Convulsions due to birth trauma

They arise as a result of hypoxic damage to brain tissue, hemorrhages or shock waves. cerebrospinal fluid. They develop in the first eight hours of a baby's life. For hemorrhages in the cerebral ventricles, tonic convulsions are characteristic, with hemorrhages in the subarachnoid space - clonic. For brain hematomas or hemorrhages under the solid meninges generalized tonic or clonic convulsions develop.

Hypoglycemic seizures

Such convulsions appear in the first two days against the background of very low level blood sugar (less than 1.1 mmol per liter). At initial manifestations hyperactivity, sweating, anxiety, respiratory disorders are characteristic. The stronger, the more severe the generalized tonic convulsions. Such conditions are caused by metabolic disorders of the infant, galactosemia, hormonal disorders, prematurity, low birth weight.

Anoxic convulsive syndrome

This syndrome is a consequence of deep oxygen starvation of the brain in children with asphyxia, which leads to cerebral edema. Tonic-clonic seizures usually develop. The first phase is tonic, followed by stopping the eyeballs, holding the breath. The attack lasts for several minutes and is replaced by lethargy and tearfulness of the child. Convulsions appear directly on the day of birth. If a similar condition develops in children older than a month, it is worth suspecting infectious process and be alert for the development of epilepsy.

Convulsions of the fifth day

They occur between the third and seventh day of a baby's life, appear as short-term (up to three minutes) clonic twitches, the frequency of which reaches forty times a day. These disorders are associated with low content in the blood of a newborn zinc.

Seizures due to hemolytic disease of the newborn

These seizures are caused toxic effect on the central nervous system bilirubin. These generalized tonic seizures develop during the first week of the child and are accompanied by jaundice, inhibition of reflexes, drowsiness, and impaired sucking. With the development of nuclear jaundice are affected subcortical structures brain. There are obsessive involuntary movements, a delay in the motor and mental development of the baby.

Spasmophilia (tetanic spasms)

This is the result of a violation of calcium metabolism. early version appears on the third day from birth, late - after the fifth day. Characterized by a spasm of looking up, tonic convulsions of the arms and legs (twisting and bringing fingers together). This may be followed by a tonic phase with loss of consciousness.

Pyridoxine dependent

This is a consequence of a violation of the metabolism of vitamin B6. They are typical for the first three days of a baby's life. Manifested in the form of common muscle twitches, head nods, shudders.

Seizures due to malformations of the brain

They are quite rare (about 10% of all cases of neonatal seizures), and occur on the first day after birth. Also, a rare variant 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

These are convulsions in children born to mothers suffering from alcoholism or drug addiction who used drugs during pregnancy. Similar conditions may occur in infants whose mothers used barbiturates.

Primary convulsive syndrome is epilepsy

At the same time, there is a hereditary predisposition to convulsions, since a certain type of metabolism is inherited in the nerve cells of the brain, which reduces their excitability threshold. This is the so-called convulsive readiness of the brain, which, in case of adverse events, can be realized in a convulsive seizure.

Epilepsy affects from 1 to 5% of children, while the disease first appears in childhood in 70% of all ill adults. In addition to seizures, epilepsy can manifest as autonomic, mental or sensory disorders. Seizures at night are not typical for epilepsy.

Distinguish epilepsy with focal or generalized convulsions.

Simple focal seizures- these are convulsions of individual muscle groups without loss of consciousness, complex - convulsions with loss of consciousness.
Generalized Seizures may be accompanied by clonic, tonic-clonic, atonic or myoclonic convulsions or small seizures (absences).
Epileptic status- a prolonged epileptic seizure (about half an hour) or a series of convulsions with loss of consciousness. It can be provoked by electrolyte disturbances, infections, medications. Often epistatus is the debut of a brain tumor.

How does a typical epileptic seizure proceed?

The beginning of an epileptic seizure is an aura:

visual
auditory
olfactory or sensory impressions that take on the character of exaggerated and intrusive

In addition to the aura, headache, irritability, and a feeling of fear may appear.

With a generalized seizure

The child suddenly loses consciousness and falls with a cry or a groan. The tonic phase with muscle tension lasts for several seconds:

tilting the head
stretching legs
spreading arms

At this time, there may be respiratory arrest or biting of the tongue due to clenching of the jaws. The pupils of the child dilate, the gaze may freeze.

In the phase of clonic convulsions are noted:

short-term twitches of various muscle groups (up to two minutes)
noisy breathing
there may be involuntary urination or bowel movements
foaming from the mouth

After convulsions, relaxation occurs, and the child falls asleep. Upon awakening, as a rule, the child does not remember the events of the attack.

focal seizures

They give twitching of individual muscles, taste, tactile, visual, auditory disorders. They may be accompanied by headache or abdominal pain, palpitations or sweating, mental disorders.

Small fit

This is turning off consciousness (lasting up to 20 seconds), stopping movements and speech, fading eyes. After the attack ends, the child does not remember its circumstances. Sometimes absences are accompanied by a simple or even complex motor activity(muscle twitching, monosyllabic movements, or even imitation of meaningful activity).

Secondary seizures develop against the background of various damage to neurocytes.

Withdrawal syndrome, as a rule, is characteristic when barbiturates are used in children.
Spasmophilia on an overdose of vitamin D or hypoparathyroidism have a clinic similar to tetany in newborns.
Traumatic brain injuries leading to massive hemorrhages in different parts of the brain can lead to convulsions.
Seizures in diabetes are the result of a drop in blood sugar.
Brain tumors often present for the first time as a seizure disorder in a secondary vascular epilepsy program.

Neuroinfections

Meningitis, arachnoiditis against the background of meningococcal, staph infection, influenza, botulism can give convulsions. The most characteristic example of tetanic convulsions with lethal outcome- this is tetanus, which, although infrequent, can take the life of a child, which does not deprive the DTP vaccination of its meaning.

West syndrome (infantile seizures)

These are myoclonic seizures that can occur against the background of epilepsy or, more often, against the background of growth and developmental disorders of the cerebral cortex in children from three to eight months of age. This type of convulsions is facilitated by asphyxia or severe hypoxia transferred during childbirth, cerebral palsy, metabolic abnormalities, increased intracranial pressure. In this case, seizures appear at lightning speed and are often combined with mental retardation. Flexion of the limbs (leg cramps in a child) and spine are typical, followed by muscle relaxation (described by West) or extensor convulsions. It is noted that convulsions follow a series and are more often manifested in the morning hours.

Poisoning medicines, mushrooms, plants

Poisoning medicines - antidepressants (amitriptyline, azaphen), strychnine, isoniazid, ethylene glycol, anticholinergics (cyclodol, diphenhydramine, atropine), antipsychotics (haloperidol, triftazin);
Mushrooms: fly agaric, pale grebe;
Plants: bleached, crow's eye, dope.

Dehydration or blood loss

Hypovolemia or a decrease in the volume of circulating blood against the background ( frequent diarrhea and vomit, wrong drinking regimen) or blood loss leads to oxygen starvation of the nerve cells of the brain and can cause seizures.

With blood loss or dehydration, night cramps are very typical due to an imbalance of magnesium and calcium ions.

First aid for seizures in a child

call an ambulance
Lay the child on a hard, flat surface on its side so that the head and chest are in line, and lift the head end with a rolled up blanket. In this case, it is impossible to displace the cervical spine and it is important to lay the child so that he does not fall from anywhere.
Remove all objects around the child that he can get hurt.
Loosen the neck and chest from tight clothing to allow free breathing.
Ventilate the room, the air temperature should not be higher than 20 C.
Do not hold the child with force from involuntary movements, do not open his jaws, do not pour liquid into his mouth, do not insert a spoon, finger, etc.!

Seizure treatment

Emergency care for neonatal seizures

Intravenous administration of 25% glucose solution (4 ml per kg of body weight).
Vitamin B6 (pyridoxine) 50 mg intravenously.
10% calcium gluconate solution up to 10 ml (2 ml per kg of weight).
50% magnesium solution 0.2 ml per kg.
Phenobarbital (10-30 mg per kg of weight) intravenously slowly.
Phenytoin 20 mg/kg intravenously.

How to treat seizures at a temperature in a child

If convulsions are rare and last no more than 15 minutes, no treatment is necessary.

Keep the child cool by any safe by physical means: wiping with a weak solution of table vinegar or an alcohol solution (since the baby's skin actively absorbs substances, you should be careful), or apply cold on the forehead, a cold wet towel on the armpits, popliteal and elbow folds, inguinal folds.
After stopping the attack, you should give -, candles - cifekon, efferalgan, panadol).
For longer and more frequent seizures, you may need intravenous administration anticonvulsant drugs, the need for this is determined by the doctor.
Also, the doctor may prescribe - Diazepam (0.5 mg per kg of body weight) or Phenobarbital (10 mg per kg) or Lorazepam (0.05 mg per kg).

Since the onset of febrile convulsions, it is impossible to leave the baby alone unattended, and during an attack, medicines or water should not be given, in order to avoid aspiration.

Relief of an epileptic seizure

0.5% solution of diazepam (0.3 mg per kg in children over 3 years of age and 0.5 mg per kg in children under 3 years of age), or midazolam (0.2 mg per kg). In the absence of effect - sodium thiopental (5-10 mg per kg) intravenously.

Emergency care for status epilepticus

Early stage (5-10 minutes from the onset of the status): diazepam or midazolam or valproic acid.
Steady epistatus (10-30 minutes): intravenous valproic acid 15-30 mg per kg, then at a dose of 5 mg per kg per hour.
Refractory stage (up to an hour): propofol 2 mg per kg, sodium thiopental 5 mg per kg, midazolam 100-200 mg per kg intravenously.
Super stable epistatus ( longer than a day): drugs of the third stage plus pyridoxine 30 mg per kg intravenously, dexamethasone, naloxone if drug addiction is suspected. If necessary artificial ventilation lungs.

Consequences of seizures

In most cases of febrile seizures, the child will not leave any traces of them in the future. Babies up to a year old, having high potential to restore the brain, the development of which is not yet completed, come out of frequent convulsive seizures with less brain deficit than older children. The more frequent the convulsions, the longer they last, the deeper oxygen starvation neurocytes, the more serious the consequences.

When it comes to primary or secondary epilepsy, then a serious approach to the problem is very important, complex treatment and observation by an epileptologist. Without containment of epilepsy and with its progression, each new seizure will take away the intellectual capabilities of the child, which can lead to severe loss of his capabilities and mental abilities.

Children suffer from convulsive syndromes much more often than adults. This is due to the many various factors. We will figure out what can provoke convulsions in a child, and how to quickly deal with the problem.

There are many prerequisites for malaise, and only the attending physician can understand them. After all, the range of syndromes is quite wide - from muscle contractions during falling asleep and during sleep to epileptic seizures. Night cramps in children are far from always referred to as pathologies, because impulses to nerve endings may be due to bright dream or an uncomfortable posture.

Convulsions in children under one year old are also explained by the rapid excitability of the central nervous system (CNS) due to its immaturity.

Similar reactions in babies are divided into epileptic and non-epileptic. Risk factors for the latter include:

hereditary disposition;
Psycho-emotional disorders;
CNS dysfunction;
Traumatic brain injury;
Metabolic disease;
Reaction to vaccination
Intoxication of the body;
Internal hemorrhages.

The cause of cramps in a child in the legs can be a deficiency of calcium, iron and magnesium.
In a newborn, seizures may occur due to asphyxia, birth trauma, problems with the heart and blood vessels, perinatal encephalopathy.

What are respiratory-affective seizures? These are involuntary muscle contractions due to an excess of emotions. They usually appear in crumbs from six months to three years and are considered the most harmless.

Only a doctor can determine the cause of seizures. If they are accompanied by others painful symptoms and often repeated, medical attention is needed.

Types of convulsive manifestations

From how the seizures manifest themselves, they can be divided into several varieties:

tonic

The nature of muscle contraction: prolonged. Because of this, the limbs seem to freeze in the process of flexion or extension. The baby's body is stretched, and the head is thrown back or lowered onto the chest. Tonic convulsions last a long time. Their appearance indicates an overexcited state. brain structures. More often occur in the limbs, for example, when a child has leg cramps. But they can also capture the stomach, neck, face.

clonic

The nature of muscle contraction: fast. Periods of muscle contraction in children and relaxation occur dynamically and visually resemble twitches. They begin when a pathological discharge occurs in the brain centers or in the muscles. If you do not eliminate their cause, but the attacks become more frequent.

Tonic-clonic

Clonic-tonic seizures are characterized by alternating muscle contractions and their increased tone. The final may be loss of consciousness or even coma. Seizures of this type are often manifested due to epilepsy.

There are also myoclonic seizures. Their difference is that they pass completely without pain. Most often, myoclonic seizures occur during sleep. These include leg cramps at night, from which the child wakes up. But they can be caused by fear or overeating (for example, hiccups). In the newborn, myoclonic seizures are often associated with inherited ailments. Also by coverage skeletal muscles doctors divide all convulsive seizures into two types: partial (local) and generalized (general).

Seizures are usually solitary. When repeated, we can talk about the occurrence of secondary myoclonus. The reasons for this may be various neurological diseases.

Febrile seizures in children

So called convulsions at a temperature in a child. Preschool children are prone to such manifestations. Febrile seizures in children with fever develop due to the fact that the brain of the crumbs is not sufficiently formed and is sensitive to various stimuli. They are observed in a child at a high temperature: 38-39 degrees and above. Moreover, seizures are possible, even if they did not appear before.

What do seizures look like at a temperature? This variety appears as follows:

Detachment up to loss of orientation;
Paleness and retention of breath;
Muscle twitching and stiffness.

Convulsions in a child at a temperature are not considered the norm, but in isolated cases they are not dangerous. The causes of febrile seizures are various infections bacterial and viral nature. Children may be genetically predisposed to such a reaction.

It is important to note: the faster hyperthermia develops, the higher the likelihood of convulsive conditions. However, there are also subfebrile convulsions. Such convulsions occur after a high temperature in a child, when the thermometer drops to 37 degrees. Usually they are repeated, with complications of the disease. However, such convulsions may occur against the background of vaccination.

Temperature cramps often occur in a child with a disease caused by the Epstein-Barr virus. Such an ailment is called. It is often confused with a sore throat, but the Epstein-Barr virus is a herpes virus. The carriers of Epstein-Barr infectious agents are the majority of the world's population. But in preschool children, due to an underdeveloped defense system, the Epstein-Barr virus is activated and provokes complete disease. Fortunately, after illness, immunity is developed. Even for those who have easily suffered an indisposition, the Epstein-Barr virus is no longer terrible. BUT disease state, which provokes the Epstein-Barr virus, is easily removed by modern medicines.

Symptoms and Diagnosis

Symptoms of seizures depend on the nature of muscle contraction. But in general, we can talk about the following common features:

Various tics and twitches;
Uncontrolled movements of the arms or legs;
Distortion of facial features;
eye rolling;
Lockjaw;
Paleness of the skin and a bluish tint to the lips;
Excessive salivation;
Freezing in an unnatural position;
Nausea and even vomiting.

The child may describe himself, faint. After an attack, most likely, he will become capricious, but at the same time he will be sleepy and lethargic.

How to recognize epileptic seizures? During them, the baby falls to the floor and begins to convulse. His eyes roll back, his lips foam, his jaw clenched. The child loses consciousness. The patient is able to urinate or make an involuntary defecation. The exit from the attack is accompanied by disorientation and loss of memory of what happened. Finishing epileptic convulsions the child has muscle relaxation, and he falls asleep.

Only a doctor can determine exactly why convulsions began. He decides which therapeutic course to choose.

But before that, the doctor collects an anamnesis, analyzes how the seizure began, and prescribes research. They usually include a blood test, electroencephalography. Sometimes required CT scan, pneumoencephalography, angiography, spinal puncture.

Convulsions are dangerous because their consequences are unpredictable. In a child during an attack, brain functions are weakened, oxygen is practically not supplied. Because of this, necrosis of brain cells begins, which leads to problems with the neuropsychic system, developmental delay.

General convulsive syndromes are the most serious, since the baby does not control the body at all and is unconscious. With an uncontrolled seizure, epileptics have a risk of choking on saliva and vomit, biting off their tongue.

Why are night attacks dangerous? The baby is alone with the disease, without the help of adults. This condition can even lead to death.

First aid for seizures in children

What to do if a child has a seizure? Call an ambulance. But since the child struggles with spasm from 2 seconds to 10 minutes, the doctors may not have time to arrive. Parents need to provide some help to the baby, using the following algorithm:

The position of the child with convulsions

Remove tight shoes and clothes, as well as open the window for inflow fresh air.
Lay the crumbs on the barrel on a flat, not soft surface. Or at least turn your head to the side.
While convulsions last, clear your mouth of mucus, while laying a roll of cloth between the teeth. This will help to avoid biting or dropping of the tongue. Hard objects should not be used, so as not to damage the teeth.
If the baby fainted, try to bring him to his senses and hold out until the doctors arrive. Fainting syndrome helps to remove cotton wool from ammonia, affectionate conversations, touches.

It is especially difficult and scary in such a situation for parents of babies. The baby not only does not understand what is happening to him, but he cannot say anything either. It is important not to panic, to act clearly and systematically.

When the baby cries a lot, he may also experience spasms. He needs to be calmed down. An attack that has already begun is stopped by sprinkling a little cool water or patted on the cheeks. Then give sedative, for example, valerian in the proportion: 1 drop for 1 year of life. A sedative will also help to cope with seizures caused by vivid dreams. And convulsions calf muscles, when the baby's leg has crumpled, they are eliminated with a light massage.

From febrile convulsions, manifested against a background of high temperature, they will save (Ibuprofen, Paracetamol). You can also do cool compresses or wraps. In a feverish state, when the heat is combined with pallor and chills, cooling procedures should not be done. These symptoms are very dangerous state The child has.

The doctor may prescribe injections in the proportion of 1 mg per kilogram of body weight. An older child can be given a tablet of this drug - No-shpa is well tolerated by children. And emergency assistance must be called.

Treatment of seizures in children and prevention of seizures

With convulsions in a child that are not associated with age-related changes or excessive emotional arousal, immediate treatment is required. Therapeutic tactics are chosen by the doctor depending on the causes of muscle spasm.

The doctor may prescribe anticonvulsant drugs, sedatives and symptomatic remedies, as well as drugs to normalize metabolism.

Additionally prescribed massage, reflexology, therapeutic gymnastics, other physiotherapy. At serious violations brain function, surgical intervention is possible.

In order for convulsions to bypass your crumbs, you need to take care of this before he is born. One month before the planned pregnancy, take drugs with folic acid. During gestation, do not allow the influence of any adverse effects, infectious diseases, drink vitamin and mineral complexes prescribed by a doctor. The newborn must be examined pediatric neurologist. A baby at the age of one month needs to undergo a neurosonography procedure.

Children need physical activity in the fresh air - often walk with the baby. When falling asleep crumbs and during sleep, the environment should be calm and peaceful. It is important to compose for children balanced menu, since the lack of valuable elements can also provoke convulsions in a child.

Remember what to put correct diagnosis only a doctor can, do not self-medicate without consultation and diagnosis by a qualified doctor.

There is no mother who does not care about the health of her baby. Therefore, every woman strives to learn as much as possible about various childhood diseases in order to be ready to help her child. One of the reasons for the concern of mothers is the spasms in the child, which, most often, occur suddenly.

Big Picture

Seizures in children are manifested in the form of uncontrolled contractions of the muscles of the body. They can be like independent disease as well as a sign of some disease. Often leg cramps in a child are accompanied by serious side effects, signaling metabolic disorders, spasmophilia, toxoplasmosis, encephalitis, meningitis, endocrinopathy, hypovolemia and other diseases.

According to medical statistics, about 2% of children suffer from seizures. In this case, the lion's share of seizures falls on the age of one to ten. Also, the disease can befall teenagers under 15 years old. Seizures in children under one year of age signal developmental disorders of the nervous system, in particular, immaturity of the brain.

Prerequisites for the development of convulsive syndrome

If the mother noticed convulsions in the child, the reasons must be clarified first. That is why observation by a pediatrician and a neurologist in the first year of a baby's life is so important. Even the most attentive mother can miss the signs of an emerging illness or simply not understand what led to it. To clarify the picture, it is worth remembering whether the baby had congenital diseases or injury.

So the most common causes seizures in children:

acute or chronic forms of brain diseases (neuroinfection, hydrocephalic syndrome, brain dysgenesis, tumor);
genetic or chromosomal disease (impaired metabolism of amino acids, carbohydrates, fats);
also, convulsions in a child up to a year old can develop against the background of toxic brain damage - infectious toxicosis, exogenous drug poisoning;
ailment is side effect endocrine and electrolyte disorders - hypoglycemia, diabetes, hypocalcemia, etc.;
Moreover, most of convulsions in a child in a dream occurs due to increased body temperature. These are the so-called febrile convulsions;
also do not discount the possibility of epileptic seizures;
sometimes muscle contractions are observed after vaccination. Most often convulsive symptom manifests itself a couple of hours after vaccination, less often - the next day or a week later;
quite often the convulsive syndrome is shown against the background of a strong fright and the subsequent sharp cry. During such an attack, the child may turn blue or lose consciousness. In addition, children often hold their breath while inhaling, i.e., as during an asthma attack.

It is worth remembering that convulsions in a child are considered serious condition and require immediate medical attention. If you ignore this ailment, it can lead to a disorder of central hemodynamics, hypoxia and other metabolic disorders nervous system.

Classification of seizures in children

Comprehensive expression of seizures is localized and generalized.

Localized seizures are also called focal and partial. They appear in any one part of the body, for example, in the legs. It is also common to have a tic on one side of the body. A similar picture indicates the defeat of one hemisphere of the brain or part of it.

At generalized convulsions, the seizure spreads throughout the body. This is a sign of damage to the entire cerebral cortex, which is responsible for movement.

Besides, muscle cramps distinguished by direction.

1. Most often observed clonic convulsions in children during sleep. Their fast, sketchy nature is due to the chaotic alternation of muscle contraction and relaxation. Often the child wakes up during a seizure and begins to cry.

2. When tonic convulsions, on the contrary, there are long periods of contraction. During muscle tension, the child often cannot utter a sound. Then comes relaxation, lasting until the next attack.

3. Under atonic cramps imply loss of muscle tone. For example, dystrophy or atrophy. Also, the cause of atonic muscle contractions can be Lennox-Gastaut syndrome (manifested in children aged one to eight), in which the neck muscles do not develop, and the head hangs helplessly, or West syndrome, observed in six-month-old children. The latter syndrome is expressed in the form of epileptic seizures affecting the muscles along the ridge and the musculature of the limbs.

There are also two broad categories of seizures - epileptic and non-epileptic.

Easiest to diagnose epileptic seizures, which are the main symptom of epilepsy. Before an attack, the child may feel unwell - fever, nausea, dizziness, chills. You may also hear sound or olfactory hallucinations. After a seizure, children fall into a deep sleep, which can last for several hours, or even days. Upon awakening, the baby is often disoriented, the reaction to others is sluggish, he may not remember the attack itself and feel headache. The peculiarity of epileptic convulsions is that they appear suddenly.

Non-epileptic convulsions in children in a dream are the result of heart disease, leukemia, hemophilia and some other diseases.

Every mother should carefully monitor her child, and at the first symptoms of convulsions, immediately seek medical help.

First aid for seizures

If a child has seizures, what should I do first? Of course, call an ambulance, since it is strictly forbidden to transport it during an attack in order to avoid worsening the condition.

While waiting for the arrival of doctors, it is necessary to place the child on a hard, flat surface, having previously undressed, and provide him with peace. In no case should you scream and shake the baby, trying to bring him to his senses. These actions are not only useless, but also quite dangerous to health.

Also, do not try to open the child's teeth (if it is not an epileptic seizure), put any objects into his mouth and try to get drunk. All you have to do is remove sharp objects, about which the child can get hurt, and open the window, as fresh air will help bring him to his senses faster than screams and fuss.

At elevated temperature accompanying febrile convulsions in children, you need to do the following - completely undress the child, rub it with any strong alcohol, or cover the body with a damp towel. You can put a thin sheet or blanket on top. More about febrile seizures in children

During an attack, you can not leave the child alone. The mother or other relatives should be near him until the seizure is completely over.

Drug treatment of convulsive syndrome

After the first convulsive attack it is necessary to undergo a thorough examination by a neurologist. If seizures do not recur, the need for drug treatment no. But with regular muscle contractions, the doctor must prescribe a course of injections.

Basically, seizures are treated as monotherapy, i.e. drugs are not combined, but are used separately. The most common treatment convulsive syndrome Phenobarbital and sodium valproate. A single dose for children is 1 to 3 mg per day.

Oral convulsions are treated with Finlepsin, Fntelepsin, Suxilep, Difenin. Doses are calculated by the doctor according to big picture disease based on the age of the child.

Lifestyle and regimen

With constant convulsive seizures, the child must comply with a certain regimen.

Mom should make sure that her child always goes to bed and wakes up at the same time. Therefore, the woman herself will have to comply with the regimen. In addition, it is necessary to create favorable conditions for sleep - remove all gadgets from the room, minimize extraneous sounds and smells, ensure fresh air and cleanliness.
Children suffering from seizures need to spend more time outdoors.
It is required to minimize stressful situations and phenomena that can frighten the child. Mom needs to take care that in the presence of her baby they do not turn on loud music, do not swear, do not shout. You also need to avoid flickering light, overheating, emotional upheaval.

A woman whose child suffers from convulsive syndrome should always control herself. Calm balanced mother - the best medicine for the baby. Convulsions are not a sentence. The main thing is to believe in the recovery of your child and everything will be fine.

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