Neonatal seizures of newborns. Convulsive syndrome in newborns - symptoms and signs. What are the types of seizures?

Convulsions (sudden and involuntary muscle contractions) in newborns, according to various sources, occur with a frequency of 1.5 to 14 cases per 1000 children, and in premature infants in a modern unit intensive care, their frequency reaches 25%.

The main causes of seizures in newborns:
1. Hypoxic-traumatic brain damage (without or with hemorrhage in the brain and - or its membranes, thrombosis of the cortical veins, cerebral edema).

2. Metabolic disorders
- hypoglycemia
- hypocalcemia
- hypo or hypernatremia
- hyperammonemia
- amnioacidopathy
- pyridoxyl dependence
- hyperbilirubinemia with kernicterus

3. Infections
- meningitis
-meningoencephalitis

4. Congenital anomalies(brain dysginesia)

5. Withdrawal syndrome (children of mothers who are drug addicts or alcoholics)

6. Drug poisoning

7. Familial seizures ( hereditary syndromes with mental retardation, benign familial epilepsy)

In 50% of cases, convulsions in newborns occur on the first day of life, in 75% of cases before the 3rd day. In the first 48 hours of life, the most common reasons convulsions, asphyxia and birth trauma, hypoglycemia.

On days 3-5 - metabolic disorders (uncomplicated primary hypocalcemia), in the period older than 5 days highest value In the development of seizures there are infectious and genetic factors.

Clinic:
The following types of seizures in newborns are distinguished:
1. minimal, elusive
2. tonic - generalized, focal
3. clonic - focal (focal), multifocal (multifocal)
4. myoclonic

Difficulties in diagnosis are caused by minimal seizures or seizure equivalents. These are seizures with minimal peripheral manifestations and seizures in the form of deviations from normal behavior. Manifest in the form of fixation of gaze, deviation of the eyes (sometimes with nystagmus), twitching, movements of the lips, tongue (sucking, smacking, chewing), tonic tension of the limbs, pedaling, floating, circular movements of the limbs, apnea attacks and unemotional screaming.

Required scope of laboratory examination:
(in addition to a thorough analysis of the nature of labor and the clinical picture)

1. Clinical analysis blood
2. Determination of the level of glucose, calcium (Ca), magnesium (Mg), sodium (Na), chlorine (Cl) in the blood, as well as urea nitrogen, creatinine, bilirubin, acid-base balance.
3. Lumbar puncture
4. Neurosonography
5. Electroencephalography (EEG)
6. For persistent convulsive syndrome, computed tomography

TREATMENT TACTICS
Treatment of a child with seizures should be etiopathogenetic. The following appointments are made for the examination period: medicinal substances:
- seduxen (diazepam, relanium), 0.5% IV or IM 0.04 ml/kg, the dose can be increased to 0.1 ml/kg 0.5% solution. If there is no effect, the injection can be repeated after 30 minutes.
- sodium hydroxybutyrate (GHB) IV slowly (2ml/min), - 20% solution at a dose of 0.5 - 0.75 ml/kg (100-150 mg/kg), pre-diluted in 10% glucose solution in a 1:1 ratio.
Less commonly, drugs are administered intramuscularly.
- droperidol IV or IM 0.25% solution 0.04 - 0.08 ml/kg (especially good for children with fever and peripheral circulatory disorders)
- phenobarbital 20 mg/kg IV for 15 minutes - loading dose, then maintenance dose per os 4-5 mg/kg - day (if a solution for parenteral administration is available)
- to increase the effectiveness of phenobarbital, diphenine is prescribed 5-10 mg/kg - daily in 1-2 doses per os.

For neonatal seizures caused by metabolic disorders their correction is carried out:
1. Hypocalcemia (level of total calcium< 1,9 ммоль/л, ионизированного < 0,9 ммоль/л; на ЭКГ - удлинение интервала QТ): в/в струйно 10% calcium solution gluconate at the rate of 1 ml/kg slowly (1 ml/min). If there is no effect, the injection is repeated after 20-30 minutes.

2. Hypomagnesemia (often combined with hypocalcemia). The critical level of magnesium is -0.5 mmol/l. A 25% solution of magnesium sulfate IM is indicated at a dose of 0.4 ml/kg (in addition to hypomagnesemia, the drug is indicated for seizures caused by cerebral edema, intracranial hypertension). For intravenous administration, a 25% solution of magnesium sulfate is diluted to a 1% concentration with 10% glucose and 6-10 ml of a 1% solution is administered slowly (1 ml/min). Complications from intravenous administration - respiratory depression, bradycardia.

3. Hypoglycemia
The diagnosis is established when the level of glucose in the blood of a full-term baby is less than 2.2 mmol/l. Clinical manifestations of hypoglycemia are pallor, sweating, weak cry, apathy, refusal to feed, lethargy (at the beginning, on the contrary, irritability, tremor, spontaneous Moro reflex may be noted), loss of tone eyeballs, general muscular hypotension, vomiting, attacks of shortness of breath, cyanosis, bradycardia, respiratory and cardiac arrest, hypothermia, convulsions.
To relieve convulsive syndrome, it is administered intravenously: i.v. 10% glucose solution 2 ml/kg for 1 minute, then 1 ml/min, then switch to intravenous drip infusion of 10% glucose solution at a rate of 5 ml/kg per hour.

4. Pyridoxine-dependent seizures: IV or IM 50-100 mg of vitamin B6, i.e. 1-2 ml of 5% solution of pyridoxine hydrochloride.

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In the first days of life, a baby (even a child under five years old) can often experience seizures. Sometimes spasms indicate the presence of serious pathologies in a child under one year old. Let's consider the most characteristic causes seizures in children under one year of age, signs and possible treatments.

The phenomenon often occurs in premature babies - up to three to five years of age. Statistics say that every fifth premature baby is subject to some degree of seizure syndrome. Mothers who gave birth to a premature baby need to be attentive to his health.

In children under one year of age, in older children (up to three and five years old), seizures show different character. The latter is associated with the characteristics of the functioning of the brain and nervous system(the nervous system of newborn children is at the stage of formation). Doctors divide seizures up to three years into a number of types.

1. Minor convulsions (spasms). Dangerous, considered to be a harbinger of the development of a dangerous disorder of brain development. The phenomenon is easy to identify - minor twitching or blinking of the eyes, facial muscles, skeletal muscles. Sometimes a slight, unexpressed blue discoloration of the skin is noticed.

Is it possible to independently determine the nature of seizures in a newborn and a child under three years of age?

The manifestations of seizures in children under one year of age are ambiguous and differ in a particular case. Parents will not be able to independently medical care determine the nature of the child’s seizure, relying solely on one’s own experience or on information gleaned from medical sources. Not in every case, rhythmic muscle twitching is considered a seizure.

Seizures in a newborn and a child under three years of age are determined exclusively in a hospital setting. Doctors use using the latest methods diagnostics, in particular, electroencephalography and magnetic resonance imaging. In the presence of small seizures, it is difficult to observe the dynamics of changes in brain activity.

It often happens that seizures do not respond to anti-epileptic drugs. The latter means that the previous diagnosis was made inaccurately, the child needs to be re-diagnosed.

Causes of neonatal seizures

There are many reasons for seizures in young children. Let's look at the common and typical ones.

• Metabolic disorders of various etiologies. These primarily include hypoglycemia and hyponatremia. With hypoglycemia, there is a decrease in the amount of sugar in the blood. The condition often leads to seizures in the child. Remain attentive to the child’s condition; in some cases, hypoglycemia leads to irreversible consequences in the cerebral cortex. Reduced content calcium in the blood (hypocalcemia) also negatively affects the functioning of the brain and leads to seizures.
• Encephalopathy. Brain damage manifests itself as acute or chronic failure oxygen in the blood.
• Meningitis and encephalitis pose a huge danger to the newborn’s brain and are considered a serious cause of seizures.
• Damage to the blood vessels of the brain, often found in premature infants. Threatens cerebral hemorrhages.
• Insufficiency of magnesium or pyridoxine (vitamin B6) in the child’s body. Often pathologies develop simultaneously.
• Birth injury.
• Congenital brain defects in children.
• When treated with psychoactive drugs, seizures occur as a withdrawal syndrome.

Symptoms of seizures in children of the first year of life

Conditions that cause seizures in newborns are often life-threatening. There are cases where children with convulsions in the neonatal period subsequently developed without any special complications. If seizures occurred due to low glucose levels in the baby’s blood, the child also did not develop complications in the future. If the spasms occurred as a result of meningitis, a high risk of developing all kinds of neurological complications is subsequently revealed.

By clinical symptoms convulsions are classified as partial, localized, and generalized. In the first case, they spread to a specific muscle group. In the second case, a general convulsive seizure develops. A generalized type of seizures develops when both hemispheres of the brain are involved in the painful process.

If there is a recurrence of convulsive seizures, they speak of convulsive status. Breathing disturbances occur with symptoms of hypoxic cerebral edema. When edema spreads to the brain stem, a disorder of the respiratory, vasomotor center occurs, pathological breathing, vomiting, fever (even up to 39 degrees), bradycardia, collapse.

A generalized tonic-clonic seizure develops suddenly. Disturbing motor excitement, depression of consciousness up to loss. Characterized by tilting the head back, bending the arms in elbow joints, leg extension, facial tension. Possible apnea (stopping breathing), the face becomes pale and blue. Vomiting is observed. Holding your breath lasts no more than a minute. After the end of the seizure, the body is completely restored, and the same happens with consciousness. The child does not remember what is happening at all. The prognosis noticeably worsens if paresis or paralysis is observed along with convulsions.

Often, infants experience short-term generalized tonic-clonic seizures. They are typical in children under one year of age, but can occur in older children. It happens against the background of a rise in body temperature. The duration of convulsions is no more than three to five minutes. The prognosis is favorable, not accompanied by neurological disorders. Nervous and mental health does not suffer from children, does not lag behind, is completely age appropriate.

With a lack of calcium in the blood, tetanic convulsions and attacks of sudden respiratory arrest occur. Specific symptoms are noticeable:

• Contraction of the orbicularis oculi muscle;
• Contraction of the angularis oris muscle;
• Abduction of the foot when tapping the forearm or shoulder;
• Laryngospasm.
• Vomit.

The child bends his arms at the elbow joints and is unable to straighten them. The brushes go down and acquire characteristic appearance"the hands of an obstetrician."

With a decrease in magnesium concentration, increased nervous excitability, muscle tremors, and convulsions are observed. With hypoglycemia, weakness, sweating, muscle tremors, a significant increase in heart rate with possible respiratory arrest are observed. The state of hypoglycemia threatens the child with the development of a coma.

The main principles of treating seizures in infants

Successful treatment of any seizure in a newborn becomes such once the cause is discovered. General rules of treatment convulsive conditions in children:

• If hypocalcemia is the cause of a convulsive state, the child is given a solution of calcium gluconate in a glucose solution (slowly and intravenously).
• For hypomagnesemia (magnesium deficiency), a solution of magnesium sulfate is injected intramuscularly.
• In case of hypoglycemia, a dextrose solution is first administered, then a glucose solution is administered in a stream and intravenously. It is necessary to monitor temperature and vomiting.
• In febrile convulsive conditions, the first step is to effectively control the fever.

Newborns diagnosed with seizures are admitted to the intensive care unit. The nurse's job is to carefully monitor the baby's condition. An electroencephalogram is also performed there to determine the state of the brain and the functioning of the organ. Based on electroencephalography indications, therapy adjustment is recommended.

If a baby under one year of age has convulsions that frequently recur and become persistent, the use of barbiturates—barbituric acid derivatives—is indicated. Barbiturates have a hypnotic and sedative effect, which is necessary for the development of seizures. The use of short, medium and long-term medications depending on the case. Long lasting Barbiturates are required for the treatment of severe epileptic seizures.

In case of difficulty breathing, loss of consciousness, fever and periodic vomiting it is indicated to maintain artificial ventilation of the lungs and blood pressure. Pressure is maintained using special drugs. It is necessary to constantly stop convulsive paroxysm due to the considerable danger to the heart. Respiratory disorders and persistent impairment of consciousness - absolute readings for urgent etiotropic therapy combined with symptomatic anticonvulsant treatment.

Due to the fact that in the neonatal period of a child’s development (especially at the age of several months) it is difficult to detect the true cause of development epileptic seizure, a third of children die. Death is associated with severe complications of seizures: ischemic encephalopathy, ischemic stroke. The prognosis for meningococcal infection is extremely poor. When caused by metabolic disorders, seizure syndromes usually have a good prognosis.

The child must be under the supervision of a pediatrician from the first month of life for at least a year. It is necessary to conduct a complete and comprehensive examination of the functioning of the baby’s nervous system in order to prevent the development of serious neurological disorders.

Convulsions in newborns are recognized as the object of close attention of parents and doctors. It is extremely important to immediately determine the cause of seizures in order to begin effective treatment. And although certain types of seizures do not have a completely favorable prognosis, they can be effective treatment. Especially if the parents consulted a doctor at an early stage of the disease.

The birth of a baby is considered a joyful event. However, its appearance is often accompanied by new troubles and worries. One of the common problems that new parents have to deal with is seizures in newborns. The causes of this disorder may vary. Typically, pediatricians associate the disorder with the immaturity of the nervous system. There are other factors that cause seizures. They will be discussed in today's article. We will also tell you how to recognize the disorder in a timely manner and what parents should do in this situation.

Seizures in newborns: description of pathology

Cramps are involuntary intermittent muscle contractions that can vary in duration and intensity. Why do they arise? All processes in the body are regulated by the brain, including muscle relaxation and tension. In its cellular elements, which are called neurons, various biochemical reactions continuously occur. The result is excitement. The neurons then transmit signals to the muscles, “ordering” them to work and contract. However, not all so simple. Not every excitation in cellular elements is transmitted to the muscles. Sometimes the brain “decides” to pause the process. As a result, the excitation generated in the neurons does not reach the muscles.

When a certain irritating factor (inflammation or traumatic injury) affects brain cells, and the inhibitory mechanism does not work, seizures occur. In children, this disorder occurs several times more often than in adults. Doctors explain this trend by the characteristics of the brain. In babies, neurons are excited easily and quickly, and the processes of inhibition have not yet had time to be fully formed by this time. IN in rare cases Convulsions in a newborn are caused by various diseases.

Main causes of violation

According to statistics, every fifth premature baby experiences seizures. In children born on time, the problem is diagnosed with a frequency of up to 10-14 cases per 1000 newborns. Among the main causes of the disorder, pediatricians name the following:

• metabolic disorders due to hypoglycemia or calcium deficiency;
• lack of oxygen flow to the brain;
• infectious damage to the central nervous system with subsequent development of ischemic encephalopathy;
• disruption of the adrenal glands due to their congenital pathology;
• hemolytic jaundice, which is a consequence high bilirubin in blood.

Who is at risk?

This pathology is usually diagnosed in children in the first year of life. At this time, the nervous system is characterized by underdevelopment and rapid excitability. The stages of maturation of the brain and the entire central nervous system determine the characteristics of the age-related manifestations of seizures. Numerous studies of this problem have made it possible to identify the so-called risk group. Among the main factors predisposing to the occurrence of pathology, doctors identify:

• underdevelopment of the central nervous system;
• difficult childbirth;
• maternal use narcotic substances or alcohol during pregnancy;
• umbilical cord entanglement, asphyxia;
• disruption of labor.

The presence of one or more items from this list increases the likelihood that parents will have to deal with the problem of seizures in their baby.

Main manifestations of pathology

Seizures in a newborn usually appear within a few days after the baby is born. Parents begin to worry about the health of the baby when the upper part of his body and legs begin to shake for no reason. Quite often, doctors diagnose tremor in newborns. This is a condition in which the chin and arms shake slightly. These symptoms indicate the neurological nature of the pathology and require immediate consultation with a specialized specialist.

Newborns may also experience seizures during sleep. They capture predominantly lower limbs. At the same time, the child suddenly begins to scream and jerk his legs. In rare cases, the attack is accompanied by holding your breath. At night, such convulsions indicate developing epilepsy. However, most often they indicate immaturity of the central nervous system and disappear after the first year of life.

What types of seizures are there?

Convulsions in a newborn baby and older children differ in their nature. The gradation of pathology depends on the development of brain functions. Therefore, doctors distinguish the following types of convulsive contractions.

1. Minor seizures are usually harbingers of serious brain pathologies. Among the main manifestations of the disorder are trembling and blinking of the eyes, some facial muscles, and limbs. Sometimes there is a bluish discoloration of the skin.
2. Tonic convulsions in newborns have the following symptoms: muscle tension throughout the body, short-term holding of breath. In this case, the baby takes an extensor position, and his head is thrown back. This state may last for several minutes. Similar attacks typical for premature babies.
3. Clonic seizures are characterized by rhythmic jerking of a specific part of the body. They are focal, multifocal and generalized. The latter are characterized by cyanosis and respiratory rhythm disturbances.
4. Myoclonic seizures in newborns are extremely rare. With this disorder, there is a sharp twitching of the entire body or individual limbs. In babies of the first year of life this pathology indicates serious brain damage, and of a congenital nature.

Possible consequences

Symptoms of pathology cannot be ignored. You should immediately seek help from a doctor. After full examination The pediatrician will be able to determine what is causing the seizures in the newborn. The causes of the disease, as a rule, determine the treatment tactics.

The lack of competent therapy often leads to irreversible consequences. First of all, seizures may be associated with brain damage or diabetes mellitus. A timely diagnosis increases the likelihood get well soon. Also, during an attack, the brain undergoes a colossal oxygen deficiency, which necessarily affects metabolic processes and incoming energy. If convulsions are frequent, the baby begins to lag behind in physical development, and his intellect suffers.

Diagnostic methods

Not every twitching or tremors in the limbs should be mistaken for newborn seizures. The causes of this disorder can only be determined by a specialist. To make a correct diagnosis, you need to contact a pediatrician and undergo an examination. This usually involves an electroencephalograph study. The device allows you to track changes in brain activity and determine the nature of convulsive contractions.

Sometimes, upon initial treatment, the doctor diagnoses epilepsy and prescribes appropriate treatment. If positive dynamics are not observed, and convulsions continue, it is necessary to undergo a more in-depth examination.

First aid

Seizures in newborns, the causes of which were described just above, require a qualified approach to treatment. This is not a condition where a child can be helped with a simple pill. If twitching occurs, you should immediately call a team medical workers. Before the doctors arrive, the baby needs to be placed in safe place and free your body from tight clothing. Try to turn the child on his side so that if he vomits, he does not choke. You can place a clean tissue between your gums. It is not recommended to disturb the newborn and give him medications.

After an attack, the baby needs to be calmed down, but be prepared for repeated attacks. It is important to pay attention to their duration, accompanying symptoms and intensity. This information will be useful to the healthcare team. If doctors suggest hospitalization, you should not refuse it. In a hospital setting, it is easier to determine the cause of the disorder, as well as choose the right treatment.

Features of therapy

To treat seizures in a newborn, the causes of the disorder must first be established. Typically, the fight against a disease comes down to following the following rules:

• for hypocalcemia, a small patient is prescribed calcium gluconate in a glucose solution intravenously;
• in case of hypoglycemia, treatment is first carried out with dextrose and then recommended intravenous administration glucose solution;
• In febrile convulsive conditions, the first step is to stop the fever.

If the pathology continues for a long time, the child is observed in the intensive care unit. In this case, medications made from barbituric acid (Phenobarbital, Phenytoin) are used as the basis for treatment. They help relax the central nervous system and reduce the intensity of muscle contraction. Gradually the patient's condition returns to normal.

It should be noted that therapy for this disorder should be comprehensive. Gives good results proper nutrition baby, gymnastic exercises, hardening through water procedures and relaxing massage. After the therapy, over the next few years the child should be observed by a neurologist and periodically undergo preventive examinations.

In the neonatal period, it is very difficult to determine what may be associated with seizures in newborns. The reasons are not easy to discover. Therefore, about a third of children die. Of course, we are talking about such serious defects as ischemia, meningitis, etc. If the seizure syndrome is caused by a metabolic disorder, the prognosis is favorable in most cases. Also, approximately a third of surviving patients have various neurological disorders.

Let's sum it up

The first manifestations of a pathology such as convulsions in newborns should not be ignored. The consequences that this disorder can lead to often darken the lives of children. It requires close attention from doctors and parents. It is extremely important to promptly determine the cause of seizures and begin therapy. Only in this case can we hope for a favorable outcome.

A small child is not only an object of joy, love and care, but also a constant cause for concern. And if he also begins to behave somehow unnaturally, then the young parents are seriously scared: what if the baby has seizures, and what if they are a symptom of some terrible disease? So, what are seizures, what do they look like and what are the causes of their occurrence in infants and older children?

A few words of reassurance

It is not always the case that what frightened parents mistake for seizures is actually one.

• sudden throwing up of arms and legs during sleep - normal phenomenon for a newborn;
• When falling asleep, babies slightly roll their eyes - no big deal;
• when frozen, the child will tremble, his toenails may turn blue - just wrap him up warmer;
• while crying, the chin may twitch resentfully, the hands may tremble - calm the baby and calm down yourself;
• A newborn baby can hold his breath for a few seconds - and this is also not a reason to panic.

In addition, even true cramps, that is, involuntary, intermittent, rhythmic muscle contractions, in most cases are associated with immaturity of the central nervous system, or their cause can be relatively easily eliminated.

Often, the fears of young parents can be confirmed, and seizures can be a symptom of a serious illness. Knowledge about their causes and types will help you understand all this and in the future understand the nature of seizures in a newborn.

Metabolic disorders

A small organism is very susceptible to a lack (or excess) of any nutrients, vitamins, microelements.

So, the cause of febrile seizures can be:

• hypocalcemia – calcium deficiency;
• hypoglycemia – glucose deficiency;
• hypomagnesemia – low content magnesium in the blood (rare, but it happens);
• elevated or reduced quantity sodium;
• deficiency (excess) of tyrosine, proline and other amino acids;
• vitamin B6 deficiency.

All these pathologies can be a consequence poor nutrition nursing mother and menacing symptoms, indicating dysfunction of internal organs.

Convulsive attacks are of a generalized nature (that is, they cover the entire body): the limbs twitch, the head may fall back, the body becomes stiff or, conversely, is completely relaxed and limp.

Heat

In babies over the age of 6 months, when the temperature rises above 38 ° C, so-called febrile convulsions may occur, characterized by respiratory arrest, during which the baby’s face may turn blue; tilting the head; twitching of limbs.

Such cramps can also be caused by other reasons related to overheating and dehydration of the baby’s body. These are too warm clothes long stay in the sun or in a stuffy hot room, bathing in hot water.

It is important to know: febrile seizures, in which both limbs twitch simultaneously, are not terrible. It is much worse if they cover only half of the body: be sure to tell your doctor about this.

Overexcitable nervous system

IN in this case Affective-respiratory convulsions may appear against the background of severe fear or when crying, when apnea is observed - holding the breath for more than 20 seconds (the child cannot exhale), the head is thrown back, the arms and legs are twitching. Possible loss of consciousness, bradycardia (one of the types of arrhythmia).

In some cases, it is possible to get the baby out of this state by spraying him cold water.

It should be remembered that similar phenomena typical for children who have increased excitability The central nervous system is combined with:

• suffered birth injuries;
• violations of the anatomy of the nose;
• enlarged tonsils;
• swelling of the nasopharynx due to allergies or inflammation.

A predisposition to affective-respiratory spasms is inherited, so if one of the parents experienced them in childhood, their child is at risk.

Congenital pathologies of the central nervous system

This is exactly what parents fear most. Most often these are so-called minor convulsions or spasms, during which there is trembling of the face and eyelids, frequent blinking, and jaw movements reminiscent of chewing. The eyes roll back, the pupils converge towards the bridge of the nose or, on the contrary, towards outer corners eye. If this happens in infants, this is serious reason for a visit to a neurologist.

Premature babies are most susceptible to seizures associated with central nervous system pathologies - they are observed in 20% of cases. For normally full-term babies, the statistics are more favorable - only 10-15 cases per thousand newborns.

Minor seizures are a consequence of:

• birth injuries;
• high intracranial pressure;
• oxygen starvation as a result of asphyxia (entanglement of the umbilical cord) in the fetus;
• pathologies of brain development. Seizures can become a symptom of diseases such as hydro-, micro- or porencephaly, epilepsy.

Other reasons

There is also whole line factors that can cause certain types of seizures.

These include:

• poisoning (overdose) with any medications;
• otitis media, runny nose;
• convulsions after vaccination;
• infections affecting the brain: purulent meningitis, tetanus, encephalitis, toxoplasmosis;
• high levels of bilirubin and the resulting hemolytic jaundice.
• dysfunction of the adrenal glands;
• pathologies of the cardiovascular system.

It is important to understand that the likelihood of seizures in a baby increases significantly if a woman had a difficult (premature) birth or she used drugs or alcohol during pregnancy or suffered from any infectious diseases. Transmission can occur through breast milk.

First aid

Regardless of the cause of the seizures, whether they are caused by physiology or vaccination, your actions should be aimed at easing the baby’s condition and preventing any injuries (bruises, vomit getting into the windpipe, etc.).

Try to calm down and remember everything that happens: later you will have to tell the doctor about what you saw to help him figure out the nature of the seizures.

Lay the child on his side, place a flat pillow under his head, free his upper torso from clothing, provide fresh air and gently support his head. When the attack passes (usually it lasts no more than a few minutes), call an ambulance.

If the seizures do not recur, the baby feels well and you know their cause, you can postpone the visit to the doctor until the morning, but it is necessary to show the child to a specialist in any case.

Not for seizures:

• shake the child and hold him tightly to you;
• trying to hold twitching limbs;
• to do for the baby artificial respiration;
• leave him lying on his back;
• try to give any medications, unclench your teeth, put foreign objects in your mouth.

If you know the reason, you can do the following:

1. For affective-respiratory convulsions: sprinkle cold water on the child’s face and let him smell ammonia.
2. At febrile seizures: wipe the body with a damp, cold towel, and after the attack stops, give an antipyretic.
3. Drinking plenty of fluids is recommended.

Prevention

The following actions will help reduce the likelihood of seizures in a newborn:

1. One month before your planned pregnancy, take folic acid.
2. Throughout your pregnancy, avoid any harmful effects and try to avoid infectious diseases, worm infections, etc.
3. Do not take any medications without first consulting a gynecologist.
4. After the birth of the child, perform a comprehensive examination, which will identify pathologies that can cause seizures, early stages and successfully cure them.

That's all: all that remains is to say that the seizures themselves do not pose a danger: they are only a symptom of some disease, but what kind of disease it is and what the risk is for the child, you will only find out by contacting a specialist: do not delay the visit!

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Convulsive conditions sometimes occur in children of different ages. Parents are always frightened by such phenomena. Why do involuntary muscle contractions of the arms or legs occur, including during sleep? What types of seizures are there? How is the cause of the problem diagnosed? How to provide first aid during an attack? How is the treatment carried out? Let's figure it out together.

Convulsions in a child are a dangerous pathological condition in which parents are required to know the rules of first aid.

Causes of seizures in children of different ages

Depending on the type of seizures, the reasons that cause them will differ. When establishing provoking factors, you will need to pay attention to the age of the child. Experts identify a number of conditions that can trigger seizures in children. The most common reasons include:

• internal bleeding;
• hysteria;
• asphyxia;
• birth injuries;
• meningitis;
• allergies (with allergies, cramps go away after contact with the irritant is eliminated);
• violations metabolic processes, diabetes;
• intoxication of various etiologies;
• heredity, genetic diseases;
• cysts, tumor formations;
• emotional and mental disorders;
• epilepsy (we recommend reading:);
• disorders in the development of the central nervous system and/or its dysfunction;
• neuroinfections and traumatic brain injuries;
• immaturity of the brain.

Birth injuries, metabolic disorders, asphyxia, and hereditary factors can lead to seizures in a child from the first days of life. Breast baby up to 1 year sometimes experiences convulsive conditions during severe cold or after routine immunization, with the penetration of neuroinfections or if the development of the central nervous system and organs does not correspond to the age.

Regardless of whether the spasm was a single one or the attacks are repeated periodically, the symptom cannot be ignored. It's better to play it safe and make sure that everything is okay with the baby. If muscle spasms in the arms and legs are caused by pathology, without proper and timely treatment there is a high risk of developing serious consequences, including cerebral palsy.

If the root cause of development is identified in a timely manner seizures in a child, there is a high chance of completely curing it and avoiding a recurrence of this dangerous symptom. Parents and doctors are required to pay close attention to the baby’s condition, thorough diagnosis and high-quality therapy.

Types of seizures

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There are several types of muscle contractions in children. According to the generally accepted classification, if a spasm involves almost all the muscles of the body and completely paralyzes the patient for a while, we are talking about generalized spasms, but if it occurs in a specific area (for example, in the leg), where it is concentrated, then it is a focal spasm.

There are also clonic and tonic types of contractions. In the first case, the muscles twitch, a pulsating contraction is observed, alternating with relaxation. A tonic spasm is characterized by strong muscle tension that persists for quite a long time. There are also tonic-clonic seizures.

In addition, experts distinguish non-febrile and febrile seizures:

1. Nonfebrile convulsions occur when the proper functioning of the brain is temporarily disrupted. In children under 3 years of age, cramps of this type may occur at night during sleep. If there are no accompanying symptoms and the case is isolated, then this indicates that the child had a vivid and realistic dream. When a night cramp during sleep is accompanied by involuntary urination or occurs in a dream in children over 3 years of age - this is a reason to consult a doctor. This category of convulsions is often accompanied by loss of consciousness - complete or partial. Non-febrile seizures also include epileptic seizures.
2. Febrile seizures are muscle contractions at very high body temperatures (more details in the article:). Usually occurs with a severe cold or flu. This is a phenomenon accompanying fever, and after an infectious or viral disease will be cured, and the convulsions will go away along with it.

Associated symptoms

Parents can recognize seizures, including tonic-clonic seizures, by their characteristic clinical picture, which accompanies their appearance. These are involuntary muscle movements that are difficult to miss or not notice.

In case of a severe attack, convulsions may manifest themselves as follows:

• involuntary urination;
• cyanosis of the skin and lips;
• tension, stretching or squeezing of the limbs;
• teeth grinding, strong clenching of the jaw;
• eye rolling;
• signs of an allergic reaction (if the attack is caused by an allergy);
• the appearance of foam at the mouth, in severe cases the child may vomit;
• distortion of facial features, twitching of limbs, their involuntary movements, tic, pulsation (we recommend reading:).

Parents cannot always determine and understand why the child jerks his leg or arm - his limb is cramping, or the baby’s movements are controlled by his brain. You can see what clonic, tonic and clonic-tonic convulsions look like in the video accompanying the article.

Diagnostic methods

Seizures are unpredictable and therefore dangerous condition. It is important to find out why the child had a seizure and eliminate the cause as quickly as possible to avoid another seizure. First of all, you need to visit a pediatrician, he will give a referral to a neurologist, neurologist or endocrinologist.

If there have been seizures of non-febrile origin, then it will be necessary to undergo a comprehensive diagnosis to assess the child’s health and identify pathological processes leading to muscle spasms. The survey uses wide range modern diagnostic methods, which include:

• laboratory blood test - indicates a deficiency or excess of any elements in the body;
• electroencephalography - a study to assess the state of the brain;
• If necessary, the doctor may prescribe a computer or magnetic resonance imaging scan.

First aid for a child

Seizures in a child may begin suddenly. In this case, it is important to provide him with first aid in a timely and correct manner. What to do in this or that case will depend on the location and intensity of the attack. When a limb is struck by a focal spasm, massage and impact on the muscle will help - it can be pricked or pinched.

A generalized attack is much more dangerous and requires compliance with several rules. In such cases, you need to urgently call an ambulance, and try to help the child until the doctors arrive. You should not give any liquids or medications until the attack is over, nor should you try to open clenched teeth.

Help tactics look like this:

• lay down little patient on your back, placing a clean towel under your head;
• heavy, piercing, cutting objects and any other objects that could injure the baby should be removed away;
• hold a towel between the child’s jaws (if possible);
• turn your head to the side - if foam appears or vomiting begins, the patient should not choke;
• neck and area chest It is advisable to remove clothes.

Features of the treatment of seizures

Treatment of seizures in patients of any age begins with identifying the cause that triggers the symptoms. Depending on the diagnosis given to the child, the doctor selects the most effective and safe therapeutic course, aimed not only at eliminating the pathology, but also at stopping repeated attacks.

Basic course of treatment

By general rule Treatment of seizures in a child is structured as follows:

• if we are talking about a febrile convulsive state, it is necessary to stop the fever;
• hypoglycemia - monitoring vomiting and temperature over time, administering a dextrose solution, then glucose (intravenous and infusion);
• hypomagnesemia - intravenous administration of magnesium sulfate solution;
• hypocalcemia - slow intravenous administration of calcium gluconate solution.

For persistent, frequently recurring convulsive conditions in infants who have not reached one year old, the use of barbiturate acid derivatives or barbiturates is recommended.

When involuntary muscle spasms develop, a medication that has a sedative effect is required - this is how barbiturates act.

Depending on the diagnosis and the severity of the little patient’s condition, long, short or medium courses of drugs from the barbiturate group are used. The first treatment regimen is indicated in the most severe cases, in particular, when treating children of any age suffering from epileptic seizures.

mechanical ventilation

Artificial ventilation and maintaining the required level blood pressure– such methods can also be used in the treatment of convulsive conditions in children of different ages, but only if there are appropriate indications. The list of conditions that accompany seizures and require the use of these measures includes:

• periodic intense vomiting;
• significant increase in body temperature;
• loss of consciousness;
• breathing disorders.

Complications and prognosis

Among newborns suffering from seizures, there is a high mortality rate of up to 30%. This is due to the difficulty of detection true reasons, provoking attacks, and the weakness of the body of the newborn, who may develop complications such as ischemic stroke and ischemic encephalopathy.

In case the attacks are caused meningococcal infection, the survival prognosis is unfavorable, but if the cause is metabolic disorders, children in the vast majority of cases can be successfully treated. In any case, even with single seizures, the child must be under the supervision of a qualified specialist for 12 months and undergo a full examination.

Some babies experience sharp involuntary muscle contractions that vary in frequency and duration. Convulsions in newborns are not always a sign of severe pathology, but the symptom cannot be ignored.

The movements of newborns are quite uncoordinated and often resemble tremors, shaking and muscle spasms. Sometimes you can distinguish the norm from manifestations alarming symptoms Only a specialist can do this. In any case, if you notice any alarming movements in your child, you should immediately contact your pediatrician.

There are several types of true seizures in infants:

1. Small, characterized by weak but prolonged muscle twitching of the face and limbs and often accompanied by a slight blue discoloration of the skin.
2. Tonic, manifested in the form of the newborn adopting a tense posture with throwing back the head and holding the breath for a long time. Most often found in premature babies.
3. Clonic, observed only in full-term babies and accompanied by pronounced rhythmic contractions of certain parts of the body.
4. Myoclonic, characterized by pronounced sharp twitching of the entire body or limbs.

Causes of seizures in newborns

1. Metabolic disorders due to hypoglycemia (low blood sugar levels) and hypocalcemia (acute lack of calcium in the body), which is often found in premature babies. The condition is dangerous with irreversible consequences for the child’s central nervous system.
2. Ischemic encephalopathy, which is a direct consequence of oxygen deprivation of the baby's brain during difficult labor and complications during pregnancy (for example, in the case of preeclampsia and eclampsia).
3. Immaturity of the nervous system in premature infants, not accompanied by pathological changes cerebral vessels.
4. CNS infections. Often the cause of brain damage is encephalitis, meningitis, rubella, cytomegalovirus infection, acute toxoplasmosis.
5. Disruption of the adrenal glands, leading to excess production of norepinephrine, which is responsible for muscle spasms and uncontrollable twitching.
6. Damage to cerebral vessels resulting from hemorrhages in premature infants.
7. Violation of the thermal regime or increase in body temperature during the period of illness. Overheating of a child in the first days of life often leads to seizures. They do not pose a danger and disappear without a trace after the root cause is eliminated.
8. Intoxication due to hemolytic jaundice of newborns.

Convulsions in newborns do not always occur in all of the above situations. However, the following factors contribute to their occurrence:

• prematurity;
• severe illness of the mother during pregnancy;
• woman's use of alcohol, drugs and illicit drugs;
• protracted labor with various complications;
• weak labor, long anhydrous period;
• asphyxia as a result of entanglement with the umbilical cord and birth trauma;
• placental insufficiency.

Parents' actions during an attack

It is impossible to ignore even minor manifestations of convulsive syndrome; this can not only lead to irreversible consequences for the central nervous system, but also have a serious threat to the child’s life. Parents should immediately consult a doctor to determine all the causes, seizures, muscle spasms and their timely elimination.

If the attack began suddenly and was accompanied by severe muscle spasms, difficulty breathing, rolling of the eyeballs and drooling, you must call an ambulance. Before doctors arrive, you should:

• place the child on a flat, hard surface with his head turned to one side;
• place a clean handkerchief or rolled gauze between the baby’s teeth;
• remove excess clothing (if the air temperature allows, undress the child down to the diaper);
• open the window to provide fresh air;
• if necessary, give the baby artificial respiration;
• if the seizures are caused high temperature body, wipe the newborn's body with a damp sponge (vinegar, alcohol and other irritating liquids are prohibited).

The newborn is usually immediately placed in a hospital (intensive care unit or general ward) neurological department depending on the severity of the condition), where dangerous infections, epilepsy and irreversible organic brain damage are first excluded. A thorough examination includes the necessary laboratory tests and instrumental studies, studying the history of childbirth and anamnesis from the mother and immediate family.

Depending on the results obtained, therapy includes the following actions:

• treatment with antibiotics in case of acute infections;
• elimination of fever and normalization of body temperature;
• intravenous administration of glucose for hypoglycemia or calcium gluconate for hypocalcemia;
• drug reduction of bilirubin levels in the blood;
• hormonal treatment in case of endocrine disorders;
• artificial ventilation in case of respiratory arrest and disturbances;
• in most cases, the prescription of anti-seizure drugs.

Primary treatment of convulsive syndrome in a child usually includes the use of barbiturates, which have pronounced antispasmodic, anticonvulsant, sedative and hypnotic effects. As a rule, in the absence serious illnesses, treatment continues for several days, and the manifestations of the pathology disappear without consequences. Persisting symptoms serve as a reason to prescribe more serious drugs (pyridoxine, folinic acid, clonazepam, etc.), sometimes the question of expediency is raised surgical intervention. After discharge from the hospital, the child is registered with a neurologist at his place of residence.

Prevention of seizures

In order to prevent recurrent seizures, the following preventive actions must be taken:

1. Completely follow the recommendations of the neurologist and pediatrician, give prescribed medications, carry out prescribed manipulations;
2. Walk with your baby in the fresh air more often;
3. Give your child a relaxing massage and daily exercises;
4. Carry out hardening in the absence of contraindications;
5. Bathe your child daily in water with the addition of sea salt;
6. Maintain a strict daily routine;
7. Maintain a calm, favorable environment at home, avoid stress;
8. Observe the condition of the baby throughout the day.

Disease prognosis

Unfortunately, due to the impossibility of accurate, quick and reliable diagnosis of pathology in newborns, about one third of cases end in fatal. Another third of children develop severe consequences from the central nervous system. The prognosis is especially unfavorable in case of hemorrhages and organic lesions brain due to infections and birth injuries.

In many children, convulsive syndrome passes easily and without a trace. This depends on the etiology of the disease, the degree of term of the baby and the time of initiation of competent treatment from the moment of the first attack. It is important for parents to remember: the health and life of the baby does not depend on their actions.

Video of baby seizures

The movements of a newly born baby are considered uncoordinated. Therefore, they may resemble newborn seizures. A similar phenomenon is often not confirmed, but for those who are diagnosed this diagnosis, requires thorough treatment. This disease is associated with several disorders. One of the reasons may be a difficult pregnancy.

The causes of seizures in newborns are considered a direct consequence of unfavorable gestation. Let's consider what exactly could influence the appearance of symptoms of the disease:

Often, the first symptoms of seizures in newborns appear within the first 24 hours after birth. In case of such a violation, neurologists conduct an examination and give recommendations to parents.

Attention! If the symptoms and cause of seizures in newborns are not identified in time and adequate treatment is not started, irreversible consequences may occur. The child may simply die due to improper function of the nervous system.

Symptoms of seizures in newborns: is it easy to spot something wrong?

Children say! Kirill (4 years old) is fiddling around on the sofa with a bunch of pillows.
- Tanya, where is my doctor’s suitcase and white coat?
- And what happened?
- The pillows are sick!!! I will give injections!

Manifestations of concussions of the limbs in a child who looks happy should be taken into account by parents, since a healthy baby who has not experienced emotional turmoil should not have such symptoms.

If you suspect seizures in your newborn, compare them with the following external symptoms:

It is known that the disease can be localized both in individual parts of the body and everywhere. Therefore, you need to carefully monitor the child, especially those who are at risk.

Watch a video about the features of the disease.

Depending on the signs nervous disorders, seizures in newborns are usually divided into tonic and clonic. The first are accompanied by the baby being pulled to the surface. At the same time, he freezes in one position. The latter manifest themselves as strictly defined twitching of the limbs.

Attention! If your baby has clonic convulsions, you need to monitor his behavior, as due to involuntary movements, the baby can injure himself. Dislocations appear, and even joint fractures are possible. To exclude similar complications, parents should reassure the child.

Adults often confuse newborn seizures with tremor, since at first they are minor and hardly noticeable. Such phenomena are called neonatal convulsions, that is, those that appeared immediately after birth. Convulsions are also possible due to asphyxia in newborns. In this case, immediate resuscitation is necessary.

Children say! Danilka (6 years old) plays cards with her sister, wins and says:
- You’re a good girl, Olesya, just a little stupid.

Therapeutic methods or how to relieve a baby from obsessive symptoms

Usually, diseases of a neuralgic nature in newborns are eliminated by general drug therapy. In the event that convulsions in newborns are very pronounced, they resort to the use of medications.

When diagnosing seizure symptoms or spasms in a child in the first days of life, it is important for the doctor to know the exact age of the baby in order to objectively assess the progressive disease. It should be noted that within three to four days after birth, the baby may experience tremors, which is often a consequence of previous birth injuries.

As general therapy and treatment of seizures in newborns, the following methods are taken:

• general relaxing massages that you can perform on your own after first studying the tactics of movements (the doctor will show you this);
• physical exercises of a therapeutic nature;
• walking with a newborn;
• hardening, if there are no other contraindications;
• compliance with the daily routine, nutrition and sleep of the newborn;
• lack of stress and a favorable family environment.

Important! If your child has severe shaking that is difficult to control, call an ambulance immediately. If the child stops breathing, give him artificial respiration and tell the doctor about all the actions taken.

In such cases, the baby is urgently hospitalized and undergoes a thorough examination. Procedures are prescribed to improve oxygen access to the brain. With absence effective results, the baby is given Seduxen or Phenobarbital. After the attack is over, the newborn is observed by the local pediatrician.

Prevention of convulsions in newborns

Measures to prevent the development of pathologies of the nervous system in newborns should be carried out even before a planned pregnancy or during its process. So, two to three months before planning conception, it is necessary to undergo an examination by a gynecologist and take appropriate tests to exclude various infections. In addition, it is mandatory to use medications Folic acid and Magne B 6.

In the early stages of pregnancy, in particular up to eight weeks, it is recommended to avoid contact with animals, sick people and respiratory infections. If one of your family members gets sick, you need to protect yourself as much as possible from viruses. Considered an excellent remedy Oxolinic ointment(it is allowed both during pregnancy and for newborns). To exclude the possibility of pathology, it is necessary to give the child an ultrasound of the brain a month after birth.

Watch a video clip from Komarovsky about infant seizures.