Under the general concept of "convulsions" combine states that are manifested by involuntary cuts of skeletal muscles. Despite the fact that the convulsive syndrome in most people is manifested almost the same, it can develop under the action of various reasons and be a symptom of various diseases.

Causes can arise under the action of several dozen provoking factors. Among them are epilepsy, violation of electrolyte exchanging (when infectious diseases, lack of calcium and magnesium in the body), irritation of cerebral shells (meningitis), increase body temperature, reduction in blood glucose, oxygen shortage, central damage nervous system.

Epilepsy - This is a disease in which in which section of the brain spontaneously arises the focus of excitement. Depending on where this plot is located, the disease can manifest itself in different ways - from stuttering to classic convulsions with loss of consciousness.

The convulsions that develop in fever are called febrile. As a rule, they are in cases where the body temperature rises quickly and reaches 38-39 degrees (in children they are already possible at 37.5 degrees). In their occurrence, not only the fact of increasing body temperature is played, but also a poisoning effect on the body of microbes life products (more often such fever accompanies infectious diseases).

There is such a kind of convulsion as affectively respiratory. it special form convulsion that may even appear healthy man. As a rule, it is preceded by some stress - severe pain (after injury, burn, painful medical manipulation) Or a sense of fear in extreme situations (for example, a road traffic accident).

The mechanism of their occurrence is as follows: In the stressful situation, the production of adrenaline and other biologically active substancessimilar to him by action. They cause gaining respiration, which leads to a decrease in blood carbon dioxide in the blood. The latter and becomes the cause of muscle contractions. In a child, such convulsions may occur when he cries for a long time; At the same time he commits deep breaths. Corrects are able to accompanounce many other states: cranial brain injury, stroke, hysteria.

Initial symptoms of seizures, determining their causes, cramps for epilepsy.

In order to properly provide urgent help, you need to be able to identify or assume the cause of seizures. When epilepsy, if it is a classic form, the so-called aura can be a convulsive attack - a change in the patient's well-being, according to which it is able to determine its approach. Each person has an Aura manifests itself in different ways: in the form of anxiety, feelings of crawling goosebumps, gravity in the head, etc. These sensations are very important for diagnosis, since, saying about them around them, the patient thus can warn himself about the imminent beginning of convulsive Attack, which will determine the algorithm to provide him with emergency care.

The epilepsy attack itself consists of two main phases, the first of which is the phase of tonic seizures. Under the definition of "tonic" implies such convulsions at which there is a strong long-term tension of the muscles; The man is pulled out, becomes motionless. All body muscles are reduced, including voice folds, so at the beginning of the attack the patient can shout.

If a person is sitting, under the action of muscular abbreviation, it is usually jumping first, and then falls. His hands and legs stretched out, the skin is pale, mimic and jaw muscles are tense, the eyes can be assigned up and to the side, pupils are extended; To the touch, all the muscles are intense and very dense. Sometimes the back because of a strong muscle tension is strung out by the arc.

In this phase of the epileptic attack, the patient almost impossible to give a certain position of the body or open the mouth. Tonic convulsions continue not more than 10-20 seconds. At this time, a person may not breathe due to muscle contraction chest and diaphragms. By the end of this phase, the skin of the pallor moves to the bugvo blue color.

Then the phase of clonic convulsion occurs. With them, various muscle groups alternately decrease, as a result of which the patient performs squeezed uncontrollable movements with their hands and legs. This phase of the epileptic attack is able to continue from 30 seconds to 5 minutes. At first, the muscle cuts are very active, but after some time they become less likely, the amplitude of uncontrolled movements is reduced, the person begins to breathe again and the attack ends.

At the end of this phase, there are often involuntary intestinal emptying and urination. As a rule, after an epileptic seizure, a person falls asleep. During the attack, the consciousness is depressed, so then the patient does not remember anything.

Causes because of the violation of the exchange of electrolytes.

Cravors developing due to violation of the exchange of electrolytes are more likely due to a lack of calcium in the body. In children, the deficit of this macroelement is called Spasofilia and can manifest itself heavy symptoms. In adults, it is usually a small lack of calcium, manifested by painful abbreviations. ion muscles. More serious forms of calcium deficiency, and therefore heavy symptoms possible, for example, after unsuccessful operation on the thyroid gland. In this case, convulsive seizures can be very strong and repeated repeated.

Symptoms of febrile cramps.

In febrile cramps among the symptoms on the fore, there are signs of the underlying disease (usually) and actually fever: redness of the skin, chills (at the beginning of the stage of lifting body temperature) or the heat of heat (when the body temperature reached maximum numbers), weakness, headache, nausea. The cramps themselves can be diverse: to be similar to a large trembling, spreading only by limbs or to the whole body, to manifest itself in the form of a transient voltage of one or another muscle group, etc.

Sometimes they are accompanied by a loss of consciousness. As a rule, they repeated many times until the body temperature decreases, but they are capable of occurring in the form of a single short-term convulsive attack.

Cramps for meningitis or meningoencephalitis.

Determine the convulsions caused by meningitis or meningoencephalitis, it is easy to know about the peculiarities of these diseases. There are several signs for which you can reveal irritation. brain shells. In a patient with meningitis, for example, the muscles of the back surface of the neck and the nape are tense, because of which it is not able to perform a simple test: Press the chin to chest.

If a patient lying on his back, try to hunch your head to the chest, then, together with your head, and shoulders are raised. You can spend another sample. Raise the leg of the lying patient, bent it at right angles in the knee and the hip joint, and then try to break it only in the knee. When trying to extend a person who conducts a test, will feel resistance - the patient because of the tension of the muscles will not be able to break his leg. It is necessary to conduct these tests at any suspicion of meningitis.

When meningitis, the following symptoms are noted: the preceding disease is acute respiratory infection, a significant increase in body temperature, small rash on the skin in the form of hemorrhages, complaints of strong headache, disorders of consciousness, patient inhibition.

Affectively respiratory cramps.

Affectively respiratory cramps are easy to confuse with an epileptic seizure. An important point B. proper definition Diagnosis is the information that shortly before the attack has suffered some kind strong stress. In the nature, such convulsions are usually clonic (disorderly reduction different groups muscles) or mixed, i.e. tonic clone. During them, as well as with epilepsy, there may be no breathing and volatile consciousness.

However, involuntary urination and emptying of the intestine at such convulsions is quite rare, the attack does not go to sleep and there is no clear division into phases, like epileptics. In addition, if the patient is not alone and there is an opportunity to ask his companions, then the fact that there were no such attacks, also speaks in favor of stressful cramps.

If the cause of convulsion has become, then the correct prefigure diagnosis is possible in two cases - if the patient himself informs either if damage is noticeable on its head - abrasions, hemorrhage. In character, they can be completely different.

First emergency medical care for cramps.

Providing assistance, it should be borne in mind that there are both common events in convulsions of any origin and important particular in which the cause of the condition arose. If a person has a convulsive attack (especially great importance It has with strong clonic and tonic clonic cramps), you need to act very quickly.

It is dangerous for a patient a few moments: injuries are likely when falling and during convulsion (sometimes strong muscle contractions can even cause bone fractures, and the fall from the height of their own growth or the head of the head about a solid subject can lead to intracranial hemorrhage) and the screened language. The latter in some cases even leads to the death of the patient: the language overlaps airways and stops access to oxygen to easy.

So, at the beginning of convulsion, if a person falls, it is necessary to try to pick it up and, if possible, put on a soft horizontal surface. It does not have to be a bed - you can use laying on the floor mattress or blanket. Often, when the attack happens on the street or in transport, it is impossible to provide this.

In this case, during a convulsive seizure, it is necessary to isolate a patient from items that can cause damage to him, and try to limit his body movements so that there is no strong injuries. For which it is usually necessary to attract a few people to help: muscle contractions are very strong and sharp, and to keep a person alone, if this is not a child, it is almost impossible.

In order to prevent oxygen starvation, it is necessary to free the neck and breasts from the shocking clothes and turn the head of the side to prevent the contents of the stomach content. To prevent the screaming of the language, the patient should insert a spatula in the teeth and, if possible, put pressure on the root of the tongue. You can hold the language with a special tool - a lifter.

At the same time, the patient will not be able to completely close the jaws and the language will not be frozen, and also will not block the respiratory tract. When performing such manipulations, many errors often make. First, sometimes incorrectly determine the time when you need to act. Provide respiratory tract is required as soon as possible from the beginning of a convulsive attack.

Of course, sometimes it is very difficult - in order to overcome the spasm of jaw muscles, it is necessary to make a greater force. But it must be done in a short timerather than waiting for the end of the seizure or at least weakening seizures - at this point, possibly the lack of breathing has been possible for several minutes, which is capable of being fatal. Secondly, when inserting a spatula in the mouth, it is necessary to comply with the safety technique: a person who assists should not insert his fingers into his mouth, opening the jaw to the patient, - the latter can involuntarly close his teeth, which will lead to unnecessary injuries.

The third error consists in choosing an item to hold the jaws in the open state. A spatula and a lifter is not always available only in isolated cases. IN extreme situation The spatula can be replaced by other objects. For example, a metal, wrapped with a napkin or a cloth to prevent injury of the mucous membrane and damage to the teeth, or a tight rolled bandage roll.

It is impossible to use wooden items or a handle for this purpose: squeezing your teeth, the patient is able to eat them ease. It will not allow to achieve the goal and lead to the injury to sharp fragments of the mucous membrane, pharynx, to getting foreign languages in the respiratory tract. Finally, the fourth important point is how to insert a spatula (spoon) in the teeth.

The spatula can not be placed between the cutters as it takes in the mouth of the fork during food or, for example, a cigarette. It does not interfere with the popularity of the language, in addition, it is easy to damage the bottom of the oral cavity, which will cause severe bleeding. The subject must be investing between the native teeth - as the dog takes stick when it carries its master. Medical assistance During convulsions, it cannot be carried out using conventional, widely available drugs.

The necessary medicines are easy to find, for example, in a medical center, if a convulsive attack occurred at work. As an anticonvulsant, a solution of diazepam in a dose of 0.3 mg per 1 kg of weight should be introduced into the muscle or vein. With a weak effect, the injection can be repeated in 10-15 minutes. After rendering urgent events All patients who have suffered a convulsive attack should be hospitalized for a detailed examination and treatment.

Features of the provision of first emergency medical care during convulsions.

For each state leading to the development of convulsions, there are features when providing emergency care. With an epileptic seizure, in addition to the diazepam solution, 10 ml of a 25% solution of magnesium sulfate intravenously either a solution of furosemide at a dose of 60-80 mg to a vein or muscle is injected. In febrile convulsions, it is primarily necessary to reduce body temperature.

It must be remembered that the so-called red and white fever distinguish. Red fever less often accompanied by convulsions. The skin with her pink color, the patient has increased sweating, it complains on. Such a type of fever is more favorable and requires the following measures: alcohol rubbing, imposing cold compresses to the body sections, where large blood vessels are closely located, - head, neck, chest. It is necessary to give a patient to drink more liquid.

White fever is a signal that the body transfers too large load And it cannot cope with the increasing temperature. Patient pale, hands and legs are cool because of the spasm of blood vessels. Sweating minimal, consciousness is often inspired or lost. At the same time, the only measure of help will be rubbing the skin with hands or coarse cloth to expand blood vessels and increase the return of heat by the body. With a white fever, the patient needs emergency care for doctors.

In order to avoid repetition of the attack of febrile cramps before the arrival of the physicians, the antipyretic agents can be used. The safest of them, allowed to use even children, is paracetamol, which is given in a dose of 200-500 mg. If after eliminating the attack of convulsion arose a suspicion of their connection with meningitis, it means that a person needs emergency medical care.

An important moment when dealing with such patients is that it is necessary not only to provide medical care, but also to protect other people from possible infection. Until the patient's transfer to the hands of doctors, you need to try to isolate the patient. A person providing assistance is obliged to be in a protective mask. Or 4 layer vanity marlevant, especially if all events are carried out in a closed room.

Cramps of calf muscles, even often repeated, are not a reason to provide emergency care. Patients should refer to the doctor in planned order. If convulsions are caused by the insufficiency of venous blood circulation ( varicose extension veins) will be appointed surgery and / or use compression stocking and vetonic money. In convulsions, due to calcium deficiency, its lack will be precipitated by calcium-containing drugs.

With affectively respiratory cramps urgent Care, besides common events, comes down to receiving accessible sedatives. In convulsions caused by the trauma of the skull, the patient should not be independently moved and gives him medicines. It is not known which damage to him in the brain and how good it will be for him this or that intervention. You need to wait for the arrival of physicians, and in anticipation of them to control vital important functions Patient - Breathing and heartbeat.

According to the materials of the book " Fast help in emergency situations. "
Kashin S.P.

- non-specific reaction of the child's body to external and internal stimuli characterizing sudden attacks involuntary muscle contractions. Convulsive syndrome In children proceeds with the development of partial or generalized cramps of clonic and tonic nature with loss or without loss of consciousness. To establish the causes of convulsive syndrome, children need consultations of a pediatrician, neurologist, traumatologist; Conducting EEG, NSG, RG, skull radiography, brain CT, etc. The relief of convulsive syndrome in children requires the introduction of anticonvulsants and conducting therapy of the underlying disease.

Causes of convulsive syndrome in children

Convulsive syndrome in children is polyethological clinical syndrome. Neonatal convulsions, developing in newborns, are usually associated with severe hypoxic damage to the central nervous system (fetal hypoxia, asphyxia of newborns), intracranial generic injury, intrauterine or postnatal infection (cytomegal, toxoplasmosis, rubella, herpes, congenital syphilis, lemiosis, etc.), congenital anomalies. Brain Development (Holoprozanecephalia, Hydroanencephalia, Lissencephalia, Hydrocephalus, etc.), Alcoholic fetus syndrome. Cauls can be a manifestation of abstinence syndrome in children born on mothers suffering from alcohol and narcotic drug addiction. Rarely newborn has tetanical convulsions caused by infection of the umbilical wound.

Among metabolic disordersThe cause of convulsive syndrome should be highlighted with electrolyte imbalance (hypocalcemia, hypomagnation, hypo and hypernatremia) occurring in premature, children with intrauterine hypotrophy, galactosemia, phenylketonuria. Separately, hyperbilirubinemia and the associated nuclear jaundice of newborns are worthy of toxico-metabolic disorders. Convulsive syndrome can develop in children with endocrine disorders - hypoglycemia with diabetes mellitus, hypocalcemia in spasofilia and hypoparathyroidism.

In breast and early childhood In the genesis of convulsive syndrome, neuroinfection (encephalitis, meningitis), infectious diseases (ARVI, Flu, Pneumonia, Otitis, Sepsis), Chmt, PostAscital complications, epilepsy are played in children.

Less frequent causes of convulsive syndrome in children are the abscess of the brain, congenital defects of the heart, poisoning and intoxication, hereditary degenerative CNS diseases, facalosis.

A certain role in the occurrence of convulsive syndrome in children belongs to genetic predisposition, namely, inheritance of the peculiarities of metabolism and neurodynamics, which determine the reduced convulsive threshold. Provoke convulsive seizures in a child may infections, dehydration, stressful situations, sharp arousal, overheating, etc.

Classification of convulsive syndrome in children

By origin, epileptic and non-epileptic (symptomatic, secondary) convulsive syndrome in children differ. The number of symptomatic belongs to febrile (infectious), hypoxic, metabolic, structural (with organic lesions of the CNS) convulsions. It should be noted that in some cases non-epileptic convulsions can go to epileptic (for example, with a long, more than 30 minutes with an uncontrollable convulsive fit, repeated cramps).

Depending on the clinical manifestations distinguish between partial (localized, focal) cramps covering separate groups muscles, and generalized cramps (common convulsive fit). Taking into account the nature of muscle contractions, the convulsions can be clonic and tonic: in the first case, the episodes of reduction and relaxation of skeletal muscles quickly replace each other; In the second there is a long spasm without periods of relaxation. In most cases, convulsive syndrome in children proceeds with generalized tonic-clonic convulsions.

Symptoms of convulsive syndrome in children

A typical generalized tonic-clonic seizure is characterized by a sudden beginning. Suddenly, the child loses contact with external environment; His look becomes wandering, the movements of the eyeballs - floating, then the eye is fixed up and to the side.

In the tonic phase of a convulsive attack the head of the child throws back, the jaws are closed, legs straightened, hands bend in elbow joints, the whole body is strained. There is a short-term apnea, bradycardia, pallor and cyanoticity of the skin. The clonic phase of a generalized convulsive seizure is characterized by restoring respiration, separate twitching of the mimic and skeletal muscles, restoration of consciousness. If convulsive paroxysms follow one after another without restoring consciousness, such a state is regarded as convulsive status.

Most common clinical form Felly syndrome in children serve febrile cramps. They are typical for children aged 6 months to 3-5 years and develop against the background of lifting the body temperature above 38 ° C. Signs of toxic-infectious lesion of the brain and its shells are absent. The duration of febrile cramps in children is usually 1-2 minutes (sometimes up to 5 minutes). Flow this option convulsive syndrome in children is favorable; persistent neurological disorders, as a rule, does not develop.

Convulsive syndrome in children with intracranial injury It flows with swelling of spring, jerking, vomiting, respiratory disorders, cyanosis. The convulsions can carry the nature of the rhythmic contractions of certain groups of the muscles of the face or limbs or a generalized tonic nature. With neuroinfection in the structure of convulsive syndrome, tonic-clonic convulsions usually dominate, the rigidity of the occipital muscles is observed. Tetania, due to hypocalcemia, is characterized by convulsions in the flexor muscles ("Hand of the obstetrician"), facial muscles ("Sardonic smile"), pylorospasm with nausea and vomiting, laryngospasm. In hypoglycemia, the development of convulsion is preceded by weakness, sweating, trembling in the limbs, headache.

For convulsive syndrome in epilepsy, children are typical of the preceding attack "Aura" (sensation of chills, heat, dizziness, odors, sounds, etc.). Actually, the epileptic attack begins with the cry of the child following this loss of consciousness and convulsions. At the end of the attack, sleep comes; After waking, the child is slow down, does not remember what happened.

In most cases, the establishment of the etiology of convulsive syndrome in children is impossible only on the basis of clinical signs.

Diagnosis of convulsive syndrome in children

By virtue of the multifactority of the desires of convulsive syndrome in children, his diagnosis and treatment, children's specialists of various profiles can be engaged in: neonatologists, pediatricians, children's neurologists, children's traumatologists, children's ophthalmologists, children's endocrinologists, resuscitational, toxicologists, etc.

The decisive moment B. correct evaluation The causes of convulsive syndrome in children is a thorough collection of anamnesis: the clarification of the hereditary burdensome and perinatal anamnesis, preceding the attack of diseases, injuries, preventive vaccinations, etc. It is important to clarify the nature of a convulsive secess, the circumstances of its occurrence, duration, recaptivity, exit of convulsion.

Essential importance in the diagnosis of convulsive syndrome in children are instrumental and laboratory research. Carrying out lumbar puncture. With the development of convulsive syndrome, children need to perform a biochemical study of blood and urine on the content of calcium, sodium, phosphorus, potassium, glucose, pyridoxine, amino acids.

The treatment of convulsive syndrome in children

In the event of a convulsive attack of a child, it is necessary to put on a solid surface, turn the head of the side, unbutton the collar, ensure the influx fresh air. If the convulsive syndrome in the child developed for the first time and its reasons are unclear, it is necessary to call an ambulance.

For free respiration, a mucus, residues or rifle masses should be removed from the oral cavity using electrical circuit or mechanical pathway, to improve the inhalation of oxygen. If the cause of convulsion is installed, then with the purpose of their relief is carried out pathogenetic therapy (Introduction The calcium solution of gluconate in hypocalcemia, a solution of magnesium sulfate - with hypomagnalionia, a solution of glucose - with hypoglycemia, antipirectrics - during febrile convulsions, etc.).

However, since the Urgent Clinical Situation does not always manage to implement a diagnostic search, symptomatic therapy is carried out to relieve convulsive paroxysism. The first aid is used intramuscular or intravenous administration of magnesium sulfate, diazepam, gomc, hexobarbital. Some anticonvulsant preparations (diazepam, hexobarbital, etc.) can be administered to children rectally. Besides anticonvulsant drugsFor the prevention of brain edema, dehydration therapy (mannitol, furosemid) is assigned to children.

Children with convulsive syndrome unclear origin, convulsions arising against the background of infectious and metabolic diseases, brain injuries are subject to mandatory hospitalization.

Forecast and prevention of convulsive syndrome in children

Frebel convulsions usually stop with age. To prevent their re-occurrence, you should not allow pronounced hyperthermia when the child occurs infectious disease. The risk of transformation of febrile convulsions to epileptic is 2-10%.

In other cases, the prevention of convulsive syndrome in children includes the prevention of perinatal pathology of the fetus, therapy of the underlying disease, observation of children's specialists. If the convulsive syndrome in children does not disappear after the termination of the main disease, it can be assumed that the child has developed epilepsy.

In today's article we will talk about such a frequency, but rather unpleasant phenomenon as convulsive syndrome. In most cases, its manifestations look like epilepsy, toxoplasmosis, encephalitis, spasofil, meningitis and other diseases. FROM scientific Vision This phenomenon refers to the disorders of the functions of the central nervous system, which is manifested by joint symptoms of the clonic, tonic or clonic-tonic uncontrolled muscle contraction. In addition, a fairly often concomitant manifestation of this state is the temporary loss of consciousness (from three minutes and above).

Convulsive syndrome: reasons

Such a state may arise due to the following reasons:

• Intoxication
• Infection.
• A variety of damage.
• Diseases of the central nervous system.
• Small number of macroelements in the blood.

In addition, this state may be a complication of other diseases such as influenza or meningitis. Special attention It is worth paying for the fact that children, in contrast to adults, are much more often subject to this phenomenon (at least once in 5). This happens due to the fact that they have not yet fully formed the structure of the brain, and braking processes are not so strong as in adults. And that is why at the very first signs of such a state, it is necessary to urgently contact the specialist, as they testify to certain violations in the work of the central nervous system.

In addition, the convulsive syndrome in adults may appear after strong overwork, hypothermia. Also quite often, this condition was diagnosed in a hypoxic state or in alcoholic intoxication. It is worth noting that a variety of extreme situations may also lead to the emergence of convulsion.

Symptomatics

Based medical practice, It can be concluded that the convulsive syndrome in children arises completely suddenly. Motor excitement and wandering look appears. In addition, there is a threading of the head and closure of jaws. Characteristic sign This state is considered to bending the upper limb in the rays-up and elbow joints, accompanied by straightening lower limb. Bradycardia also begins to develop, a temporary stop of breathing is not excluded. Quite often, during this state, changes were observed.

Classification

According to the type of muscle cuts, convulsions can be a clonic, tonic, tonic-clonic, atonic and myoclonic nature.

By propagation, they can be focal (there is a source of epileptic activity) generated (diffuse epileptic activity appears). The latter, in turn, are primary-generalized, which is caused by bilateral attraction of the brain, and secondary generalized, which are characterized by local attraction of the cortex with further bilateral distribution.

Localizing convulsions can be in the facial muscles, muscles of limbs, aperture and in other muscles of the human body.

In addition, distinguished seizures are simple and complex. The main difference between the second ones is that there are no violations of consciousness.

Clinic

As practice shows, the manifestations of this phenomenon are striking by their variety and can have a different time interval, form and frequency of occurrence. The nature of the flow of the seizure directly depends on pathological processeswhich can be as their cause and to wear the role of provoking factor. In addition, convulsive syndrome is characterized by short-term spasms, relaxation of muscles, which quickly follow each other, which is the reason for a stereotypical movement that has a different amplitude from each other. This appears due to excessive irritation of the cortex of the brain.

Depending on the cuts of muscles, the convulsions are clonic and tonic.

• Clonic attractive muscular abbreviations that continuously replace each other. It is distinguished by rhythmic and neurotic.
• The tonic convulsions include muscle contractions, which are longer. As a rule, the time of their flow is very long. There are primary, those that appear immediately at the end of clonic convulsions, and localized or general.

It also needs to be remembered that convulsive syndrome, whose symptoms may look like convulsions, requires immediate provision of medical care.

Recognition of convulsive syndrome in children

According to numerous studies, cramps in children in breast and early age worn tonic-clonic character. They manifest themselves to a greater extent with the toxic form of Oci, ORVI, neuroinfection.

The convulsive syndrome, which developed after the increase in temperature is febrile. In this case, it is safe to say that in the family there are no patients with predisposition to the attacks of convulsion. This species, as a rule, can manifest itself in children from 6 months. up to 5 years. It is characterized by low frequency (maximum up to 2 times in all the time of fever) and short-term. In addition, during the cramp, the body temperature can reach 38, but all the clinical symptoms indicating the lesion of the brain are completely absent. When conducting the EEG during the absence of convulsion, the data on convulsive activity will be completely absent.

The maximum flow of febrile convulsion can be 15 minutes, but in most cases it is a maximum of 2 minutes. The basis for the appearance of such convulsions is the pathological reactions of the central nervous system on an infectious or toxic effect. The convulsive syndrome in children is manifested during fever. Its characteristic symptoms are considered to be a change in skin cover (by pale to cyanosis) and changes in the respiratory rhythm (wheezing are observed).

Atonic and efficient respiratory cramps

In adolescents, they suffer neural or neurosis, efficient respiratory cramps can be observed, the flow of which is caused by anoxy, due to a short-term suddenly manifested apnose. Such convulsions are diagnosed in persons whose age varies from 1 to 3 years and are characterized by conversion (hysterical) attacks. Most often, they are manifested in families with a hyperopic. In most cases, the convictions are accompanied by losses of consciousness, but usually short-term. In addition, the increase in body temperature has never been fixed.

It is very important to understand that convulsive syndrome, which is accompanied by a synicopal state, is not dangerous for life and as such treatment does not provide. Most often, these convulsions arise in the process of metabolic disorders (salts sharing).

Also distinguished also atonic cramps that arise during the fall or loss of muscle tone. It can manifest itself in children aged 1-8 years. It is characterized by atypical absansum, mythonic drops and tonic and axial attacks. They arise quite with high frequency. It is also quite common to appear epileptic status that is resistant to treatment, which once again confirms the fact that assistance in convulsive syndrome should be timely.

Diagnostics

As a rule, the diagnosis of a convulsive symptom does not cause special difficulties. For example, to determine pronounced myiostsbar, during the period between attacks, a number of actions aimed at identifying the high excitability of nerve stems are necessary. To do this, apply the tapping of the medical hammer on the trunk facial nerve before own sink, in the area of \u200b\u200bthe wings of the nose or corner of the mouth. In addition, it is quite often a weak galvanic current (less than 0.7 mA) begins as an irritant. The history of the patient's life and the definition of related chronic diseases. It should also be considered that after a full-time inspection, the doctor can be appointed additional researchaimed at clarifying the reason that caused this condition. To such diagnostic measures Believe: Take spinal puncture, electroencephalography, echohetephalography, survey of the eye bottom, as well as a variety of brain surveys and the central nervous system.

Convulsive syndrome: first aid for man

At the first signs of convulsion, the following is medical events:

• Laying the patient on a flat and soft surface.
• Ensuring the inflow of fresh air.
• Restraining nearby items that can harm him.
• Establing shy clothes.
• Marting B. purph cavity (between indigenous teeth) spoon, pre-wrapped it in wool, bandage, or if they are missing, then a napkin.

As practice shows, the relief of convulsive syndrome is the reception of drugs that cause the smallest oppression of the respiratory tract. As an example can be actively active substance "Midazolam" or Tablets "Diazepam". Also quite well established the introduction of the drug "Hexobarbital" ("Huxenel") or a sodium type. If there are no positive shifts, then the oxygen anesthesia can be used with the addition of means "fluorotan" ("halotan").

In addition, emergency assistance in convulsive syndrome is to introduce anticonvulsant drugs. For example, intramuscular or intravenous administration of a 20% solution of sodium oxy-butirate (50-70-100 mg / kg) or in a ratio of 1 ml by 1 year of life. You can also use a 5% glucose solution, which will significantly delay or completely avoid repetition of seizures. If they continue enough for a long time, then you need to apply hormone therapy, which is the reception of the preparation "prednisone" 2-5 m7kg or "hydrocortisone" of 10 m7kg during the day. The maximum number of administrations intravenously or intramuscularly is 2 or 3 times. If observed serious complications, such as failures in respiration, blood circulation, or the threat of life to the child, then assistance to convulsive syndrome is to hold intensive therapy With the appointment of potent anticonvulsant drugs. In addition, for people who have experienced severe manifestations of this state, a mandatory hospitalization is shown.

Treatment

According to numerous studies, which confirm the widespread opinion of most neuropathologists, the appointment of long therapy upon completion of 1 attack of convulsion is not entirely true. Since single outbreaks arising against the backdrop of fevers, changes in metabolism, infectious lesions or poisoning are fairly easy to fix during therapeutic measures aimed at eliminating the cause of the main disease. Best of all, monotherapy has proven itself in this regard.

If people are diagnosed with periodically repeated convulsive syndrome, treatment is the admission of certain medical drugs. For example, for the treatment of febrile cramps optimal option It will receive the means "diazepam". It can be used as intravenously (0.2-0.5) or rectally (daily dose is 0.1-0.3). Reception it must be continued and after the disappearance of the attacks. For more prolonged treatmentUsually prescribe a medicine "Phenobarbital". Also orally can be taken by the preparation "diphenin" (2-4 mg / kg), "Suxile" (10-35 mg / kg) or "Antellexin" (0.1-0.3 mg / kg within 24 hours).

Also worth paying attention to the fact that the application antihistamine drugs And neuroleptics will significantly increase the effect of anticonvulsants. If, during convulsion, there is a high probability of a heart stop, you can use anesthetics and muscle relaxants. But it should be borne in mind that in this case a person should be transferred to IVL immediately.

With bright pronounced symptoms Neonatal seizures It is recommended to use Peniton and Phenobarbital preparations. The minimum dose of the latter should be 5-15 mg / kg, then it should be taken at 5-10 mg / kg. In addition, half of the first dose can be administered intravenously, and the second is orally. But it should be noted that this preparation should be taken under the supervision of doctors, as there is a high probability of stopping cardiac activity.

The attacks of convulsion in newborns are caused not only by hypocalcemia, but also hypomagnesiamia, vitamin B6 deficiency, which implies operational laboratory screening, is especially true when it does not remain a time to carry out a full diagnosis. That is why urgent assistance in convulsive syndrome is so important.

Forecast

As a rule, with a timely manner rendered first aid and in the future correct diagnostics with the appointment of the treatment scheme, the forecast is quite favorable. The only thing to remember is that, with a periodic manifestation of this state, you must urgently contact a specialized medical institution. It should be noted that people whose professional activity Related to permanent mental loads, it is worth passing periodic checks from specialists.

Convulsive syndrome - a suddenly arising state characterized by involuntary abbreviation muscles. Accompanied by the same parietal painful sensations. Cauls can be localized in a particular place or spread to several muscle groups. The causes of the occurrence of the syndrome are different, they determine the nature of the painful sensations, the duration of seizures and their consequences for the body.

Causes of convulsive syndrome

The etiology of the disease is different. It is important to determine the provoking factors due to the fact that the treatment of syndrome, for example, with genetic origin, is radically different from pathology therapy due to the effects of toxic substances. The convulsive syndrome in adults can be caused by such reasons:

• Genetic predisposition provoking the development of primary epilepsy.
• Perinatal development factors: impact on a pregnant woman and, accordingly, on the fruit of infections, medical drugs; oxygen starvation; Injuries during childbirth.
• Heart injuries.
• Reception of some drugs from various pharmacological groups (antibiotics, neuroleptics, analgesics, etc.).
• Impact on the body of toxic substances (mercury, lead, carbon monoxide, Strichnin, ethanol).
• An abstitent syndrome of various nature (alcohol, drugs, some medicines).
• Infections affecting brain (encephalitis, meningitis).
• The form of the late toxicosis of pregnancy is eclampsia.
• A violation of cerebral circulation due to such pathologies (stroke, acute hypertensive encephalopathy, etc.).
• Tumor neoplasms in the brain.
• Atrophic brain diseases.
• Violations of metabolism (carbohydrate and amino acid), electrolyte imbalances.
• Forestands.

Statistics show that different age groups are characterized by their most frequent causes of convulsive seizures.

Thus, in children under 10 years old, the main factors of the appearance of convulsion are considered fever against the background of increasing body temperature, infection of the central nervous system, brain injuries, congenital metabolic disorders.

In the age group, from 10 to 25 years, the most frequent causes of the syndrome are the epilepsy of uncertain etiology, ICC, brain tumors, angioma.

The next age group is limited to the framework of 26-60 years, the so-called late epilepsy is common among patients. It is caused by alcoholism, tumors with metastases in the brain, cerebrovascular diseases, inflammatory processes.

The convulsions arising for the first time after 60 years are most often caused by overdose of drugs, brain tumors, vascular pathologies.

Classification and main signs

Ferry attacks are unequal by origin, localization, duration and symptoms.

In the sign of which part of the brain, the hyperactivity of neurons causes convulsions, the seizures are divided into partial and generalized. Each of the types is divided into smaller classification groups characterized by their own features.

Partial

The convulsions relating to this species are caused by the excitation of neurons in a small area of \u200b\u200bthe brain. Depending on whether partial seizures are accompanied by changes in consciousness, they are simple and complex.

Simple

Such states occur without changing human consciousness. Duration - from a few seconds to a few minutes. Basic signs:

• Incoming convulsive cuts of muscles of limbs, neck, torso, accompanied by painful sensations. Sometimes there is a so-called Jackson march - a phenomenon in which convulsion is gradually covered by different groups Muscles of one limb.
• Changing the perception of sense organs: the appearance before the eyes of the flashes, the feeling of false noise, taste and olfactory changes.
• Sensitivity disorders expressed in parrestsees.
• Deja vu, depersonalization and other mental phenomena.

Sophisticated

Such convulsions are accompanied by a violation of consciousness. A similar phenomenon lasts for one or two minutes. Basic signs:

• Convulsive phenomena.
• Automated - characteristic repetitive movements: walking on one trajectory, rubbing palms, pronunciation of the same sound or word.
• Short-term perisage of consciousness.
• No memory of what happened.

Generalized

Such convulsions arise due to the excitation of neurons on the extensive section of the brain. Partial seizures can transform into generalized over time.

In the process of such pathology, a person loses consciousness.

The classification of states arising against the background of the hyperactivity of neurons on a large sector of the brain is based on the character of spasms:

• Clonic convulsions are characterized by rhythmic compression of muscles.
• Tonic - long spasm of muscle tissue.
• Mixed (clonic-tonic).

According to symptoms, allocate next species Generalized seizures: myoclonic, atonic, absans and epileptic statuses.

Tonic-clonic

This species is distinguished by the presence of two phases. The symptoms are:

• Sound fainting.
• The tonic phase is characterized by throwing the head, the tension of the muscles of the body, the bending of the hands and the extension of the legs. Skin of a blue shade, pupils do not react to light. An involuntary cry may occur, urination. The duration of such a state is 10-20 seconds.
• Clonic phase. Looms for one or three minutes, during her rhythmic spasms of the whole body occur. From the mouth goes foam, eyes rolled out. In the process, the language is often born, as a result of which foam occurs with blood admissions.

From clonic-tonic convulsion man does not come immediately. At first, tremor, drowsiness, dizziness is observed. Coordination of movements is somewhat violated. The patient does not remember anything that happened to him during an attack, which makes it difficult to determine the painful state.

Absans

This type of attack is characterized by its small duration - just a few seconds.

Characteristics:

• Dismissed current.
• The lack of a person's reaction to external stimuli during the attack.
• Pupils are expanded, eyelids are slightly lowered.
• A person does not fall, but remains in the same position, without consciousness of these a few seconds, he can continue to stand.

Absanx almost always remains unnoticed not only by the patient himself, but also the people around him.

Mioclonic

Such attacks around others resemble "twists" and are often not perceived by people as a pathological condition. Characterized by short asynchronous cuts of muscles. If in the process the seizure man kept any object in his hands, as a rule, his sharp discarding towards.

The patient in the process of attack most often does not fall, and if the fall occurs, the attack stops.

ATONIC

This type of seizures is characterized by fainting and a decrease in muscle tone. If the condition is briefly, it is expressed in the omission of the head and the feeling of weakness, the person falls under long time.

Epileptic status

Most dangerous view The syndrome in which the attacks go one by one, and in the intervals between them a person remains unconscious.

Knock alarm symptoms It is necessary as early as possible as complications of seizures can be quite serious:

• stop breathing, emitting emit;
• critically dangerous increase in body temperature;
• arrhythmia, increase pressure to critical indicators, stop heart.

Diagnostics

The diagnosis of the syndrome involves collecting anamnesis, in the process of which the doctor makes an assumption of the nature of pathology and directs the patient for additional examinations in order to confirm or refute the possible diagnosis.

Diagnostic methods to determine the cause of the development of syndrome are:

1. Electroencephalography. Focal or asymmetrical slow waves after an attack can talk about epilepsy.
2. Radiography. Shows the premature closure of spring and seams or the discrepancy between the latter, the change in the contours of the Turkish saddle, intracranial hypertension and other changes. These indicators can confirm the organic origin of seizures.
3. Reoeczephalography, pneumoencephalography. Show the asymmetry of blood flow, impaired blood flow and blood supply to the brain, which may indicate the tumor nature of pathology.
4. Research of the spinal fluid.
5. Blood research.

In addition to determining the factors of the development of the disease, the methods described above allow differential diagnosis.

Effective treatment methods

The method of therapy is different depending on which factors provoked the development of the syndrome.

It is important to inform close patients about how urgent assistance should be with convulsive syndrome, especially if we are talking about serious cases of the disease.

Giving help

First aid for cramps involves the following actions:

1. Give a horizontal position on a smooth surface, setting it to the side.
2. Remove objects that can be injured.
3. Provide fresh air access.
4. Unbutton collar, if possible, remove the shy throat and chest clothes.
5. The head and body can be a bit, while not squeezing.

Such prefigure help will help avoid injury to the patient. In addition to the described actions, it is important to track the duration of the seal. At the end of the attack of a person must be sent to the medical institution.

Traditional methods

The therapy of convulsive syndrome implies an impact on the root cause of the pathological condition.

If we are talking about epilepsy, such drugs are prescribed:

• valproic acid derivatives;
• heterocyclic compounds (barbiturates, hydantoins), oxazolidinions, succinimides;
• tricyclic compounds (carbamazepine, benzodiazepines);
• preparations of the last (third) generation.

People's methods of treatment of pathology can only be applied after the consultation of the doctor and in the complex with medical preparations, not instead of them.

Folk Medicine offers the following means to treat convulsive states:

• blend of grass of peony, licorice, rod;
• maryan root;
• stone oil.

Dangerous consequences

On time, unavaled attacks, as well as the lack of treatment, their root causes provoke hazardous consequences:

• empty and difficulty breathing, up to its complete termination;
• cardiovascular disorders that are fraught with a heart stop.

The seizure, if he overtook a person in the process of performing certain types of activities, on the street or behind the wheel of the car, can lead to injuries and more severe consequences.

Patients with diagnosed syndrome contraindicated service in the army.

Convulsive syndrome is non-specific reaction The body for external and internal stimuli, for which the sudden and involuntary attacks of muscle contractions are characteristic. Causes appear against the background of the pathological synchronized activity of the neurons group and may arise both in an adult, so in a newborn baby. To establish the cause of this phenomenon, as well as for further treatment Medical consultation is needed.

According to statistical studies, convulsive syndrome in children is found in 17-25 cases out of a thousand. At preschoolers, this phenomenon is observed five times more often than in the population. Wherein most of Slippers fall on the first three years of the child's life.

Varieties Sailor: Quick description

Muscular reductions in convulsive syndrome may have a localized and generalized character. Local (partial) convulsions apply to a certain muscle group. In contrast, generalized convulsive seizures cover the entire body of the patient and are accompanied by foam at the mouth, loss of consciousness, involuntary defecation or urination, a bite of the tongue and a periodic stop of breathing.

According to the manifest symptoms, partial convulsive seizures are divided into:

1. Clonic cramps. They are characterized by rhythmic and frequent muscular contractions. In some cases, they even contribute to the development of stuttering.
2. Tonic convulsions. They cover almost all the muscles of the torso and can spread to the respiratory tract. Their symptoms include slow muscle contractions over a long period of time. At the same time, the body of the patient is elongated, the hands bent, the teeth are compressed, the head is thrown back, the muscles are tense.
3. Clone-tonic convulsions. it mixed type convulsive syndrome. In medical practice, it is most often observed in comatose and shock conditions.

Causes of syndrome

To reasons for the development of this syndrome, congenital defects and pathologies of the central nervous system can be attributed, hereditary diseases, tumors, functioning violation of cardio-vascular system and much more. The convulsive syndrome in children often occurs against the background of strong emotional overvoltage or a sharp increase in body temperature.

The most common causes of convulsive syndrome, depending on the age of a person are presented in the table:

Age category	The reasons
Up to 10 years old	diseases of the central nervous system; fever; Head injuries; disorders of the metabolism of congenital character; idiopathic epilepsy; Canvas and Batten disease; cerebral paralysis in children.
From 11 to 25 years	brain tumors; traumatic head damage; toxoplasmosis; angioma.
From 26 to 60 years	use alcoholic beverages; metastases and other neoplasms in the brain; Inflammatory processes in brain shells.
From 61 years	drug overdose; cerebrovascular diseases; renal failure; Alzheimer's disease, etc.

It can be concluded that the manifestation of convulsive syndrome in both adults and children may be associated with a number of reasons. Therefore, its treatment will be based primarily on the search for a factor provoking the manifestation of this syndrome.

Facial seizures: Features

Symptoms of convulsive syndrome in children are manifested at the beginning of the attack. The baby's glance suddenly becomes wandering, and he gradually loses contact with the outside world. In the tonic phase, this syndrome in children can be accompanied by the heading of the head back, closing the jaws, straightening of the legs, bending the hands in the elbow joints and the pale of the skin.

The most common form of convulsive syndrome in children is called febrile. As a rule, it develops against the background of a sharp increase in body temperature, observed in babies and children under the age of 5 years. At the same time, there are no signs of infectious damage to the shells of the brain. The outcome of the flow of febrile convulsions in most cases is favorable. It should be distinguished by a single case of febrile seizures from epilepsy.

The convulsive syndrome in newborns is manifested in 1.4% of the dyed and 20% of premature children. This condition proceeds with shinking, disorder of respiration, vomiting, cyanosis and most often does not exceed 20 minutes. The occurrence of this syndrome in newborns requires an immediate survey, as it can be associated with generic injuries, heredity and other factors.

Urgent Care

Emergency assistance in convulsive syndrome can be provided by any person. The most important thing is that it can recognize the seizure and understand what kind of interest to help you have to have a victim. In order to prevent serious damage The organism of the patient's action, providing first aid should be accurate and consistent.

Prefigure help is of great importance for this syndrome! It can be conventionally considered the first stage in the treatment of this pathology, because when it does not have the likelihood of a fatal outcome.

Imagine the situation. Your friend with whom you are talking, suddenly falls to the ground. His eyes are open, the hands are bent, and the torso stretched out. At the same time, the skin of the victim is pale, and breathing almost stops. Moreover, it receives additional damage when hitting the Earth. Therefore, it is very important if it turns out to react - try to prevent the fall of a person.

Immediately call the "ambulance", specifying that a person began with convulsive seizures and he needs emergency assistance!

Then you should provide the influx of fresh air to the patient. To do this, remove the shirtless clothes, unzip the gate of shirts, etc. Also, it is also necessary to put a rolled handkerchief in his mouth so that he does not bite himself a tongue and broke his teeth. Turn the head of the victim or all his body side. These actions are preventive measure From suffocation, because thus, possible vomit without any harm will come out.

Note! It is very important to remove all items from the victim, which during an attack can be injured. Under the head can be put something soft, for example, a pillow.

If a strong crying and hysteria preceded by a convulsive seizure, and during the attack, the color of the face, a fainting state, a violation of cardiac activity, should not allow the respiration of the victim. Namely, to spy the face with water, give to breathe summer alcohol, wrap a spoon with a clean cloth and press it with a cutter to the root of the language. Try to reassure and distract the child.

Treatment of convulsive syndrome

The treatment of convulsive syndrome in children and adults begins with the definition of a factor provoking its appearance. A survey and personal inspection of the patient is carried out. If this syndrome originated, for example, due to fever or infectious disease, its symptoms will disappear independently after the treatment of the main disease.

After providing first aid, doctors tend to prescribe the following treatment:

1. Reception sedatives (Seduksen, Trioxazine, Andaxin).
2. The relief of convulsive syndrome with strong seizures is possible only when intravenous administration Preparations (Droperidol, Oxybutirate sodium and others).
3. No less an important stage In the treatment of this syndrome is a full nutrition to restore the normal functioning of the body.

The diagnosis of "convulsive syndrome" indicates the presence of seizures that may arise against the background of many diseases, injuries and other phenomena. With their manifestation, depending on their scale, it is important to provide a patient with the right, urgent assistance and call a doctor for examination and appointment of treatment.