Psychology and Psychiatry

Epilepsy in a child

Epilepsy in a child - This is a pathological condition, neurological in nature, manifested by sudden convulsive seizures. Much more often than in the adult period, there is observed ailment in childhood. An epileptic seizure is a manifestation in the brain structures of a pathological and excessive electrical discharge, which provokes the emergence of sudden motor and mental dysfunctions, autonomic disorders, as well as alteration of consciousness.

Epilepsy in children is characterized by a variety of clinical symptoms of seizures and a large number of varieties resistant to therapeutic effects.

Causes of epilepsy in a child

When such a serious illness, like epilepsy, befalls the smallest family member, all parents want to find out the reasons that gave rise to the disease, and possible ways of correction.

Modern medicine systematizes the described pathology, depending on the pathogenesis and etiological factor, into groups: symptomatic, idiopathic and cryptogenic groups. The first is the result of a violation of the brain structure (eg, cyst, tumor process, hemorrhage), idiopathic occurs when there are no significant transformations in the brain, but there is a genetic predisposition, the third is diagnosed when the pathogenesis of the disease remains unexplained.

Timely detected etiological factor contributes to the appointment of adequate therapy and the onset of a speedy recovery. Also, in order to predetermine the strategy of corrective action of the state in question, it is necessary to determine the symptoms of the disease in a timely manner.

Epilepsy in children, the causes of its occurrence can be classified into six subgroups. So, below are the factors leading to increased excitation in the brain. In the first turn, the occurrence of an epileptogenic focus causes various defects in the maturation of the fetus, especially its brain. Also, the appearance of epilepsy in babies is influenced by the behavior of mothers during pregnancy. For example, the abuse of future "mothers" alcohol-containing drinks, smoking lead to disruption of the maturation of the baby's brain. Various complications (severe gestosis) and catarrhal ailments, transferred by a woman in a position, may further generate foci of increased excitability in the infant's brain. In addition, age groups are considered a risk group.

Secondly, epilepsy can arise in a child directly during the birth process, due to damage to the already formed brain, which provokes the development of early organic brain damage. This is more often observed with prolonged labor, prolonged anhydrous period, entanglement of the neck of the crumbs of the umbilical cord, the use of obstetric forceps.

The third subgroup consists of transferred infectious diseases of the nervous structures, such as arachnoiditis, encephalitis, meningitis. These diseases contribute to the appearance in the brain of segments of increased excitability.

In addition, often lead to the occurrence of this pathology of persistent colds, accompanied by convulsions and high temperatures. However, this is solely due to the predisposition to the formation of the ailment in question, which may be associated with small brain lesions that occurred during ontogenetic maturation or as a result of labor and remained unnoticed due to insignificance.

The fourth subgroup includes various head injuries, in particular, brain concussions, which contribute to more active production of nerve impulses by brain areas, transforming them into epileptogenic pathological foci.

The fifth subgroup includes hereditary factors. Simultaneously with the formation of a center of increased excitation in the brain from nearby neurons and chemical neurotransmitters, the inhibitory pressure on this source should decrease. The main inhibitory neurotransmitter in the brain is dopamine, the amount of which is programmed in the genetic code of the animal world. That is why the presence of the parent of epilepsy, in the future can produce a low level of dopamine in the child.

The sixth subgroup consists of various tumor processes that take place in the brain, which are capable of giving rise to the formation of high excitability in it.

A variation of the pathology described is focal epilepsy in children, which can be provoked by various metabolic disturbances in brain segments or circulatory disorders in them.

Also, this type of illness often occurs in children at any age due to the above factors, as well as due to dysgenesis of nervous tissue, various somatic diseases, inflammatory processes of the brain, neck dysplasia, hypertension, osteochondrosis in the cervical spine.

Epilepsy in a newborn child often occurs as a result of primary processes occurring inside the skull, or systemic disorders. The first include: meningitis, encephalitis, hemorrhage, malformations, neoplasms. The second - hypocalcemia, hypoglycemia, hyponatremia and other metabolic disorders.

Thus, epilepsy in children causes its occurrence, the features of the course are quite diverse and individual. They depend mainly on the localization of the epileptogenic focus and its nature.

Symptoms of epilepsy in children

The clinical symptomatology of the pathology being analyzed is quite significantly different in babies compared to the manifestations of the ailment in adults. This is often due to the fact that the epilepsy in a child, its signs can often be confused with the normal physical activity of children. That is why the diagnosis of the considered violation of the smallest is difficult.

Many are convinced that convulsions always accompany epilepsy. However, there are varieties of disease without convulsive seizures.

The variety of clinical symptoms of this violation quite often impedes timely diagnosis. The following are typical manifestations and symptoms of epilepsy in children, due to species.

Generalized epileptic seizures in children begin with a brief cessation of breathing and tension of the whole musculature, after which convulsions occur. Often spontaneous urination occurs during epipriation. Convulsions stop on their own, after their completion, the baby falls asleep.

Abscesses or epipripadki without convulsions, occur less noticeable. With such epiphristies, the child freezes, his gaze becomes nothing expressing, absent. It is rare to observe a slight twitching of the eyelids, the baby may throw back his head or close his eyes. At such moments, the crumb stops responding, it is impossible to attract his attention. The child returns after a seizure to the unfinished lesson. Epipripsies usually last a maximum of twenty seconds. Most often, the adult environment does not notice these attacks or take this behavior for absent-mindedness.

This type of epilepsy makes its debut around the range of five to seven years. Absans girls suffer twice as often as boys. Considering the form of the disease, it can last until puberty, after which the seizures either gradually disappear on their own or develop into a different form of the ailment.

Atonic attacks of epilepsy in children are found in a sudden loss of consciousness, along with relaxation of the entire musculature. Such a seizure resembles an ordinary swoon.

Children's spasm is characterized by involuntarily bringing the upper limbs to the chest area, straightening the legs, leaning the entire body forward or just the head. More often similar attacks come in the morning, right after awakening. Sometimes cramps cover only the muscles of the neck, which is found in the spontaneous movement of the head back and forth. Seizures last only a few seconds. Mostly, they suffer kids of two or three years of age. By the age of five, the children's spasm goes completely or goes into another form.

Epilepsy in a child, signs of it, in addition to the above, may be less clear and obvious. For example, some kids suffer nightmares at night, often they wake up in tears from their own scream. They can also wander in their sleep without reacting to those around them.

Another symptom of the violation in question is considered to be headaches, which appear abruptly and often accompanied by nausea with vomiting. Sometimes the only early factor indicating the presence of epilepsy in a child is short-term speech disorders.

These signs of the anomaly in question are rather difficult to notice, but even more difficult to associate with a neurological disorder.

Epilepsy in a child under one year old

The described disorder in infants is characterized not only by a specific pathogenesis, but also by a peculiar clinical symptoms. The manifestation polymorphism allows to consider epilepsy as a whole group of diseases, the foundation of which is abnormal electrical excitability of the brain.

Epilepsy in a newborn child is atypical, less pronounced than in an adult. Often, epipridation in newborns is quite difficult to distinguish from ordinary physical activity. But if you carefully observe, then notice their manifestations is easy. In the first turn, the baby stops swallowing and freezes, he notes the absence of any reactions to stimuli, his gaze becomes frozen and fixed.

Epilepsy in a child under one year, her symptoms are due to the form of the disease. It can be revealed in the form of traditional convulsive jerks, originating in one or simultaneously in several muscle groups. Such local manifestations often develop into a vast tonic-clonic epipadiad accompanied by a mandatory loss of consciousness and convulsions. In addition, absences often occur.

In babies, there may be precursors before convulsions. The disease in question often begins with an aura that precedes the loss of consciousness. The state of the aura is rather fleeting and is remembered when the seizure is complete. It is visual and auditory, olfactory and taste, somatosensory, mental, epigastric. Manifestations of the aura are due to its type. For example, with the auditory aura, the baby can hear a variety of sounds, with the olfactory - fetid odor, with the taste - an unpleasant taste, epigastric - nasty sensations in the retroperitoneal area, mental - fear, anxiety or anxiety.

The aura always remains unchanged, it is individual for each crumb. It is the aura that allows parents to predict the onset of a seizure and allows the baby to take a comfortable position in order to avoid injury.

The first convulsive manifestations of the disease in infants usually occur at about six months of age. The duration of the seizure is up to three seconds. At the same time, epiphriscuses may occur several times during the day. Often this condition is accompanied by an increase in temperature, facial hyperemia, which disappear upon completion of the seizure. Convulsions can capture individual parts of the infant’s torso (neck, limbs). For infants, especially for newborns, epiprips are extremely dangerous, because they are not able to control their own body.

There are several variations of the pathology in question, the debut of which comes to the infant age of babies.

A rare form of the disease, which manifests itself on the second or third day of the postnatal stage, are benign idiopathic neonatal family convulsions. A family history of babies suffering from this type of illness is aggravated by the presence of similar seizures at the neonatal stage in the nearest environment of the baby. This form of the disease is due to heredity.

Clinically, this type of convulsions is manifested by focal clonic or generalized multifocal epiprips, characterized by short periods of respiratory arrest, stereotypical motor phenomena and oculomotor phenomena of the type of tonic tension of the muscles along the spine, tonic reflexes. Visceral disorders and autonomic dysfunction are also often observed (hyperemia of the cervical and facial area, changes in breathing, excessive salivation).

Benign idiopathic neonatal nonfamily convulsions appear more frequently on the fifth day of the postnatal period. Convulsions of the type of focal clonic or generalized multifocal epiphriscuses. Seizures manifest by non-simultaneous clonic contractions of the muscles of individual body segments. Their distinctive feature is considered to be migratory. In other words, the clonic contraction goes very quickly, spontaneously and randomly from one part of the body to another segment of it. The minds of babies with these seizures are usually preserved.

Rare, due to age, epileptic syndrome, is early myoclonic encephalopathy. Often, this type of illness debuts at the age of three months. Seizures appear as a fragmented myoclonus. Frequent tonic spasms and sudden partial epipripsies can also occur. Myoclonias can occur in a state of dream and wakefulness. Convulsions can range from a slight twitching of the phalanges of the fingers of the upper limbs to trembling hands, forearms, corners of the mouth and eyelids.

A typical outcome of the disease is the death of children under five years of age. Surviving children suffer from serious psychomotor disorders.

Epilepsy in a child 2 years

The described disease is characterized by a huge number of varieties caused by pathogenesis, localization of the abnormal focus, age period of the debut seizures, the diversity of the clinical picture.

In children from the age of two, a rolandic form of epilepsy can occur. It is a benign form of temporal epilepsy (the focus of seizure activity is located in the cells of the cortex of the temporal segment of the brain). It manifests itself more often with short night seizures. The prognosis is favorable.

The clinical symptoms of epilepsy in a 2-year-old child contain simple and complex partial epipripers. Often in the process of dreaming, babies can make specific sounds resembling "gurgling", "gargling".

The rolandic form of the disease begins with a somatosensory aura: there is numbness, a tingling sensation in the area of ​​the tongue, gums. The frequency of seizures no more than four times a year, however, in infants and two-year-old children may occur more often.

It is possible to single out such characteristic features of the considered type of the ailment: numbness in the cheeks, lips of the tongue, speech disorder, convulsive condition of the muscles of the limbs and face, full consciousness, drooling, night seizures.

Another type of pathology under consideration that can debut at the age of two is the idiopathic partial form of the disease, accompanied by occipital paroxysms. It is characterized by simple partial epiphriscues, motor, convulsive and visual impairments - hallucinations, visual illusions, and migraine-like manifestations - headaches, nausea, dizziness.

Children suffering from epilepsy are practically not interested in contact with close friends or peers. Their mental maturation and mental development are slow.

Diagnosing the disease in question is a rather complicated process, especially in infants. Since the epilepsy in a child under one year old does not describe the symptoms and sensations of the children, they are also not able to recognize the precursors of seizures and predict the time of the onset of convulsions.

Therefore, the history is collected on the basis of stories, complaints of parents, from a detailed description of the condition of their offspring. Before the close environment of the baby is a serious task. They should describe with maximum accuracy all manifestations of the disease.

At the stage of instrumental diagnostics, magnetic resonance imaging and electroencephalography are carried out, which help to identify possible foci of brain damage.

An important step in the diagnosis of epilepsy in a 2-year-old child is the detection of the etiological factor of the disease. For this purpose, a complex of laboratory tests is appointed, including blood sampling to check the electrolyte content, finding possible viruses or bacteria, an analysis of feces and urine is done, and the acid-base balance of the blood can also be measured.

Epilepsy in a child 5 years

The assorted disease is characterized by various species that have a specific course.

Эпилепсия у ребенка 5 лет - причина зарождения всегда является дисфункция различных отделов мозга. The defeat of a segment of the brain causes the clinical picture of the disease.

If the epileptogenic focus is localized in the area of ​​the temples, then this form is characterized by a short-term loss of consciousness against the background of the absence of convulsions. The described type is manifested by motor dysfunction and disorder of mental processes. It begins with a psychic (feeling of fear), epigastric (tickling sensation in the retroperitoneal area) aura, dream state. Often the seizure may be preceded by illusions and complex hallucinations. Often, epileptics show automatism on the type of smacking, lip chewing, autonomic dysfunction in the form of heartbeat and increased respiration.

In the case of a frontal form, epi-attacks can be short or long attacks (the baby can be in an unconscious state for more than half an hour).

This type of illness is characterized by secondary-generalized, simple and complex partial epiphysics. Psychomotor frontal epiprips are more common.

The seizure begins suddenly, often without an aura. The described form is characterized by rapid secondary generalization, a series of attacks, pronounced motor phenomena (chaotic movements, gestural automatisms), and the absence of motivating motives.

Clinical manifestations of the parietal form of epilepsy contain paresthesias, algies, disorders of the body pattern. The most characteristic symptom of paroxysms are simple paresthesias ("crawling goosebumps", numbness, tickling, tingling). Mostly, paresthesias occur in the upper limbs and the facial area. A typical feature of seizures is the focus on the spread of epileptic readiness to other areas of the brain. Therefore, at the time of the seizure, in addition to somatosensory dysfunctions, other manifestations may occur - blindness (occipital lobe), automatism and tonic tension (temporal lobe), clonic trembling of the arms or legs (frontal lobe).

Occipital epilepsy is characterized by simple partial paroxysms against the preservation of consciousness. Its manifestations are clinically classified into initial symptoms and subsequent. The first ones are caused by the localization of the convulsive focus in the occipital segment of the brain, the second ones are the result of the transition of pathological activity to other areas of the brain. The initial symptoms include paroxysmal blindness and visual field disorders, visual hallucinations, head deviation, blinking.

Almost eighty percent of the identified types of epilepsy in children are frontal or temporal types of ailment. In some cases, one of the brain segments is affected, then focal epilepsy occurs in children.

The functional transformation of neurons is inherent in the idiopathic focal form. The nervous structures of the brain are made excessively excitable.

Typical manifestations of convulsive epipadiopathy in children can be distinguished: uniform twitching of the trunk muscles or convulsions, loss of consciousness, spontaneous urination, respiratory arrest, strong muscular tension of the body, chaotic movements (trembling of the extremities, lip pulling, head turning).

Treatment of epilepsy in children

The methods of influence aimed at the correction of the pathological condition are characterized by duration and complexity. Epileptic treatment requires tremendous patience, dedication and self-discipline. The goal of therapeutic interventions is considered to be the absolute elimination of epipads with the least side effects.

Modern medicine identifies two key areas of therapeutic treatment: surgical and drug. Pharmacopoeial agents used in the fight against convulsive state are selected individually, taking into account the pathogenesis, nature and specificity of epipripsy, their frequency, frequency, age of epileptic and other factors, since individual antiepileptic drugs show the necessary action and effect only for certain types of epilepsy.

Treatment of epilepsy in children is carried out by an epileptologist or a neuropathologist. The drugs are usually prescribed in various combinations or monotherapy is practiced. They should be taken necessarily, since the lack of adequate therapy leads to an increase in convulsions, progression of the pathological condition, mental degradation of the crumbs and intellectual dysfunction.

Adequate antiepileptic therapeutic effect involves identifying features of the episyndrome, determining the toxicity of a pharmacopoeial remedy, and establishing the likely harmful effect. The choice of the drug is due, above all, the nature of the epipridations and, to a lesser extent, a type of epilepsy.

Modern anticonvulsant pharmacopoeial drugs are directed either to suppress the pathological readiness of neurons (ethosuximide) in the epileptogenic focus, or to prevent the spread of other neurons from the anomalous focus of excitation and involvement, thereby preventing epiphysias (phenobarbital).

The most commonly used drugs are: Carbamazepine, Phenobarbital, Valproate sodium, Difenin. In babies, Phenobarbital is considered to be the most effective, since it is easily tolerated, has minimal side effects, does not cause liver pathology and provokes changes in the child's psyche.

The treatment of epilepsy in children with the described preparation is rather long. It is not allowed to interrupt the reception even once. The dose of Phenobarbital ranges from three to eight milligrams per day per kilogram of body weight of the baby. Begin to use this drug with a small dosage, gradually increasing the dose, bringing to an average level. If side effects are not observed, and the number of epiprips decreases, then you can increase the dosage to the maximum. This drug in children is not canceled even with a prolonged absence of convulsive epipadia.

Most often, for epileptic children, the prognosis is favorable. Prevention of epilepsy in a child should begin at the stage of gestation (excluding all potentially dangerous factors that can adversely affect ontogenesis). Breastfeeding helps reduce the risk of the occurrence of the described disease in babies. In addition, prevention should include the following mandatory measures: maintaining a balance of sleep and wakefulness, timely treatment of diseases, proper nutrition, protection of the head from injury (for example, putting on a helmet when cycling).

Parents should not accept epilepsy as a sentence that cannot be appealed, because modern medical science is developing rapidly. Therefore, today the disease under consideration is successfully amenable to correction.