Epilepsy in children ... This is a disease in everyone athearing, but few ordinary people have an idea of what it is. But epilepsy is not such a rare disease, unfortunately. According to statistics, every hundredth inhabitant of the planet suffers from this disease - you must agree, this is a very impressive figure. What is this mysterious epilepsy? Doctors describe it as follows: epilepsy is a kind of complex of symptoms, the distinguishing feature of which are cramps or their equivalents - both mental and vegetative. Most often epileptic seizures affect children of the first few years of life - at this age, about 80% of all epileptic seizures occur. The older the child becomes, the less likely is the occurrence of epileptic seizures. This is due to the fact that as the child grows, epileptic activity - the so-called convulsive alertness - is significantly reduced. All parents who learned that their children are suffering from epilepsy, at the first moment fall into a real panic. However, I would like to reassure Mom and Dad a little, who faced this disaster. In fact, the future of children suffering from epileptic seizures is not as gray and bleak as it might seem at first glance. Even the story itself talks about this - a lot of great people of the past suffered from severe attacks of epilepsy. However, despite their disease, they not only reached professional heights, but also immortalized their name in history forever. And notice, all this they achieved at a time when there were no anticonvulsants in sight.
What is epilepsy?
Modern medicine has made significant progress ina study of the nature of the onset of epilepsy: the mechanisms underlying the disease, to date, everyone knows. And with these mechanisms today we will introduce our readers. The human brain has a certain bioelectric activity, which arises as a result of the work. This bioelectric activity is very different in an adult and a child. This very bioelectric activity is a different electrical discharge - the waves. With the normal functioning of the brain these waves are strictly defined. But in the event that a child suffers from epilepsy, bioelectric discharges significantly change, become pathologically strong and sharp, like lightning charges. It goes without saying that such a phenomenon can not but negatively affect the normal functioning of the brain - its work is disrupted. What happens during an epileptic fit? Epileptic seizure, in its essence, is nothing else than paroxysm - a convulsive attack. During this seizure, a child suffering from epilepsy experiences a disturbance of consciousness: the child is not in a position to control his behavior, hear and understand the speech addressed to him, follow instructions received from adults. After the end of the seizure, the child does not remember anything - the manifestation of the so-called short-term epileptic amnesia. It goes without saying that for no apparent reason, bioelectric activity of the brain is not violated and the child will not have a predisposition to the occurrence of epileptic seizures. A cause of violation of bioelectric activity is the resulting imbalance of the relationships between the most important active substances that exert both an exciting and inhibitory effect on the brain cells. In addition, epileptic seizures are often provoked by a violation of normal acuity, as well as water-salt balance. For some time, sometimes even very long, all the above pathological processes can be completely asymptomatic, in no way manifesting themselves. However, with certain factors, they will not slow to make themselves felt. Such provocative factors can be:
- Various brain injuries, both severe and minor.
- Violation of high-grade cerebral circulation of any nature of origin.
- Tumors of the brain of any etiology.
- Heavy infections that affect the whole body.
- Severe intoxication of the body, affecting the brain.
However, in many cases of epilepsy, allthe above-described reasons are completely irrelevant. In order for the child to have epilepsy, it is enough ordinary genetic predisposition. It is the genetic predisposition that causes an increased excitability of brain cells, a violation of metabolic processes, normal electrical activity.
Types of epilepsy in children
Doctors distinguish several varietiesepilepsy, depending on the nature of its origin and the features of the course of the disease. Different types of epilepsy require absolutely different principles of treatment and care for a sick child. So, what is it like, this mysterious epilepsy?
- Idiopathic anemia.
Immediately after the doctors appearreason to believe that a child suffers from epilepsy - usually after the first attack - they begin to conduct a thorough examination of the child, whose purpose is to identify the root causes that cause the disease. However, sometimes doctors can not find those reasons that triggered the development of epilepsy. And in this case we are talking about the "asymptomatic" form of the disease - idiopathic anemia. In such cases, when collecting an anamnesis, it turns out that one of the relatives of the baby, often very, very distant, also suffered from epileptic seizures. But do not panic if someone from your family and friends has suffered from epilepsy - this does not mean that your children's epilepsy will be a compulsory companion. By inheritance, only the propensity to epileptic seizures can be transmitted, but not the disease itself. And on deciphering the electroencephalogram doctors clearly see the epilepsy characteristic pathological electrical activity of the brain, but the disease itself is not always present in the child. It manifests itself only in the presence of certain unfavorable factors. Incidentally, the prognosis for idiopathic form is most favorable. And the course of this form of the disease is also the easiest.
- Symptomatic epilepsy.
Symptomatic epilepsy, or secondary,develops in the event that the cause of its occurrence is some organic brain damage. There is a fairly large number of various factors that can lead to the onset of organic brain damage. Such factors include:
- Adverse effects on the child during intrauterine development.
- The defeat of the central nervous system that resulted from the resulting birth trauma.
- Asphyxia of newborns flowing in severe form.
All these factors, provided there is a genetic predisposition, can form an epileptic focus in the cerebral cortex of a child.
Other features of the forms of anemia
In addition, both somatic and idiopathic types of epilepsy are divided into two subspecies:
- Localized form of epilepsy.
Localized is called such an epilepsy, in which the epileptic focus of the child is strictly localized in a certain area of the cortex of the brain.
- Generalized form of epilepsy.
In the event that a child suffers from a generalized form of epilepsy, the whole brain, including any part of the brain, participates in the epileptic seizure.
- Mixed form of epilepsy.
In addition to localized and generalized formsThere is another epilepsy - mixed. Epileptic attack begins as a localized one, but very quickly it is transformed into a generalized one. Similar epileptic signs are also called secondary generalized. Epilepsy in children has symptoms in this case, and that, and another form of the disease.
Large epileptic seizures
However, not only the disease itself is dividedon different species. The same goes for the epileptic seizures themselves. Doctors distinguish two types of epileptic seizures that are significantly different, requiring a different approach to treatment: In most cases, children have precisely large generalized epileptic seizures. Similar seizures are accompanied by a sharp loss of consciousness, a child's fall and cramps. Epileptic seizure occurs in several phases. In the first phase, the child begins cramps - a kind of involuntary tension of all the muscles of the body and limbs. At the child the respiratory process for a while stops, because of what the coloring of integuments gets a cyanotic shade. After 30 - 40 seconds, breathing is restored, and the attack flows into the tonic phase. Convulsive spasms in the limbs subside, turning into easy rhythmic twitchings. These twitches end in about a couple of minutes. After this, there comes the phase of the so-called "post-epileptic" sleep. Sleep lasts only a few minutes, after which the sick child wakes up, not remembering anything that happened during the seizure. Due to the fact that the attack is accompanied by tonic convulsions, including convulsions of the chewing muscles, the sick kid during the fit with a very high risk of risk biting the tongue. And, in addition, at the peak of an epileptic fit in a sick child, spontaneous urination often occurs. Symptoms of epilepsy in infants may vary slightly. There are a number of features of large generalized seizures in children, the characteristics of which all parents who are faced with a similar problem should know. This knowledge will help parents to save their crumbs during seizures from unnecessary complications:
- Convulsions. During tonic convulsions very carefully, but firmly enough to hold the handle and legs so that the child does not accidentally hurt himself - not scratched or hit something.
- Biting the tongue. As already mentioned above, very often during epileptic seizures a child bites his tongue. Be sure to remember this and during the attack of the disease, be sure to fix the language of the child. Your doctor will show you how to do it correctly.
- "Post-epileptic" sleep. After an epileptic seizure, a child has a post mortem sleep. It is highly desirable for parents to not bother their child for several minutes, but to let them wake up on their own. By the way, for about two to three hours a child may have weakness in his arms and legs.
There is also such a thing asstatus epilepticus. Epileptic status refers to those cases in which epileptic paroxysms last one after another, and their duration increases all the time. Such a state endangers the life of the child, so it is necessary to deliver it as soon as possible to the nearest medical institution or call an ambulance team if you are at home. Typically, this phenomenon is very, very rare. Most often, the child has single epileptic seizures that do not represent any threat to his life. However, sometimes, extremely rarely, a baby with epilepsy begins with exactly the same epileptic status, which requires an immediate resuscitation package.
Harbinger of epileptic seizure in children
As a rule, most children have an epilepticthe attack appears completely unexpectedly, like a thunder from the blue, when nothing seems to be predicting the approach of an epileptic seizure. However, sometimes some children feel the approach of an attack in a few minutes, sometimes even hours, noting the changes in their condition. Of course, this phenomenon is observed only in older children, who already understand everything and can note changes in their state of health. After all, a small child, as you know, can not do it. Such precursors of an epileptic seizure include:
- Headache. Moreover, it should be noted that the headache can be absolutely anything - sharp, aching, weak or strongly pronounced, lasting only a couple of minutes or longer. However, remember that the headache can be a sign of other diseases, often quite serious.
- Irritability. Sharply arising causeless irritability and tearfulness of the child can also testify to the approaching epileptic fit. However, remember that the mood of a child - a very changeable thing. Therefore, not every hysterics indicates that an epileptic seizure is about to begin.
- Impairment of appetite. Sometimes shortly before the attack, children almost completely lose their appetite. And sometimes and at all nausea and vomiting begins.
Small epileptic seizures
In addition to large there are also smallepileptic seizures. Their manifestation is very diverse, but strong seizures and falls, which are typical for a large epileptic fit, are not observed. There is also a difference in the duration of epileptic seizures - small ones last only a few seconds. A sick child suddenly faints, his consciousness is turned off. However, it returns in a few seconds, and the child quietly continues to do the same things he did before - playing, reading, watching TV. Typically, young children do not even realize that something has happened to them, and only at a later age does the child realize that something is happening to him. Small epileptic seizures can be quite regular - up to several times a day. Do doctors distinguish various forms of small epileptic seizures? However, the most common is absense. They are very similar to those described above - the child freezes for a couple of seconds, losing touch with the world around him. He does not fall, he does not have cramps. Such forms of epileptic activity are most typical for school-age children, and their frequency can reach several tens per day. Such children are greatly reduced in school performance: they become inattentive, and from the side it may seem that the child at the time of an epileptic seizure is simply busy with his thoughts. Very often in the notebook of the child you can see the omissions of the text - they occur just at the time of the epileptic attack. Parents, and teachers, it is extremely important to remember this feature of small epileptic seizures. In the event that a child for no reason, for no apparent reason, has greatly deteriorated school performance, he has a gap in the letter, an absent look - do not rush to scold and punish the child. You should consult a doctor to exclude the possible presence of a child such a disease as this. In no case should not ignore such phenomena. It is much better if the doctors examine the child and do not detect the disease than they do not examine, and it will remain unrecognizable. In the future, if there is no necessary treatment, the disease will continue to progress.
Diagnosis of the disease
Due to the fact that epileptic seizures havequite diverse manifestations, the diagnosis of the disease is often extremely difficult. Often the description of the parents of convulsive syndromes is very much like a description of the true epileptic seizures. However, later, with in-depth detailed examination, the doctor understands that the fact that the child does not actually suffer from epilepsy. As a rule, in the event that a child suffers from a convulsive syndrome, and not from epilepsy, the causes that cause seizures will be established quickly enough. After the child receives the necessary treatment, and the causes are eliminated, the child's seizures will stop. There is also another type of seizure - febrile. Such a convulsive symptom arises against a background of significantly increased body temperature. As a rule, such a reaction to hyperthermia is an individual feature of the child's body, and no treatment is required. The diagnosis of a convulsive syndrome in a child requires a doctor of high qualifications, experience and responsible approach to this issue. The doctor should ask parents in detail about how long the child has started seizures, how often they last, their duration, the peculiarity of their course. After this, the doctor will give the child an additional examination:
- Electroencephalographic examination.
- Computer or magnetic resonance imaging.
- Positron emission tomography.
- Dopplerography of cerebral vessels.
And on the basis of all the data obtained, the doctor will determine whether epilepsy has occurred, or else the convulsive syndrome is caused by some other reasons.
First aid for a child with epileptic seizure
As mentioned above, the child duringepileptic seizure in need of first emergency care. Strictly speaking, the real threat to the health of the child is not the short-term epileptic seizures themselves, but the loss of consciousness by the child during it and, as a consequence, the fall of the baby. That is why all parents and other adults surrounding the sick child should know exactly how to behave with the child during an epileptic fit. And do not just know it in theory, but be able to apply it in practice. About how to help the child during the attack, has already been told above. But it's also worth mentioning what to do after the end of the attack. Observe the following rules:
In some cases, it's better not to act on your own, but as soon as possible call an ambulance team. Such cases include:
- The child had a convulsive attack for the first time.
- The duration of seizures lasted more than five minutes.
- Seizures repeated in less than 30 minutes.
- During the seizures, the child was injured.
- After cramping, the child's breathing does not return to normal within three minutes, remains convulsive, heavy and uneven.
Treatment of epilepsy in children
The treatment of epilepsy is quite complex and takesa very long time, almost the whole life of the child. Treatment should appoint only a doctor. The treatment regimen is selected strictly individually, taking into account the characteristics of the general condition of the child, his age and the nature of the course of the disease. A huge part of the treatment falls on the shoulders of the parents. As already mentioned, treatment is often necessary for the child throughout his life. The main task entrusted to the treatment of epilepsy is to prevent the recurrence of epileptic seizures. Or, at least, reduce their intensity and frequency of occurrence. This article will not give the names of any drugs for epilepsy. All anticonvulsant pharmacological agents should be prescribed only by a doctor, taking into account the survey data and the individual reaction of the child's organism to a particular drug. There are very strict guidelines for the treatment of this disease. Almost all doctors strictly follow them, and parents should know about them. It is very important to choose the correct dosage of the drug - it should strictly correspond to the age and weight of the child. During the very beginning of treatment, not the entire age dose of the antiepileptic drug is prescribed, but only a part of it. Increase the dosage gradually, carefully monitoring the health of the child, until the optimal one is selected. The effectiveness of the drug can be assessed no earlier than 14 days after the start of the drug. Typically, the selected dosage of the drug does not change for several years. Important! All drugs should be taken by the child systematically! It is inadmissible to skip a single reception! In the event that this principle of taking medications is disrupted, the course of the disease is significantly worsened, seizures become more frequent and more pronounced. The chances of your child recovering are also significantly reduced. In addition, an independent reduction in the dosage of the drug or its complete cancellation, can cause such complications as the development of status forms of epileptic seizures, as well as violations of the child's psyche. Do not put experiments on your child. In the event that the treatment has given a positive dynamic and the seizures do not recur within three to five years, the child's attending physician may decide to cancel the antiepileptic drug. However, the abolition must also be carried out wisely, so as not to harm the child and not worsen his state of health. The abolition of anticonvulsant drugs should in no case be done abruptly. Dosage should decrease gradually, for at least a month, under the strict supervision of doctors and various surveys. At the slightest deterioration in the child's well-being, the dosage should be slightly increased for a while. In addition, in no case should we forget about such a phenomenon as a provoking factor. Such factors can be:
- Vaccination of the child.
- Hyperthermia is an increase in the body temperature of a child, especially if the temperature rises above 38 degrees, or else it keeps continuously more than one day.
- Heavy infections and intoxication of the body.
- Craniocerebral injuries received by a child.
In such situations, doctors, to avoiddeterioration of the health of the child, it is recommended to give the child preventive doses of the drug. However, the dosage and drug should also be prescribed by a doctor, not by mom and dad. It is also necessary to remember the fact that treatment with antiepileptic drugs, even if they are prescribed strictly with the age and weight norms of the child, can cause signs of general intoxication of the body. Such a condition is characterized by such signs as a violation of the ability to coordinate movement, the appearance of a feeling of nausea, perhaps even the appearance of vomiting, a child can quickly get tired and always want to sleep. Also allergic reactions are frequent, both from the side of the skin and from the respiratory organs. In such cases, the dosage of the drug should be changed or the drug itself should be replaced. And, it goes without saying that all these changes and appointments are in no way inadmissible to do on their own - leave this right behind the attending physician - a neurologist who has been closely monitoring the state of health for a long time and knows the specifics of the child's disease course. In no case do not self-medicate - no traditional medicine, plant and homeopathic remedy can not replace adequate treatment with medicines. All these funds can serve only as auxiliary, and then only after the approval of the attending physician. Otherwise, you put your child's health at an unreasonable risk! Parents of a child suffering from epilepsy should have a special diary in which it is necessary to note all the changes in the state of the child:
- The frequency of epileptic seizures, their duration.
- The reaction of the child's body to the appointment of new drugs or changes in dosage.
- Other diseases of the child.
The way of life of a child suffering from epilepsy
Illness is a disease, but the child, despitethat, continues to be a child. And parents should help him as fully as possible to adapt to life in this world with his illness. And parents themselves must take into account a huge number of nuances. So, for example, a child's illness. All children are periodically ill with various childhood diseases, flu, colds. This applies to those children who suffer from epilepsy. Remember that these babies require parents to pay more attention. Be attentive to the choice of medicines. Very many medications can have a significant effect on the action of antiepileptic drugs. Some drugs can also provoke an increase in the epileptic activity of the baby's brain and, as a result, provoke the development of another epileptic episode in the child. In order to avoid the occurrence of such situations, parents should have the fullest information about each of the drugs that they are going to give their child. And it will be more reasonable before giving a child this or that drug, consult his treating doctor - neurologist. It is also very important to give enough time to the moral side of the problem of epilepsy. Child psychologists who have worked with children suffering from epilepsy for a long time believe that the child should have an idea of his illness and what is happening to him. Of course, information should be submitted to the child in a form that is understandable to him. In addition, adults should take care of the fact that the team in which the sick child is in the know that the baby can become bad at any time and he will lose consciousness. Do not hide this information from others, as there is always a risk that an epileptic seizure will occur in a child outside the home. Yes, and adults surrounding the child - teachers in the school, kindergarten teachers, will be able to provide the child with the first aid only if they have the necessary information and are aware of a phenomenon such as epilepsy in children. Be sure to keep track of what kind of lifestyle your child is leading. Remember that the right way of life is simply necessary for a person suffering from epilepsy. Watch your child's sleep - it should last at least 10 hours a day. Also, try to prevent the child from playing too much computer games and watching TV. A dynamic picture is an excellent factor that can provoke the development of an epileptic attack. Instead of sharing the next action movie or drama, turn off the TV and go for a walk. And the most important task that faces all parents of children suffering from epilepsy is to convince their child that there is nothing terrible or shameful in his illness. And once your child understands this, a huge number of psychological problems will disappear. We advise you to read: