Infant convulsion

Introduction Infant and child convulsions: convulsions, medically known as "convulsions", is a common emergency in childhood, children suddenly twitching limbs, shaking their heads, blinking, waking up, foaming in the mouth, incontinence, Western medicine called convulsions, Chinese medicine said It is a gust of wind. There are many reasons why a baby can be amazed. High fever is the most common cause of convulsions in infants, so parents must pay attention to the uncomfortable performance of the baby. Once the baby has a high fever and has symptoms similar to infant convulsions, take the baby immediately.

Cause

Causes of convulsions in infants and young children:

A common cause of convulsions is high fever. In addition, meningitis, craniocerebral trauma, epilepsy and other diseases can also cause convulsions, mainly due to the sudden and massive abnormal discharge of cerebral cortical motor nerve cells, resulting in temporary, involuntary contraction of the whole body or local muscles, often accompanied by disturbance of consciousness. The specific performance is binocular gaze, strabismus or upturn, the complexion turns from red to green, the head turns to one side and leans back, the muscles of the face and limbs are clonic or tonic twitching; due to the laryngeal spasm and poor airway, it may be accompanied Breathing; some children have incontinence. Generally, convulsions last for a few seconds or a few minutes, and the baby is often very weak, wants to sleep, and then goes into a state of drowsiness. The baby's convulsion often makes parents unprepared. If not handled properly, it will cause serious consequences. Here is a brief introduction to the emergency treatment of the baby's convulsion.

an examination

Related inspection

Brain nerve examination CT examination

Examination and diagnosis of infantile convulsions:

1. The newborn baby suddenly does not open, does not eat, and a slight irritating stimulus causes systemic twitching. It should first consider the infection of tetanus in the delivery.

2. If a newborn is born with a forceps before delivery, there is a large blood blister on the head, sudden convulsions, no fever, should consider intracranial hemorrhage.

3. A slightly larger baby's milk infection is as usual, the limbs or face suddenly twitch, no fever, should first think of calcium deficiency.

4. In case of convulsions and fever, lack of energy, vomiting, bulging in front of the head (front squatting), neck stiffness, should be thought to be infected with meningitis or encephalitis.

5.3 ~ 5 years old children suddenly do not wake up personnel, convulsions biting tongue, mouth spitting foam, incontinence, it is likely to be epilepsy.

In short, any disease that can cause abnormal discharge of cerebral cortical neurons can cause convulsions.

Differential diagnosis

Infant and child convulsions are easily confused:

1, high fever: fever is a common symptom of a variety of diseases. High Fever is clinically critical. Normal body temperature in children is usually measured by anal temperature of 36.5 ~ 37.5 ° C, and temperature of 36 ~ 37 ° C. Under normal circumstances, the temperature of the sputum is 0.2 to 0.5 ° C lower than the mouth temperature (sublingual), and the temperature of the anus is about 0.5 ° C higher than the temperature of the sputum. Although the anus temperature is more accurate than the temperature, it is often based on various reasons. If the temperature exceeds 37.4 ° C and the body temperature fluctuates above 1 ° C during the day, it is considered to be fever. The so-called low heat means that the temperature is 37.5 ° C 38, the moderate heat is 38.1 ° 39 ° C, the high heat is 39.1 ~ 40 ° C, and the super high heat is 41 ° C or more. Long-term fever is caused by fever for more than two weeks.

2, epidemic meningitis: epidemic meningitis is an acute infectious disease caused by meningococcus. When a healthy child inhales the dust of the bacteria, the pathogen first invades the respiratory mucosa, which is characterized by fever, cough, runny, etc., and the performance is not easily distinguished from the general cold. Some children are controlled during the upper respiratory tract infection. If they are not controlled, the bacteria will enter the blood circulation and form bacteremia. At this time, it is characterized by high fever, nausea, vomiting, skin sputum and ecchymosis, which are mainly characterized by shoulders, elbows, buttocks and other parts that are easily pressed.

3, purulent meningitis: purulent meningitis (purified meningitis), is caused by various pyogenic infections caused by meningeal inflammation. Pediatrics, especially in infants and young children. Since the use of antibiotics, the mortality rate has dropped from 50% to 90% to less than 10%, but it is still one of the serious infectious diseases in children. Among them, meningococcal bacteria are the most common, can occur epidemic, clinical manifestations have their own specificity, called epidemic cerebrospinal meningitis.

4, tuberculous meningitis: tuberculous meningitis (Tubercolous meningitis) is the most important type of tuberculosis in children, usually more than 3 months to 1 year after the original tuberculosis infection, more common in children 1 to 3 years old . The course of tuberculous meningitis from onset to death is about 3 to 6 weeks, which is the most important cause of tuberculosis death in children. Before the advent of anti-tuberculosis drugs, the mortality rate was almost 100%. Since the widespread promotion of BCG vaccine and the prevention and treatment of tuberculosis in China, the incidence of this disease has decreased significantly compared with the past, and the prognosis has been greatly improved. Most cases can be cured if diagnosed early and treated reasonably. However, if the diagnosis is not timely and the treatment is not appropriate, the incidence of mortality and sequelae is still high. Therefore, early diagnosis and reasonable treatment are the key to improving the prognosis of this disease.

5. Japanese encephalitis: The pathogen of epidemic encephalitis B (hereinafter referred to as JE) was discovered in Japan in 1934, hence the name Japanese encephalitis. In 1939, the Japanese encephalitis virus was also isolated. After a lot of investigation and research work, renamed epidemic encephalitis. The disease is mainly distributed in the Far East and Southeast Asia, and is transmitted by mosquitoes. It is more common in summer and autumn. It is clinically acute, with high fever, disturbance of consciousness, convulsions, tonic spasm and meningeal irritation. Aftereffects.

7, viral meningitis: Viral Meningitis (Virus Meningitis) is a central nervous system infectious disease caused by a variety of different viruses, also known as aseptic meningitis or serous meningitis. The disease is found all over the world. Its incidence rate is 11 to 27/100,000 per year. The clinical manifestations are similar, mainly invading the meninges and causing meningeal irritation, and there are lymphocytes mainly in the cerebrospinal fluid. The course of the disease was benign, mostly within 2 weeks, generally not more than 3 weeks, with self-limiting, good prognosis, and no complications. The virus invades the meninges and forms meningoencephalitis if it also invades the brain parenchyma. According to the condition of the disease, it may be of a different size and may be scattered. It is generally believed that this disease belongs to the category of traditional Chinese medicine for warm disease and phlegm and blood stasis. It is caused by warming out of the heat, burning people, closing the heart and igniting the liver wind.

8, toxic encephalopathy: toxic encephalopathy is a central nervous system organic disease caused by poison, can appear a variety of clinical manifestations. Brain pathological changes include diffuse hyperemia, edema, punctiform hemorrhage, neuronal degeneration, necrosis, and demyelination of nerve fibers. Acute toxic encephalopathy caused by acute poisoning of lead, bismuth, tetraethyl lead, organic mercury, benzene, gasoline, carbon disulfide, methyl bromide, organophosphorus, organochlorine pesticides and other asphyxiating poisons such as carbon monoxide, cyanide and hydrogen sulfide Early symptoms include headache, dizziness, lethargy, nausea, vomiting, etc., followed by hallucinations, disturbances of consciousness, and increased intracranial pressure. Severe patients may develop cerebral palsy. Treatment is only for cerebral edema and hypoxia. Chronic toxic diseases are caused by severe chronic lead, mercury, manganese, tetraethyl lead, organic mercury, carbon disulfide and other poisoning, clinical manifestations of tremor paralysis syndrome, toxic schizophrenia and toxic dementia. Treatment is similar to related neuropsychiatric patients except for dissociation and special effects.

9, neonatal tetanus: neonatal tetanus, also known as "four-six winds", "umbilical wind", "seven winds", etc., refers to the invasion of Clostridium to the umbilicus, and the production of scorpion toxins caused by the teeth An acute infectious disease characterized by tightness and muscular tonicity. With the application and promotion of new urban and rural birth control technologies in China, the incidence of this disease has been significantly reduced.

10, brain abscess: pathogens such as bacteria, fungi or parasites invade the purulent inflammation caused by brain parenchyma, and then form an abscess. The abscess is formed in the brain parenchyma, which is clinically characterized by increased intracranial pressure, localized signs, and infectious symptoms. Brain abscesses caused by the latter two pathogens are rare. It can occur at any age and is more common in children and young adults. The incidence rate is about 2% of inpatients in neurosurgery, and the ratio of male to female is about 2.5:1.

11, the newborn baby suddenly does not open, will not eat, a slight sound stimulation will cause systemic tics, should first consider the infection of the tetanus.

12, if a newborn is born at the birth of a forceps to deliver, there is a large blood blister on the head, sudden convulsions, no fever, should consider intracranial hemorrhage.

13, a little older baby eating milk infections as usual, limbs or face suddenly twitching, no fever, should first think of calcium deficiency.

14, in case of convulsions and fever, lack of energy, vomiting, head (front squat) bulging, neck stiffness, should be thought to be infected with meningitis or encephalitis.

15, 3 to 5 years old children suddenly do not wake up personnel, convulsions biting tongue, mouth spit foam, incontinence, it is likely to be epilepsy.

In short, any disease that can cause abnormal discharge of cerebral cortical neurons can cause convulsions.

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