Epilepsy in children. Causes, symptoms and treatment, clinical guidelines

Epilepsy - is a chronic type of the disease, characterized by impaired functioning of brain cells and the nervous system is manifested by spontaneous contraction of muscles. This pathological condition is observed in both children and adults. Despite the fact that the disease is already more than 100 years, the causes are not fully understood.

The mechanism of occurrence of epilepsy

All contractile muscle movements due to electrical pulses, which are formed in the neurons of the brain and are sent through the cells of the nervous system. In normal operation, after the signal transmission, the neuron becomes resting phase, before the next transmission pulse the necessity.

Epilepsy in the brain there is a kind of center clusters of neurons are constantly in an excited state. The cells in the resting phase creates a barrier preventing transmission of pulses. But sometimes the signal breaks through the protection, at the same time in the excited state of substantially all the neurons. This violation causes the development of epileptic seizure.

The patient noted an unnatural contraction of the muscles, may urination and loss of consciousness. After neuronal excitation pulse total yield subsides. Contraction of muscle fibers to normal, the attack gradually recedes. The victim feels pain after the seizure of muscle tissue due to its strong surge and extreme weakness.

Before beginning an attack in a patient there is an increase of the temperature indicators may be present hallucinations (auditory, visual) as well as the familiar sensation of taste or smell. High temperatures can cause fever or chills. They provoke the development of further seizures.

In childhood epilepsy dangerous increase in the size of focal accumulations of excited neurons or their plural form.

As a result, after the pulse from the source at one side of the brain (with subsequent decay of excitation of neurons) signal breakthrough may occur in the other locus. That increases the number of seizures. Seizures violate the physical and mental development of the child.

The causes of the disease in children

Epilepsy in children (the causes are acquired or congenital in nature) is manifested in the presence of the following abnormalities:

Cause	Description
Predisposition to genetic level	The presence of epilepsy in the immediate family
Disruption of the brain cells	Head injury with open and closed injuries
Surgery on the brain tissues
Infectious diseases (meningitis, encephalitis) in which the agent can penetrate to the brain cells and disrupts its activity
Strong emotional stress
Natal brain tissue formation violation	Lack of oxygen
The use of the mother drug, potent medications or smoking during gestation
strong toxicosis
Infectious diseases in the mother, especially at the beginning of pregnancy
Injury during childbirth	Clamping of the baby's head
Rapid or prolonged labor
Neoplastic processes in the brain tissue	Malignant or benign
Circulatory disorders of vessels in the head	It can be caused by head trauma, infections or tumors
Disruption of the heart muscle	Stroke
chromosomal abnormalities	congenital acromicria

Since epilepsy is a little known disease, so the list of possible causes is regularly updated.

Factors that trigger epileptic seizures

Availability of reasons indicates the likelihood of the development of epileptic seizures.

Sami attacks occur under the influence of provoking factors:

• lack of vitamins and minerals in the diet;
• disease accompanied by an increase in temperature characteristics to high elevations;
• stressful situation or fright;
• strong nervous or physical stress;
• loud noise or bright light;
• failure to sleep;
• vaccine formulation;
• severe poisoning;
• infectious disease in a severe form;
• injury of brain tissue;
• taking potent medicines affecting the nervous system and the blood;
• skipping receiving antiepileptic drugs.

Neonates may provoke an attack of severe motion sickness.

varieties disease

Epilepsy in children (the causes differ by type of pathology) can occur in different forms.

Depending on what area of ​​the brain hit by epilepsy is divided into 2 main types:

• Focal. Characterized concentration hotbeds in one hemisphere of the brain.
• Generalized. With this type struck both hemispheres.

Both types of epilepsy have an additional division for development reasons disease and the excited neurons localization:

1. idiopathic epilepsy develops due to the presence of genetic factors, wherein the additional changes in brain structure is not observed. Divided into subspecies:

• rolandic;
• Gastaut syndrome.

2. symptomatic epilepsy It has acquired the character develops due to internal or external influences on the brain cells. Divided into subspecies:

• temporal. The hearth is localized in the temporal region. Often due to the birth or personal accidents;
• frontal. Excited neurons are located in the frontal part. Seizures often occur at night;
• parietal. This form is more common in adults;
• occipital. In children it is rare;
• chronically progressive.

3. Cryptogenic epilepsy. When attacks causes are not identified.

There are also additional separation of the focal and generalized epilepsy severity of seizures, frequency of seizures and the muscle group involved.

The main symptoms of the disease

Symptomatology of seizures depends on the excited neurons localization zone.

But there are major signs characterizing the pathology:

• clouding or loss of consciousness;
• violation of the motor function of limbs;
• hallucinations (visual, auditory or flavorings);
• a sudden change of mood;
• respiratory failure frequency;
• muscle tension;
• violation of view of concentration, the emptiness in his eyes.

Additionally epilepsy accompanied by frequent psychological disorders (depression, nervous breakdowns, tantrums).

Generalized seizures

They are the most dangerous and contain pronounced symptoms:

1. It begins fit with small hallucinations, chills or tingling due to changes in temperature characteristics.
2. body muscles tense up strongly, so that the patient loses his balance and crashes in breathing.
3. Further, there are strong muscle contraction (spasms) Rolling Eyes with foam and release from the oral cavity.
4. Additionally, it may occur spontaneous release of urine and feces.

Seizure duration from 10 seconds to 20 minutes. At the end of the patient temporarily regains consciousness at the same time experiencing severe muscle weakness. After 2-5 minutes a deep sleep occurs.

Non-convulsive generalized seizures

This form is typical for the age period from 5 to 15 years and takes less noticeable. Often it left without much adult attention.

Signs of a seizure:

1. Focusing and fading eyes on one point. Pupils are empty. Possible closure of the eyelids with tilting the head back.
2. Duration of detachment from the external world is not more than 20 seconds. At this time, it is impossible to draw the patient's attention.
3. After completion of the attack the patient returns to continue the activity.

This behavior is often similar to pensive. After 15 years of epilepsy retreats or moves into a more severe form.

atonic seizures

Atonic seizures are characterized by sudden relaxation of muscle tissue and loss of consciousness. This type of seizure is different from the repetition frequency of syncope without significant provoking factors.

Infantile spasms

Epileptic seizures are characteristic of this form for ages 2 to 5 years. They appear at the moment of waking up after a night's sleep. The child presses the hands to the chest, the upper part of the body takes the form of a semicircle with the tilt head forward. The legs are in a straight condition.

The duration of 1 min. After 5 years of attacks disappear or turn into a more severe form.

Other symptoms of epilepsy in children

Epileptic seizures in children and may be accompanied by additional features that are rarer:

• temporary disturbance of speech. In this case there is no disturbance of consciousness or muscle tissue overvoltage;
• frequent awakening during the night's rest with altered breathing and fright;
• scoring movements during sleep (sleepwalking);
• sudden and severe headache, with no precipitating factors. Perhaps with vomit;
• sudden jerking of the century and other contractile activity of one muscle group with regular repetition.

These symptoms are not always a sign of the presence of epilepsy, but require timely survey to identify the exact cause.

Epipristupov especially in infants

Children under one year are also possible seizures. These symptoms depend on the cause of the pathology caused, but expressed in the box, compared with features in adults. Parents are important to promptly detect the onset of attacks for proper first aid.

Characteristic features of epilepsy in infants:

• beginning an attack characterized unreasonably increased tearfulness, increased activity and an increase in temperature characteristics to a level above 38 degrees;
• child can suddenly freeze and does not respond to external stimuli;
• sudden cessation of swallowing;
• fading sight;
• twitching of eyelids;
• arbitrary zakidyvanie head back;
• WinCE without fear;
• temporary loss of consciousness with a complete relaxation of muscle tissue;
• spontaneous flexion of arms and legs;
• Changes in skin color on the face (flushing, pallor or cyanosis);
• violation of the rhythm of respiration or cessation of Sighs 10-15 seconds;
• emptying of the bladder and bowel in an unconscious state.

After the end of the seizure the child may continue to continue to watch. When epileptic seizures, these symptoms are repeated at regular intervals. After 6 months, the appearance of foam is possible and enhancement of breath twitch.

methods of diagnosis

Timely diagnosis of epilepsy in children will prevent the development of disease in the severe forms.

Stages and methods for determining pathology:

1. Anamnesis pathology:

• visual inspection of the child;
• when the first signs were noted;
• clarification and possible genetic predisposition;
• to prevent the possibility of developing the disease as a result of injury during childbirth or due to the formation of brain damage in the womb;
• identify possible trigger factors (after which most often has attacks observation of parents);
• description of the frequency of seizures and their manifestation.

2. The study of brain cells using electroencephalogram reveals the center cluster of excited neurons and track activity of nerve cells.

3. Study genes. To determine the transmission of the disease is inherited genes or for detecting mutations.

4. Magnetic resonance imaging or computed tomography. To study the activity of brain cells.

5. Investigation of the behavior during an epileptic seizure. To do this, create triggers (bright light, loud noise, physical or mental overload);

6. A study of the fundus by an ophthalmologist.

In addition, taken blood and urine samples. Changing their composition can indicate the probable cause of seizure development.

At suspicion of epilepsy due to trauma, infection or of tumor diseases additionally assigned:

• roentgen brain (trauma);
• electrocardiogram (in violation of the heart);
• spinal tap (with suspected tumor development or the influence of infection).

After completion of the diagnostic procedures and confirm the diagnosis, parents receive instruction on the rules of first aid and treatment assignment. The child remains under the control of a regular neurologist and pediatrician (frequency of visits set individually).

First aid for seizures

First aid is from the outset. It requires timely (if possible) to define the beginning of an attack. In this case, the danger is traumatizing the fall.

The sequence of actions of parents at the beginning of the attack:

1. Keep calm, so that the child does not panic.
2. Give the child a horizontal position away from sharp edges and objects.
3. Head recommended to hold hands or lock securely.
4. If possible, lay the child on the side to avoid getting vomit and saliva into the airways.
5. Loosen the top buttons on clothes and remove the ornaments on the neck;
6. Ensure adequate supply of fresh air.
7. Before the beginning of the attack to put in the mouth soft cushion (can be from a handkerchief) to avoid injury to the language and teeth. During the attack of these activities are prohibited.

Timely help to reduce the risk of injury during the period of the attack.

The sequence of actions at the time of the attack:

1. Do not give your baby to roll over on his back.
2. If possible, limit the movement of the limbs, in order to avoid injury. But do not put strong efforts, as the probability of injury to muscle tissue.
3. Do not leave your child alone until the complete cessation of seizure and recovery of consciousness.

After the end of an attack the following measures are recommended:

1. Check rhythmic respiratory movements. In the absence of artificial respiration process.
2. Comply with horizontal or sitting position to a full restoration of the state after the attack.
3. Do not allow to use liquid and solid food until you have eliminated all the symptoms completely.
4. While maintaining high temperature performance is required intake of antipyretics.

Emergency call is required at the first seizures or frequent repetition frequency, as well as personal injury when fit. If possible, remove yourself fit in the video, in order to facilitate diagnosis.

Treatment of epilepsy in children

Epilepsy (children cause of the need to eliminate gradually, so the treatment takes a long time) requires combination therapy. Drugs and treatments are selected individually for each patient, the general schemes of treatment does not exist.

Unauthorized modification of the course or cancellation of drugs while improving, could aggravate the situation and increase the frequency of seizures increased symptoms. The goal of treatment is to reduce the number of attacks to a minimum. Timely therapy in children in rare cases, can result in complete recovery.

antiepileptic drugs

To eliminate epileptic seizures using 4 kinds of medicines. Importantly, the reception begins with the minimum dose. Further, under the supervision of a specialist, there is a gradual increase in dosage. Even interrupt the course of 24 hours is prohibited.

List of drugs:

1. anticonvulsant. Contribute to removal of muscle tissue and eliminate the overvoltage seizures. Used in the vivid forms of manifestation of epilepsy. To these medicines include:

• phenobarbital;
• benzobarbital;
• carbamazepine;
• Primidone.

2. Tranquilizers. Can reduce excitation in nerve cells. Most often used for small attacks. List of drugs:

• diazepam;
• phenytoin;
• phenazepam;
• Lamotrigine.

3. Sedatives. To speed up the normalization of nerve cells after the attack. Specialists appointed by the following drugs:

• Pantogamum;
• Children tenoten;
• nootrop;
• Glycine.

4. Injection. Used in strong violation of orientation in space or under bright psychological disorders. List of drugs:

• aktovegin;
• Cere.

Experts select the compatibility of drugs and the full course. The duration of administration depends on the dynamics of seizures. Treatment can take up to 10 years.

Folk remedies

Folk remedies recommended to use in conjunction with the reception of medicaments. Provided that they are compatible (check with your doctor is required). Decoctions of soothing herbs and tinctures allow to remove excess stress in the cells of the nervous system. Which facilitates the flow of attack.

Recommended recipes:

• connect rose hips and black chokeberry with chamomile, valerian root and calendula in equal proportions. In 180 ml of boiling water 30 g steamed mixture. Infuse thermos 25 min. The beverage divided into 4 doses and consumed within days;
• steamed in 180 ml of 15 g of dried lavender flowers. Consumed before a meal to 25 mL;
• brew a mixture of 20 g (chicory root, and dandelion in equal proportions) in 180 ml of boiling water. Divided into 2 doses, use morning and evening.

You can also use aroma oils uspokayuschego action. And compliance with food enriched with vitamins and minerals.

Psychotherapy

Epilepsy is often provoked by fear, stress and anxiety. For the normalization of the need to consult a psychologist.

Treatment may comprise the following methods:

• appointment of sedatives;
• baby talk to a specialist for removal inferiority complex due to the presence of the disease;
• hypnotic.

This method is considered to be valid, and allows you to get rid of the attacks is not worse than taking drugs. But it is not suitable for every patient. A properly conducted hypnosis or psychological impact can only aggravate the situation.

Surgical intervention

Surgical treatment is applied when epilepsy provoked by the presence of tumor formation in the brain tissues or receiving head trauma.

In other cases, this practice is rarely used, only in the absence of results at medical treatment and worsening of the disease. The danger of this treatment lies in the probability of subsequent paralysis, loss of vision or hearing.

Physiotherapy

Physiotherapy administered with medication intake.

To remove the raised nervousness appointed:

• relaxing massages;
• regular visits to water treatment;
• magnetic therapy. Formed by the magnetic field acts on neurons, improves blood circulation and increases the absorption of drugs;
• electrophoresis. Used for administration of medicines with a low discharge current.

These procedures have contraindications. Therefore, the expert appointed after eliminating prohibitions.

Influence of trace elements on child epilepsy

Epilepsy in children (the causes are often associated with malnutrition) requires receiving the complex vitamin supplements containing zinc and magnesium. Since their deficits often observed bouts of epileptic seizures.

Forecast

With early diagnosis of disease, especially in childhood, it allows to reduce to a minimum the attacks or stable remission. In the future total abolition of medicaments. With strict observance of professional purposes.

How epilepsy affects a child's life?

If the child is under the supervision of specialists and is being treated with a drug and a visit to a psychologist, that epilepsy does not have a strong influence on lifestyle. It is important that people knew CPR and first aid in the event of an attack.

A way of life that is possible and impossible, that it is forbidden

To reduce the number of attacks recommended to comply with the rules prescribed by the doctor:

• powered with a sufficient amount of vitamins, minerals and nutrients. Food intake is recommended to produce in the time available;
• restful sleep. The body must have time to recover during the night rest;
• protection from nervous and physical overload and emotional distress;
• Avoid sports bearing the likelihood of head injury;
• not run infectious disease and strengthen the immune system;
• to take timely medication and make appointments procedure.

Parents should plan ahead for the birth of the child and avoid during the childbearing mother reception of alcohol, nicotine and aggressive medication. This will prevent the development of disease in utero.

Tips for parents

For a quick recovery of the child and reduce the number of attacks requires the active participation of parents:

• know first aid rules;
• Do not focus attention, limiting the child's actions on the disease;
• give the child to develop fully visiting sports groups (safe: tennis, dancing, swimming);
• minimize the time spent in front of TV or computer screen;
• to protect the head from the effects of ultraviolet radiation. Sunbath in the morning or evening hours when the sun is not very active.

Do not allow a child to be alone in the water or in the bathroom, as at the time of the attack, he could drown in the water. A timely treatment specialist with frequent seizures or increased symptoms.

Epilepsy is not a sentence for a child. Proper and timely treatment in the event of seizures can achieve complete absence seizures. In children, the symptoms of disease to have a distinctive expression, so parents should closely monitor any changes in behavior. After the detection and elimination of the cause (if possible) the number of attacks is reduced.

Author: Svetlana Kotlyachkova

Registration of the article: Mila Friedan

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