What is convulsion

Perhaps many parents have found that their children have fainted, which is actually a convulsion. There are many causes of convulsions. It is very likely caused by damage to the child's nervous system, or it may be caused by children's brain diseases such as meningitis, brain tumors, etc. People need to pay special attention to the disease of convulsions. Let us introduce in detail what convulsions are.

Convulsion is a common pediatric emergency and the most common neurological symptom in children. It is a common acute and serious disease in children, with the main clinical features being rhythmic limb movements (convulsions) and coma. Also known as "convulsion", commonly known as "convulsion" or "shock". It can occur in any season and is more common in infants and young children. The younger the age, the higher the incidence rate. Some seizures are potentially life-threatening. Generally, short-term convulsions have almost no obvious effect on the brain, but long-term convulsions, especially status epilepticus, may cause permanent neurological damage. Convulsions in children may or may not be accompanied by fever. Those accompanied by fever are mostly caused by infectious diseases. Common intracranial infectious diseases include meningitis, brain abscess, encephalitis, brain parasitic diseases, etc.; common extracranial infectious diseases include febrile convulsions and various serious infections (such as toxic bacillary dysentery, toxic pneumonia, sepsis, etc.). Those who are not accompanied by fever are mostly caused by non-infectious diseases. In addition to the common epilepsy, there are also water and electrolyte disorders, hypoglycemia, drug poisoning, food poisoning, genetic metabolic diseases, brain trauma, brain tumors, etc.

Pathophysiology

The pathophysiological basis of childhood convulsions can be either epileptic or non-epileptic seizures. The former is caused by brain cell dysfunction due to various reasons, excessive excitability of brain neurons, sudden and abnormal super-synchronous discharge of neurons, which causes motor attacks of skeletal muscles through nerve conduction. The latter can be caused by increased excitability of the brainstem, spinal cord, neuromuscular junction and muscles themselves, such as changes in electrolytes in the body (such as increased potassium and sodium or decreased calcium and magnesium); it can also be caused by emotional changes such as hysteria.

Symptomatic treatment

① Anticonvulsant: The first choice of anticonvulsant drugs is the rapidly acting diazepam. Diazepam is highly lipid-soluble and can easily enter the brain tissue. It takes effect 1 to 3 minutes after injection, but the effect lasts for a short time (15 to 20 minutes). If necessary, it can be repeated after 15 to 20 minutes. Or choose 10% chloral hydrate enema. At the same time or subsequently as diazepam, phenobarbital, which has a longer duration of action, may also be used to maintain the anticonvulsant effect.

Children with typical febrile seizures generally only need treatment directed at the primary disease. Those with frequent seizures can also receive short-term preventive treatment. Only a few cases of complex febrile seizures may require long-term preventive treatment with sodium valproate or phenobarbital. However, there is no consensus on the prevention of febrile seizures.

② Reduce fever: Febrile convulsions are the most common cause of convulsions in children, so you should pay attention to ways to reduce the temperature quickly. ① Drug cooling: acetaminophen or ibuprofen can be taken orally. ② Physical cooling: Warm water baths, ice packs, etc. are effective cooling measures. Except for infants under 3 months old, they can be used alone. For children of other ages, they are only likely to be effective if used after drug cooling.

③Prevention and treatment of cerebral edema: Patients with recurrent seizures or those with seizures in a persistent state often have secondary cerebral edema and should be given 20% mannitol to reduce cerebral edema.