Seizures in infants are often subtle, pay attention to the following signs

This is an automatically translated article.

The article was professionally consulted by resident Doctor Ho Thi Hong Tho - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Phu Quoc International General Hospital.
Seizures in newborns are often subtle and easy to miss. There are many causes of infant convulsions and determining the exact cause is very important in managing this condition.

1. Seizures in infants are often subtle

Infants who have twitching of their limbs while sleeping but when they are held, held, or changed in position, the symptoms will disappear, this is not a disease caused by a seizure but just a benign muscle tremor and will go away on its own. In the case of a child having a convulsion, but when being held and changed, the symptoms do not go away, it can be concluded that the child has a convulsion. In the case of neonatal convulsions, infantile convulsions manifest themselves in a variety of ways but are sometimes subtle. Therefore, parents when caring for children need to pay attention to the following important signs:
Seizure symptoms: Abnormal movements or changes in muscle tone of the trunk and extremities with manifestations such as: Generalized convulsions body or focal, onset of generalized spasticity or hypotonia; Abnormal movements in the face, mouth, tongue,...; There is abnormal movement in the eye area. Other symptoms: Valuable in the diagnosis of causes and prognosis: fontanelle bulge; Respiratory failure with manifestations such as cyanosis, dyspnea, apnea; Anemia ; Focal nerve damage: Paralysis of cranial nerves or extremities; Fever and signs of infection ; The baby's head circumference is unusually large or small. Finding and treating the cause of infantile convulsions is of great significance in controlling and managing this condition.

2. Diagnosing infant convulsions

2.1 Taking history Ask about medical history, obstetric history: Did the baby choke at birth; whether there is intervention by suction, forceps; whether the child sucks poorly or stops sucking; does the child have a fever; whether the mother used pyridoxine or isoniazid during pregnancy,...; Time of seizure onset: Valuable in diagnosing the cause of seizures in infants. Specifically: In the first 48 hours after birth: Mainly due to asphyxia, hypoglycemia, intracranial hemorrhage, hypocalcemia, brain malformations, pyridoxine dependence; Days 3-7 postpartum: Usually due to hypocalcemia, meningitis; After 7 days after birth: Due to congenital metabolic disorders.

2.2 Physical examination Determine whether the child has generalized or focal seizures; Check pupils, light reflexes; Feel the fontanelle for signs of bulging; Look for craniocervical or serous tumors; Identify apnea episodes; Look for signs of anemia based on the color of the skin and mucous membranes; Identify the source of infection; Identify birth defects in the brain. 2.3 Perform the test Dextrostix test for hypoglycemia; Ionogram tests: sodium, calcium, magnesium to determine electrolyte disturbances such as hypocalcaemia, hyponatremia, hypomagnesemia; Blood smear test, blood culture, CRP to find the cause of infection; Cerebrospinal fluid test identifies meningitis; Transfocal brain ultrasound to determine the state of cerebral hemorrhage, to observe brain damage due to lack of oxygen in infants born with asphyxia; EEG performed when neonatal epileptic seizures or pyridoxine dependence are suspected (indicated when other causes of convulsions have been ruled out and the mother has a history of pyridoxine use); Screening for metabolic disease: blood NH3 when common causes of neonatal seizures have been ruled out. These tests help the doctor determine the cause of the infant's convulsions so that appropriate treatment can be instituted. In addition, neonatal convulsions can be caused by a combination of causes: Metabolic-electrolyte disturbances with central nervous system diseases.

3. Treatment of convulsions in infants

Principles of treatment of neonatal convulsions include: respiratory support, anticonvulsant and specific treatment according to the cause of the disease. Specifically:
Airway clearance: Suction viscous sputum; Respiratory support: Option to give the child oxygen or intubate to help with breathing depending on the degree of hypoxia; Anticonvulsants: Use anticonvulsants Phenobarbital or other appropriate drugs as prescribed by the doctor; Treatment of the cause: As soon as the cause of the seizure is detected in a child, it is necessary to treat it according to the specific cause of the disease. The causes of hypoglycemia, hypocalcemia, hypomagnesemia, hyponatremia, pyridoxine dependence, cerebral hemorrhage - meningoencephalitis, meningitis, etc., are treated according to each appropriate regimen according to indications. doctor.

The symptoms of seizures in infants are often subtle and easily overlooked. Therefore, parents need to closely monitor their babies when they have seizures and other symptoms, and promptly go to a pediatric specialist for an accurate diagnosis and timely and effective treatment interventions.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment. Doctor Ho Thi Hong Tho has 10 years of experience in the field of pediatrics and neonatology, with strengths in child nutrition, pediatric emergency resuscitation, and treatment of pediatric diseases from basic to advanced levels. Doctor Tho is a former lecturer in Pediatrics at Thai Binh University of Medicine and Pharmacy. During his work, Dr. Tho regularly participates in training courses to improve his expertise. Currently, Dr. Tho is working and working at the Department of Pediatrics - Vinmec Phu Quoc International General Hospital.
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