In the disorder of calcium-phosphorus metabolism,which accompanies moderate or severe rickets, 4% of children develop spasmophilia, which is also called children's tetany. This pathology is accompanied by the spastic condition of the muscles of the limbs, face, larynx, and the emergence of common clonic and tonic seizures. It is detected, as a rule, from the age of three months to two years. One of the brightest manifestations of developing ailment are the symptoms of Khvostek, Tissaur and Lust, helping to find out the severity of the ongoing disease. About how these symptoms are determined and how they are treated, we will discuss later in the article.
To conduct a check for the presence of the Khvostek symptom, also called the facial nerve phenomenon, the child is placed on a bed without a pillow. The legs should be straightened, and the hands should lie along the body.
Symptom is checked by easy effleuragepercussion hammer or fingers at the site of the trigeminal nerve (above the zygomatic arch). If the patient is involuntary jerking of the eyelid and the corner of the upper lip, then the symptom mentioned is considered positive. By the way, it is checked on both cheekbones.
The symptoms of Khvostek have 3 degrees of manifestation:
In the presence of obvious tetany, the child manifests the first degree of a symptom, even from a slight touch in the area of the facial nerve.
Not less indicative in terms of determining the severity of the condition of the baby are the symptoms of Tissaurd and Lust.
Symptoms of Khvostek, Trusso, Lusta are consideredspasmophilic. They become positive if a sick child has a change in the amount of calcium responsible for muscle contraction in the blood. This can lead not only to the presence of rickets, but also other diseases.
Symptoms of Tail and Trousseau are signsspasmophilia (tetany). This disease is characterized by increased nervous excitability, manifested by muscle cramps of limbs or larynx. Most often, this pathology is observed in boys in the first six months of life.
And the biological basis of this disease is the low level of ionized calcium in the child's blood.
Photos of children, sick tetany,what are the signs of the disease. The main one is laryngospasm, which is expressed by difficulty in inhaling, paleness of the face, sweating, and sometimes loss of consciousness. Periodic spasms of feet and hands (carpopedal spasm), which last sometimes for several hours, are also characteristic. There are also spasms of other muscle groups - respiratory, chewing, eye, etc.
But the most serious sign of the disease isan attack of eclampsia - clonic-tonic convulsions, starting with the twitching of the muscles of the face and passing into convulsions of the limbs and laryngospasm. The child thus most often loses consciousness, a foam appears on the lips, involuntary urination is observed. Eclampsia is dangerous for the ability to stop breathing or the heart.
In the first days of life convulsive conditions and hypocalcemia most often occur in toddlers born premature, in twins, as well as in jaundice or infectious diseases.
The symptom of the tail in children of the first months of lifecan be provoked by a decrease in the intake of calcium in the body of the child, and an increase in the secretion of calcitonin. This condition of the physician is associated with a violation of the intake of phosphorus and calcium during the sharp transfer of the baby to feeding with cow's milk, and (in rare cases) with a lack of vitamin D and calcium in the mother's body.
As a rule, hypocalcemia manifests itself in children with neuromuscular excitability, convulsions, vomiting, tachycardia and respiratory symptoms.
Attacks of eclampsia require urgent help to the child, and in case of stopping breathing or heart - and resuscitation.
At any displays of tetany to the child are appointed or nominatedanticonvulsants (Sibazon intramuscularly or intravenously, Sodium oxybutyrate intramuscularly, Phenobarbital rectally in candles or orally, etc.). Intravenous administration of 10% r-ra gluconate of calcium or intramuscular 25% r-ra of magnesium sulphate is also shown.
Spasmophilia, which causes symptoms of Khvostek andTrusso, as a rule, has a favorable forecast in most cases. The danger is only prolonged laryngospasm, threatening to stop breathing.
When the child reaches the age of 2-3 years, the pathological condition is eliminated as a result of stabilization in the blood of the level of calcium and phosphorus.
The symptom of the tail is also an obvious signa pathological condition called hypoparathyroidism, in which a decrease in parathyroid gland functions is observed. Most often, this problem occurs as a result of surgery for a thyroid gland or if there is an inflammatory process in it. And sometimes dysfunction can be caused by infectious processes, such as measles or influenza.
In newborns, hypoparathyroidism develops incase of congenital absence of parathyroid glands or suppression of their functioning by increased secretion of parathyroid hormone in the mother's body during pregnancy.
At the patient thus, as a rule, it is found outa decrease in the calcium content in the blood in parallel with an increase in the concentration of phosphorus. And outwardly it manifests itself already described tetany, intestinal phenomena, anomalies of the growth of teeth, nails and hair, as well as skin changes.
In such cases, the symptoms of Khvostek and Tissaur, along with laboratory tests, help to accurately identify the developed tetanic state and diagnose the patient.
To treat this disease, it is importanttake into account the causes that caused its appearance, as well as the severity of the symptoms. In the acute course of the disease with tetany, rapid administration of 10% calcium chloride or calcium gluconate intravenously is recommended. This is done slowly, taking into account that the first mentioned solution contains 27% of the same substance, and in the second it only 9%.
As a rule, in order to eliminate symptomsKhvostek, treatment with calcium preparations is required for at least 10 days. A good effect is taking the calcium inside, and doctors advise doing this, dissolving the drug in milk, to prevent the development of gastritis.
Chronic condition of hypoparathyroidism requiresintake of vitamin D, starting with a shock dose (200-300 thousand units per day), with mandatory control of the content of phosphorus and calcium in the blood, and after normalizing their level, the dose is reduced to 50 thousand units. per day in children up to a year or up to 125 thousand units. - in patients after a year.
In addition to diseases caused only by the reduction for any reason of calcium in the blood plasma, the symptoms of Khvostek, Trusso and Lust can also be found in other ailments. They include:
As you probably already saw, withdiseases that accompany the symptom of Khvostek, in children the treatment is reduced to the indispensable restoration in the blood of a normal level of calcium and phosphorus. Therefore, the prevention of these pathologies also requires, first of all, control of the concentration of these substances, which are performed by district pediatricians.
It is important to create optimal conditions for developmentfetus in a pregnant woman. To do this, if the future mother lives in unsatisfactory social conditions or is at risk (for diabetes, nephropathy, hypertension and rheumatism), she is prescribed vitamin D in the last 2 months of pregnancy. In the normal course of pregnancy, compliance with the regime is sufficient nutrition and physical activity.
A newborn, so that he grows strong andhealthy, it is important to have breastfeeding, timely introduction of complementary foods, daily outdoor activities, free diapering, massage, gymnastics and light-air baths.