Spasmophilia in children

What is spasmophilia

The disease occurs in young children. It is characterized by a tendency to convulsions of a tonic and tonic-clonic nature, symptoms of increased neuromuscular excitability due to a decrease in the level of ionized calcium in the extracellular fluid against the background of alkalosis. It comes in two forms:

• hidden;
• explicit.

Basically, the disease begins with a latent form. In this case, the child does not have demonstrative clinical signs, and more often only a doctor finds them during a physical examination. But the doctor must have a reason to start looking for them. Basically, these children have signs of rickets – this is the first. Secondly, parents usually complain about increased activity or capriciousness of the child, superficial sleep, awakening during sleep, frequent shyness of the baby without a serious reason, muscle twitching (chin, limbs). In the presence of a laboratory blood test – hypocalcemia. It is with these complaints from the nervous system that the mother can go to the doctor.

“In an obvious form, the baby has laryngospasm (glottic spasm), carpopedal spasm, an attack of eclampsia. Also, the diagnosis can be interpreted in different ways – rickets II subacute course, ” — says pediatrician Dilshod Ruziev.

Causes of spasmophilia in children

The main cause of spasmophilia in children is a sharp increase in the level of vitamin D in the blood. This occurs when a child receives increased solar exposure in the spring. At this time, the solar spectrum is just especially saturated with ultraviolet rays. In the second case, vitamin D hypervitaminosis may occur due to the intake of large amounts of vitamin D3. That is why doctors recommend consulting with specialists before taking vitamins and taking them only after passing the tests.

Due to the large amount of vitamin D, a lot of calcitriol is formed, and at the beginning, hypercalcemia and hyperphosphatemia are noted in the blood. In response, the production of parathyroid hormone (PTH) decreases, and then, under the action of calcitriol and a smaller amount of PTH, even more calcium and phosphorus are absorbed in the intestine, and even more of them are reabsorbed in the tubules of the kidneys. Further, an excessive amount of phosphorus and calcium increases the alkaline reserve of the blood, which leads to the development of alkalosis. Calcium is absorbed in large quantities into bone tissue, and its amount in the blood decreases sharply. Ionized calcium acts on the neuromuscular system, a decrease in the amount of ionized calcium is manifested by excitation of the neuromuscular apparatus.

Another contributing factor is a decrease in the amount of magnesium.

Signs of spasmophilia in children

laryngospasm

As mentioned earlier, this is a spasm or even complete closure of the glottis. If it is present in a child, the following violations are expressed:

1. Spasm. The baby’s skin is pale, he breathes noisily, and when he sighs, he looks like a reprise with whooping cough;
2. Closing of the glottis. This phenomenon is usually short-lived, can last a maximum of two minutes: the child throws his head back, pale skin turns blue, and increased sweating is noticed. The child has fear on his face, and he tries to catch air with his mouth. The pupils are dilated at this time.

Carpopedal spasm

It is manifested by the following involuntary contractions of the muscles of the upper limbs. At this moment, the shoulders are pressed to the body, the feet are bent at the ankle joints and their fingers are bent. Reminds me of a ballerina’s legs. This spasm can last from a few seconds to several days. At first, it proceeds painlessly, and if the course of the spasm is long, pain syndrome, swelling on the hands and feet appear. These spasms are the most frequent and less dangerous. Very rarely, spasm of the muscles of other parts of the body can occur: the face, gastrointestinal tract, urinary system (involuntary urination), respiratory system and heart. The most dangerous are spasms of the respiratory and heart organs. This can result in respiratory arrest, cardiac arrest and death.

Eclampsia

This species is the most dangerous. The child may lose consciousness against the background of tonic-clinical convulsions, during which foam is released from the mouth, involuntary urination and defecation occur. The danger arises in a possible cessation of breathing and blood circulation. This type of attack lasts from several minutes to several hours, after which the child falls asleep.

The specialist notes that all three types of overt spasmophilia can occur several times a day, after a few days. There are cases that one species lies on another – that is, first there is laryngospasm, and then – carpopedal spasm. Between intervals, the child may look like a healthy child. The examination for overt spasmophilia is similar to that for the latent form.

Treatment of spasmophilia in children

When an attack occurs in a child, specialists create a dominant focus of excitation by irritating the nasal mucosa – they tickle, blow in the nose, bring ammonia. Methods such as injections, dousing the face with cold water can also be used.

You can not delay with an appointment with a doctor with obvious and hidden symptoms of spasmophilia. The pediatrician usually prescribes medication – intravenous and intramuscular injections, droppers. Also, children are given oxygen inhalations.

The specialist will correct the nutrition – it is desirable to breastfeed or limit the content of cow’s milk to the maximum, increase the amount of vegetable complementary foods.

A few days after the attacks and after the introduction of drugs containing calcium, the doctor may prescribe vitamin D3 (only according to the results of the tests). Therapy is carried out until the symptoms of latent spasmophilia disappear completely. It is necessary to limit as much as possible all unpleasant procedures that can cause an attack of spasmophilia.

Diagnostics

Spasmophilia is not difficult to diagnose – this disease is not difficult for a pediatrician or pediatric neurologist. He will immediately begin an examination for this ailment if the child has:

• a history of complaints of spasms and cramps in the extremities;
• signs of rickets are revealed – curvature of the spine (scoliosis), legs, deformity of the chest, skull (tower, high skull).

Next, the doctor will check the level of calcium in the blood. The latent form of spasmophilia is more difficult to diagnose. In this case, the doctor conducts several tests confirming the excessive excitability of the neuromuscular system, and in conjunction with the analysis of the level of calcium in the blood, establishes the diagnosis of spasmophilia.

Prevention of spasmophilia in children at home

According to the doctor, the basis for the prevention of spasmophilia in children is the prevention of childhood rickets. Preventive measures are primarily based on the need for breastfeeding, and in cases where this is not possible, the selection of an adapted milk formula.

– Do not ignore the prophylactic intake of vitamin D, children born in late autumn or winter. Also, the vitamin should be taken by children who live in regions where there is little sunlight. They are recommended an oil or water solution in the winter and autumn seasons. For the natural production of vitamin D, you need to walk in the fresh air. Prevention of spasmophilia in children of the first year of life includes massage, hardening procedures, water procedures and other measures to strengthen the immune system, says the pediatrician.

Popular questions and answers

Dilshod Ruziev, pediatrician, answers: