Dravet syndrome | Epilepsy Action

Dravet syndrome is a rare form of childhood epilepsy but possibly more common than was previously thought. Out of 500 children with epilepsy, 2 or possibly 3 children are likely to have this form of epilepsy. It is also known as an ‘epileptic and developmental encephalopathy’ because the epileptic seizures and the abnormal EEG are thought to be important in these children’s developmental delay and learning difficulties.

The epilepsy usually starts with seizures that may seem to be very similar to febrile convulsions. The more typical features of Dravet syndrome usually become more obvious during the second year of life.

Other names for Dravet syndrome

Severe myoclonic epilepsy in infancy (SMEI), though this name is only rarely used now.

Symptoms

The seizures begin in the first year of life, usually at around 6 to 10 months of age. They are most often associated with a high temperature (febrile seizure or febrile convulsion). They often involve just one side of the body, although both sides of the body may also be involved. The seizures are characterised by stiffness and jerking (called a tonic-clonic seizure), or just repeated jerking (called a clonic seizure). These ‘febrile convulsions’ in Dravet syndrome are usually long, and certainly longer than the more common febrile seizures or convulsions. The seizures in Dravet syndrome last for 15 or 30 minutes and often much longer. This is called febrile convulsive status epilepticus and is common in the first year of life. However, at this time it can be difficult to differentiate or separate these children from others with briefer febrile convulsions, who do not go on and develop other types of seizure.

During the second year of life the seizures become more frequent and persistent, and are often more obviously focal (previously called partial) involving one part of the body. They may happen with or without a fever, and at any time of day and night. In addition to the tonic-clonic seizures, myoclonic seizures (‘myo’ meaning muscle, and ‘clonus’ meaning jerk) and focal seizures become common. Often the children are photosensitive (have seizures brought on by flashing or flickering lights or even certain patterns such as checked or striped materials). A few children are very sensitive to these patterns. Seizures may also sometimes be brought on by hot environments or hot showers or baths.

The early development of children with Dravet syndrome is usually normal. However, the child’s development starts to slow down and children may lose skills towards the middle or certainly by the end of the second year of life. The child’s speech and language is particularly affected. Their manner of walking (called ‘gait’) is also abnormal and is quite fast and unsteady (called ‘ataxia’).

Diagnosis

A full history and description of the seizures that have happened in the past and at the time the child attends their hospital appointment is very important. It is also important for parents to give the doctor a detailed account of their child’s development. Videos of the child’s seizures may also be helpful.

The EEG, which records the electrical activity in the brain, is usually normal early on in this condition. By the time the child is 18 months old, the EEG shows abnormal activity, with spike and wave or polyspike discharges. These happen either as a single event, or in bursts. They may be generalised involving the whole brain, or happening just from one small area of the brain. Some, but not all, children with Dravet syndrome show EEG evidence of sensitivity to flashing or flickering lights, called photosensitivity. The photosensitivity is more common in younger children with Dravet syndrome aged between 1 and 5 years of age. It becomes much less common after 5 years of age. Brain scans in children with Dravet syndrome are usually normal.

A specific genetic abnormality, called a ‘mutation’ has been found in at least 8 out of 10 children with Dravet syndrome. This mutation usually involves the SCN1A gene and is therefore known as the ‘SCN1A’ mutation. A very large number of different mutations on this gene have been found in people with Dravet syndrome. However, rarely mutations may also be found on other genes, including on the SCN1B gene. It is very likely that some patients with Dravet syndrome will be found to have mutations in different genes. One of the difficulties is that children may present with what appears to be possible Dravet syndrome and genetic analysis shows they have a mutation in a different gene. Doctors then have to ask the question as to whether the child does have Dravet syndrome with a completely new mutation – or whether the child has a different epilepsy syndrome with its ‘own’ mutation. This question will only be answered with more research. The research must be clinical – to obtain a better understanding of the clinical features of the epilepsy syndrome – and also genetic. This will then allow doctors to make a clearer link between the different epilepsy syndromes and the gene mutations that have been found.

A mutation can be looked for in a simple blood test. The discovery of this mutation has been very helpful in making or confirming a diagnosis of this epilepsy syndrome. About 90% of mutations are new or ‘de novo’ mutations. This means that the mutation has not been inherited from a parent, but it is a new mutation that has started for the first time in the child. Because of this, it is very un-common for the same parents to have another child with Dravet syndrome. If this does happen, the parents will need to have very detailed genetic testing. However, in identical twins, if one twin develops Dravet syndrome, then it is very likely that this other twin will also have the condition.

In some families a mutation in the SCN1A or SCNIB gene may cause a different form of epilepsy such as GEF+.

Treatment

Dravet syndrome is one of the epilepsy syndromes that is most resistant to epilepsy medicines. Sodium valproate (Epilim) or topiramate (Topamax) are usually tried first. Other medicines which are helpful include clobazam (Frisium) and stiripentol (Diacomit).

Some medicines should be avoided as they may cause an increase in seizures in children with Dravet syndrome. These medicines are carbamazepine, gabapentin, lamotrigine, oxcarbazepine, phenytoin, pregabalin, tiagabine and vigabatrin. Sodium valproate should not be offered as a first treatment to women and girls of childbearing potential unless other options don’t work or are not tolerated. This includes young girls who are likely to need treatment into their childbearing years. If it is prescribed to a girl or woman of childbearing potential, a pregnancy prevention programme should be in place. This is because sodium valproate taken during pregnancy can harm the baby.

Many children with Dravet syndrome seem to respond best to a specific combination of 3 epilepsy medicines. In fact, Dravet syndrome is the only epilepsy syndrome when 3 epilepsy medicines used together are better than 1 or 2.  This combination is sodium valproate, stiripentol and clobazam. It is very important that only specialist epilepsy doctors, called paediatric neurologists, prescribe this combination of medicines. Other treatments that might be helpful include clonazepam (Rivotril), topiramate (Topamax), zonisamide (Zonegran) and levetiracetam (Keppra). A course of a steroid (called prednisolone) may also be helpful for a few weeks if a child’s epilepsy is going through a difficult time. The ketogenic diet may also be helpful but it may take a number of weeks to be effective. The diet will usually have to be given with at least one epilepsy medicine.

Another medicine, called cannabidiol (Epidiolex) has recently been shown to be effective in the treatment of Dravet syndrome. The medicine reduces the number of the different seizures the child has and may help improve their development and also their behaviour.

Information about epilepsy medicines for children can be found on the Medicines for Children website.

A child is very likely to have prolonged or repeated seizures as part of Dravet syndrome. The hospital doctor (paediatrician or paediatric neurologist) will discuss a ‘rescue’ or emergency care plan to treat any prolonged or repeated seizures that may happen at home. This rescue or emergency care plan is important for the child.

Because children with Dravet syndrome always have some degree of learning disability, they will also need a full educational assessment and support.

There has been – and continues to be – a lot of research into Dravet syndrome. This research includes different medicines and treatments. Some new information suggests a medicine, called fenfluramine, might also be effective but much more research needs to be done. You could ask your child’s hospital doctor about this and they will be able to discuss this with you.

Outlook

The seizures continue to be very difficult to control, throughout childhood. Learning difficulties are very common and can range from mild to very severe. These difficulties usually persist and only rarely improve. Many children will also show some signs of autism and this may become obvious at 3 or 4 years of age. As the condition progresses most children become more unsteady (ataxic) on their feet. They also walk with a rather fast and slightly crouched pattern. Children with Dravet syndrome will need to be cared for throughout their lives. Usually by the age of 14 or 16 years, the seizures tend to become less frequent but they still happen.

Finally, and this is often difficult to talk about, children with Dravet syndrome under the age of 5 or 6 years seem to be at a slightly higher risk of SUDEP (sudden unexpected death in epilepsy). It would be helpful for you to discuss this with your child’s hospital doctor.

Support

Contact
Charity for families of disabled children.
Freephone helpline: 0808 808 3555
Website: contact.org.uk
Email: [email protected]

Dravet Syndrome UK
PO Box 756
Chesterfield
S43 9EB
Phone: 07874 866937
Website: dravet.org.uk
Email: [email protected]

What is a syndrome?

A syndrome is a group of signs and symptoms that, added together, suggest a particular medical condition. In epilepsy, examples of these signs and symptoms would be things like the age at which seizures begin, the type of seizures, whether the child is male or female and whether they have physical or learning disabilities, or both. The results of an electroencephalogram (EEG) are also used to help identify epilepsy syndromes.
If you would like to know more about an epilepsy syndrome, please speak to your doctor. If you would like to know more about epilepsy in general, please contact Epilepsy Action.

Infant Seizures | Causes, Symptoms and How to Treat

The human brain is like the central command and control center for the entire body. All movements of the body are generated and controlled by electrical impulse signals transmitted from the brain. Infant or neonatal seizures are a relatively common but potentially serious medical event that occurs when the brain is suddenly flooded by abnormal electrical transmissions that momentarily disrupts the functioning of the brain.

Types of Infant Seizures

Infant seizures are classified into different subtypes based on the particular area of the brain that is involved, how severe the brain interruption is, and the physical response triggered by the seizure.

• Focal Seizures: a focal seizure (also referred to as a “partial seizure) occurs when the abnormal brain functioning is focused on one or more specific areas of side of the brain. Infants and children will often experience some sort of pre-cursor symptom (called an “aura”) just before the seizure occurs. Common pre-cursor signs include mental confusion, fear/anxiety, vision or hearing changes, and strange smells. Focal seizures are further divided into 2 subtypes: (1) simple; and (2) complex. Simple focal seizures involved various symptoms and characteristics depending on the particular part of the brain that is affected. Most simple focal seizures involve the occipital lob and trigger muscle spasms in an isolated group of muscles such as the arms or legs. Complex focal seizures involve the temporal lobe of the brain and the infant or child typically passes out or temporarily loses mental awareness.

  The types of seizures described below are considered “generalized seizures” involving both sides and more than one specific area within the brain. With these types of seizures, there is almost always a brief loss of consciousness.

• Absence Seizures: also known as “petit mal” seizures, absence seizures typically involve a sudden altered state of consciousness while the child or baby’s eyes remain open in an abnormal fixed gaze. This type of seizure rarely lasts longer than 20-30 seconds and can happen several times a day. Infants rarely experience absence seizures as they almost always begin after a child is 4-5 years old.
• Atonic Seizures: this type of seizure causes a very sudden and dramatic loss of muscle tone causing babies to go limp (like a rag doll) or older children to fall from a standing position or drop their head and arms and become unresponsive.
• General Tonic-Clonic Seizures: also referred to as “grand mal” seizures, these normally involve a series of phases: the arms, legs and/or body will first contract; then straighten out; followed by tremors or shakes; and end with a clonic phase where the muscles gradually relax and return to normal.
• Infantile Spasms: this is a particularly rare type of seizure occurring in infants under 6 months old. This type of seizure is characterized by sudden spasms of the neck, legs and/or body which often occur just as the baby is waking up or falling asleep. These seizures can occur over a hundred times in a single day and can have very serious, long-term health consequences.
• Febrile Seizures: febrile seizures are somewhat different in that they are generally only triggered by high fevers (usually caused by infections) and not necessarily related to underlying neurologic issues – although infants with brain damage are generally more prone to febrile seizures when they get fevers.

Causes of Infant Seizures

When infants experience any of the various types of seizures described above the most likely potential causes are trauma during birth causing damage to the baby’s brain, congenital birth defects, or infection.

• Brain Injury During Birth: all types of seizures are the result of some type of electrical abnormality involving the brain. Infant seizures are often an indication of underlying neurologic problems that may be the result of oxygen deprivation during labor and delivery. Infant seizures can be a proximate result of a number of different types of head and brain related injuries that frequently occur during a difficult childbirth. External trauma to the baby’s head is a common problem. Head trauma during birth is often related to the use of vacuum extractors or obstetrical forceps by doctors to facilitate vaginal delivery of a baby. When these instruments are not used with the necessary level of care and skill they are notorious for causing injuries to a baby’s head and neck. External head trauma from forceps or vacuum extractors can lead to injuries such as hematomas (brain bleeds), skull fractures, hydrocephalus and other potentially serious injuries that can affect the brain and cause different types of seizures. The primary cause of brain injury to babies during childbirth is oxygen deprivation. When the baby is deprived of oxygen or its oxygen supply is restricted for any length of time during delivery it can cause cells in the brain to decay and die. Oxygen deprivation is probably the leading cause of major birth injuries involving the brain and infant seizures are a key early indicator of brain damage.
• Infection: another frequent cause of seizures in infants (particularly certain types of seizures) is infection. Although seizures can be caused by a number of different types of infection, there are certain infections, namely Group B strep, passed from mother to baby during pregnancy, that are strongly linked with infant seizures. Group B strep is an exceedingly common type of infection that affects 1 out of every 4 pregnancies. This is why careful 37^th week screening for group B strep (and other types of infection) is a critical part of prenatal care. If the infection is diagnosed it can be easily treated to prevent it from being passed onto the baby. If left untreated, however, infections can cause fever and trigger seizures in infants.
• Cerebral Palsy: certain types of infant seizures (particularly the generalized seizures such as “petit mal” or “grand mal” seizures) are often one of the earliest and most definitive symptoms that a newborn baby may have cerebral palsy. Cerebral palsy is a movement disorder caused by injury to the developing brain of a fetus (usually from oxygen deprivation) during pregnancy or childbirth. The damage disrupts the full, normal development of the baby’s brain leaving it unable to properly control the movement of certain muscles in the body.

Seizures (for Parents) – Nemours Kidshealth

Seizures are caused by a sudden surge of electrical activity in the brain. A seizure usually affects how a person looks or acts for a short time. Someone having a seizure might collapse, shake uncontrollably, or even just stare into space. All of these are brief disturbances in brain function, often with a loss of or change in consciousness.

Seizures can be frightening, but most last only a few minutes, stop on their own, and are not life-threatening. A person who has had two or more seizures may be diagnosed with epilepsy, also known as seizure disorder.

Seizure Basics

Usually, electrical activity in the brain involves neurons in different areas sending signals at different times. During a seizure, many neurons fire all at once. This abnormal electrical activity can cause different symptoms depending on the part of the brain involved, including unusual sensations, uncontrollable muscle spasms, and loss of consciousness.

Some seizures may be due to another medical problem, such as a fever, an infection, a head injury, accidental poisoning, or drug overdose. They also can be caused by a brain tumor or other health problem affecting the brain. And anything that results in a sudden lack of oxygen or reduced blood flow to the brain can cause a seizure. In some cases, a seizure’s cause is never found.

Febrile seizures can happen in children younger than 6 years old. While they can be scary to watch, these seizures are usually brief and rarely cause any serious or long-term problems, unless the fever is related to a serious infection, such as meningitis.

Syncope (SIN-ko-pee), or fainting, is not uncommon in older kids and teens. When it happens, kids might have a brief seizure or seizure-like spell. They might stiffen or even twitch or convulse a few times. Fortunately, fainting rarely is a sign of epilepsy. Most kids recover very quickly (seconds to minutes) and don’t need specialized treatment.

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If Your Child Has a Seizure

First, make sure that your child is in a safe place where he or she can’t get hurt. Place your child on the ground or floor in a safe area, preferably on his or her right side. Also:

• Remove any nearby objects.
• Loosen any clothing around the head or neck.
• Don’t try to wedge your child’s mouth open or place an object between the teeth, and don’t try to restrain movements.

Once the seizure seems to have ended, gently comfort and protect your child. It’s best for kids to remain lying down until they have recovered fully and want to move around.

Call 911 immediately if your child:

• has difficulty breathing
• turns bluish in color
• has had a head injury
• seems ill
• has a known heart condition
• has never had a seizure before
• might have ingested any poisons, medicines, etc.

If your child has previously had seizures, call 911 if the seizure lasts more than 5 minutes or is for some reason very alarming to you and you’re worried for your child’s safety.

If your child is breathing normally and the seizure lasts just a few minutes, you can wait until it lets up to call your doctor.

After a seizure, kids are often tired or confused and may fall into a deep sleep (called the postictal period). You do not need to try to wake your child as long as he or she is breathing comfortably. Don’t try to give food or drink until your child is awake and alert.

For a child who has febrile seizures, the doctor may suggest giving fever-reducing medicine like ibuprofen or acetaminophen to ease discomfort.

After a seizure — particularly if it is a first or unexplained seizure — call your doctor or emergency medical services for instructions. Your child probably will need to be seen by a doctor as soon as possible.

Common Causes of Seizures in Newborn Infants

When you’re about to have a baby, you want everything to go perfectly according to plan. You hope to leave the hospital with a happy, healthy baby, but that isn’t always the case. Some newborns are born with birth injuries that can affect development.

Seizures can be a sign that your baby suffered from a birth injury, especially to the brain. Some specific injuries cause seizures, but they can also be a result of a condition the baby had before birth. If you suspect your baby has suffered a brain injury, you’ll want to know what to look for.

Common Neonatal Seizure Causes

The most common cause of neonatal seizures is Hypoxic Ischemic Encephalopathy (HIE). HIE is a type of birth injury in newborns where oxygen deprivation and limited blood flow cause brain damage. If the baby is not given therapeutic hypothermia treatment immediately after the diagnosis, their brain damage could be permanent and cause cognitive disabilities. According to the HIE Help Center, between 2 and 9 of every 1,000 live births are cases of HIE, which comes out to thousands of babies affected each year.

Since HIE should be treated right away before permanent damage can form, it’s important for parents to be vigilant of any warning signs. Here are some symptoms your baby might show if they have HIE:

• Seizures
• Low heart rate
• Trouble breathing
• Feeding problems
• Pale skin
• No reflexes
• Low muscle tone described as “floppy”
• Lower cognitive abilities
• Apgar score less than 3

Other Causes of Seizures in Newborns

Birth injuries and defects can also cause seizures in newborns. Some common causes of seizures in newborn infants are:

• Lack of oxygen
• Infection
• Stroke
• Blood clot in the brain
• Brain bleeding
• Blood sugar or electrolyte imbalance
• Drug withdrawal

Newborn Infant Seizure Types

In general, a seizure is caused by sudden and abnormal electrical activity in the brain. University of California San Francisco Benioff Children’s Hospital lists four categories of seizures in newborns. These are the types and symptoms to look for in your baby, as outlined by an article on the National Center for Biotechnology Information (NCBI):

• Subtle. These account for 50% of all seizures in newborns and are classified as subtle because the signs are usually overlooked. Signs might be fixed eyes, facial movements, bicycle kicking, and crying.
• Clonic. These are the next most frequent kind of seizures and account for 25%. They can be identified by localized rhythmic jerks in one part of the body.
• Myoclonic. Accounting for 20% of neonatal seizures, these are distinguished by being single, rapid arrhythmic jerks. Myoclonic seizures can affect a body part as small as a finger, or as big as the whole body. These are the most dangerous and indicate a major brain injury when severe.
• Tonic. Only 5% of seizures are tonic. Sustained muscle contraction in the face or limbs could indicate that your baby is having a tonic seizure.

When it comes to seizures, it’s best to take your baby to the doctor even if they have the slightest symptoms. If you are unsure if your baby’s actions are signs of a seizure or not, you never want to risk it. Take your baby to their doctor so that you can get your baby diagnosed right away. Most of the time early intervention can keep the seizures from progressing and can reduce further brain damage.

To diagnose a newborn’s seizures, an electroencephalogram (EEG) test is required. An EEG monitors the brain’s electrical activity for abnormalities. Most times an EEG shows risks for seizures, but some neonatal seizures don’t affect EEG readings, and so the results can come back normal. In that case, doctors might use an MRI or a CT scan to find the cause of the seizures.

When infants have seizures, it’s scary. If they were caused by a birth injury that could have been avoided, you’ll want an experienced attorney on your side. Corban Gunn will fight for your family with compassion and help you get justice. Reach out today for a free consultation of your case.

Causes, Symptoms, Diagnosis and Treatment

How Are Seizures Treated?

Specific treatment for a seizure will be determined by your child’s doctor based on:

• Your child’s age, overall health, and medical history
• Extent of the condition
• Type of seizure
• Your child’s tolerance for specific medications, procedures, or therapies
• Expectations for the course of the condition
• Your opinion or preference

The goal of seizure management is to control, stop, or decrease the frequency of the seizures without interfering with the child’s normal growth and development. The major goals of seizure management include the following:

• Proper identification of the type of seizure
• Using medication specific to the type of seizure
• Using the least amount of medication to achieve adequate control
• Maintaining good medicating levels

Treatment may include:

• Medications
  There are many types of medications used to treat seizures and epilepsy. Medications are selected based on the type of seizure, age of the child, side effects, the cost of the medication, and the adherence with the use of the medication.

  Medications used at home are usually taken by mouth (as capsules, tablets, sprinkles, or syrup), but some can be given rectally (into the child’s rectum). If the child is in the hospital with seizures, medication by injection or intravenous (IV) may be used.

  It is important to give your child his/her medication on time and as prescribed by your child’s physician. Different people use up the medication in their body differently, so adjustments (schedule and dosage) may need to be made for good control of seizures.

  All medications can have side effects, although some children may not experience side effects. Discuss your child’s medication side effects with his/her physician.

  While your child is taking medications, different tests may be done to monitor the effectiveness of the medication. These tests may include the following:

  • Blood work – frequent blood draws testing is usually required to check the level of the medication in the body. Based on this level, the physician may increase or decrease the dose of the medication to achieve the desired level. This level is called the “therapeutic level” and is where the medication works most efficiently. Blood work may also be done to monitor the affects of medications on body organs.
  • Urine tests – these tests are performed to see how the child’s body is responding to the medication.
  • Electroencephalogram (EEG) – a procedure that records the brain’s continuous, electrical activity by means of electrodes attached to the scalp. This test is done to monitor how the medication is helping the electrical problems in the brain.
  • Ketogenic diet – Certain children who are having problems with medications, or whose seizures are not being well controlled, may be placed on a special diet called the ketogenic diet. This type of diet is low in carbohydrates and high in protein and fat.

What Is a Ketogenic Diet?

The ketogenic diet is sometimes offered to those children who continue to have seizures while on seizure medication. When the medications do not work, a ketogenic diet may be considered. No one knows exactly how the diet works, but some children do become seizure-free when put on the diet. However, the diet does not work for everyone.

What Does the Diet Consist of?

The ketogenic diet is very high in fat (about 90 percent of the calories come from fat). Protein is given in amounts to help promote growth. A very small amount of carbohydrate is included in the diet. This very high- fat, low- carbohydrate diet causes the body to make ketones. Ketones are made by the body from the breakdown of fat. They are made for energy when the body does not get enough carbohydrates for energy. If your child eats too many carbohydrates, then his/her body may not make ketones. The presence of ketones is important to the success of the diet.

High-fat foods:

• Butter
• Heavy cream
• Oil
• Mayonnaise
• Cream cheese
• Bacon
• Cheese

High-carbohydrate foods:

• Fruit and fruit juice
• Breads and cereals
• Vegetables (corn, peas, and potatoes)
• Beans
• Milk
• Soda
• Snack foods (chips, snack cakes, crackers)
• Sweets

Your child’s doctor will determine if this diet is right for your child. When the ketogenic diet is started, your child will be admitted to the hospital. It may take four to five days in the hospital to get the diet started and for you to learn how to plan the diet.

While in the hospital, your child may not be able to eat for one to two days until ketones are measured in the urine. Once ketones are present in the urine, special high-fat, low-carbohydrate shakes may be started. These are sometimes called “keto shakes.” After several meals of keto shakes, your child will be started on solid foods.

You may also be taught how to check your child’s urine for ketones. The dietitian will help determine how much fat, protein, and carbohydrate your child is allowed to have, usually divided into three meals a day. The ketogenic diet can by very challenging to prepare and requires that all foods be weighed using a food scale. The ketogenic diet is not nutritionally balanced, therefore, vitamin and mineral supplements are needed.

Some medications and other products, such as toothpaste and mouthwash, contain carbohydrates. It is important to avoid these products if your child is on the ketogenic diet. Your child may not make ketones in their urine if too many carbohydrates are included in the diet. Your child’s doctor and dietitian can give you a list of medications, and other products, that are free of carbohydrates.

How Long Is the Diet Used?

Children usually stay on the diet for two years. The diet is slowly changed back to a regular diet. 

Sample Ketogenic Meal

60g heavy cream
21 g strawberries
53 g eggs
10 g cheddar cheese
10 g bacon
21 g butter

Sample Ketogenic Shake

500 g Ross Carbohydrate-free Formula (concentrate)
270 g heavy cream
13 g Egg Beaters 

Additional Treatment Options:

• Vagus nerve stimulation (VNS): Some children, whose seizures are not being well-controlled with seizure medications, may benefit from a procedure called vagus nerve stimulation (VNS). VNS is currently most commonly used for children over the age of 12 who have partial seizures that are not controlled by other methods.

  VNS attempts to control seizures by sending small pulses of energy to the brain from the vagus nerve, which is a large nerve in the neck. This is done by surgically placing a small battery into the chest wall. Small wires are then attached to the battery and placed under the skin and around the vagus nerve. The battery is then programmed to send energy impulses every few minutes to the brain. When the child feels a seizure coming on, he/she may activate the impulses by holding a small magnet over the battery. In many people, this will help to stop the seizure.

  There are some side of the effects that may occur with the use of VNS. These may include, but are not limited to, the following:

  • Hoarseness
  • Pain or discomfort in the throat
  • Change in voice
• Surgery. Another treatment option for seizures is surgery. Surgery may be considered in a child who:
  • Has seizures that are unable to be controlled with medications.
  • Has seizures that always start in one area of the brain.
  • Has a seizure in a part of the brain that can be removed without disrupting important behaviors such as speech, memory, or vision.

  Surgery for epilepsy and seizures is a very complicated surgery performed by a specialized surgical team. The operation may remove the part of the brain where the seizures are occurring, or, sometimes, the surgery helps to stop the spread of the bad electrical currents through the brain.

  A child may be awake during the surgery. The brain itself does not feel pain. With the child awake and able to follow commands, the surgeons are better able to make sure that important areas of the brain are not damaged.

  Surgery is not an option for everyone with seizures. Discuss this with your child’s doctor for more information.

Types of Seizures in Pediatric Patients

Seizures are caused by electrical disturbances in the brain. When most people hear the word “seizure,” they tend to think of the “grand mal” type, which has dramatic outward signs. But, in fact, there are many different types of seizures:

Partial Seizures in Children

Partial seizures (also called “focal seizures”) originate on one side of the brain. Symptoms vary greatly, depending on which part of the brain is affected. A few signs of a partial seizure can include:

• Feeling tingling in part of the body
• Repeating sentences in a nonsensical way
• Hand fumbling movements
• Experiencing odd smells or tastes
• Jerking an arm or leg
• Appearing dazed and unaware of surroundings
• Lip/mouth movements

Partial seizures are divided into three categories:

• Simple Partial Seizures typically last less than one minute. Children remain alert, are aware that they are having a seizure at the time, and remember it afterward.
• Complex Partial Seizures typically last less than three minutes. Children are not aware they are having a seizure, and do not remember it.
• Secondarily Generalized Seizures start from one side of the brain, but the electrical disturbance spreads across the whole brain, resulting in a generalized tonic-clonic seizure, or “grand mal” seizure.

Generalized Seizures in Children

Generalized seizures involve both sides of the brain:

Absence Seizures cause children to stop, stare and be unresponsive for a few seconds. They may occur several times throughout the day, often without a child being aware of them. Absence seizures are most common between the ages of 4 and 12.

Myoclonic Seizures result in brief, jerking movements that can affect the whole body or a single limb. The movements may be subtle or very pronounced. Myoclonic seizures can occur several times a day. Typically they last less than 5 seconds, but can also occur in clusters, with repeated myoclonic seizures back-to-back.

Atonic Seizures cause children to suddenly lose muscle tone, go limp, and fall to the ground. They usually last for only a few seconds. The child will typically regain consciousness and alertness immediately following the seizure.

Generalized Tonic-clonic Seizures, also known as a “grand mal” seizures, are associated with a loss of consciousness or loss of awareness. These seizures have distinct phases:

• As the seizure begins, children may yell or groan and fall to the ground.
• In the tonic or “stiffening” stage, they become rigid and may drool, clench their teeth, or bite their tongues. Breathing may appear to slow down or stop.
• In the clonic or “jerking” phase, the torso and limbs jerk. Breathing becomes shallow.
• When the jerking movements stop, children gradually regain consciousness, but are often very sleepy after the seizure.
• Most generalized tonic-clonic seizures last less than 2 minutes. Afterward, children are often tired, confused, and sometimes anxious.

Infantile Spasms

Infantile spasms are a less common type of seizure disorder that typically starts when babies are between 4 and 8 months. Infantile spasms often occur when babies are waking up or falling asleep. A baby may have several spasms in a row, with quick, sudden movements of the head, arms, and legs.

It is important to start treatment for infantile spasms as soon as possible to minimize the risk of long-term complications.

Neonatal Seizures

Neonatal seizures occur in newborns. They can be subtle, with movements that may appear as:

• “pedaling” movements of the legs
• repetitive sucking or chewing
• repetitive blinking
• fixed staring

Or, they may be more pronounced, with jerking movements or muscle contractions. Only about 1 percent of all infants have neonatal seizures. Less than half will experience seizures later in life.

Febrile Seizures

A febrile (or “fever”) seizure is usually a harmless event. These seizures are associated with fever in children 6 months to 5-years-old.

This is the most common type of seizure, occurring in 3 to 5 percent of children in the U.S. Febrile seizures tend to occur in families: A child with a sibling or parent who has had a febrile seizure is more likely to have one.

Only a small percentage of children who have a febrile seizure will develop epilepsy.

If a child has seizures with a fever, but also has seizures without a fever, this is not considered to be febrile seizures; this is considered to be epilepsy, or a seizure disorder.

Seizures in children | Pregnancy Birth and Baby

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Seeing your child have a seizure or convulsion can be frightening. Simple first aid can help keep them safe. About 1 in 20 children will have a seizure by the time they are 15. For most, it’s a one-off seizure – very few have epilepsy.

What is a seizure?

A seizure is best described as sudden, momentary surge of electrical activity in the brain. This surge can cause a person to see, feel or smell unusual sensations, or might cause them to move in unusual ways or hold unusual postures.

A fit, where someone falls to the ground and shakes for a minute or so, is just one type of seizure. There are different types of seizures:

• Focal seizures happen in one part of the brain.
• Generalised seizures happen all over the brain.

Seizures can also be described by the symptoms they cause.

• Tonic seizures make the muscles go stiff and often happen when your child is asleep.
• Atonic seizures make your child lose control of their muscles. Their head may slump, or they may fall to the ground.
• Clonic seizures are where the muscles jerk around repeatedly.
• Myoclonic seizures cause the muscles to jerk suddenly and briefly.
• Tonic-clonic seizures (previously called grand mal seizures) are a type of generalised seizure. They’re also known as fits. Someone having a tonic-clonic seizure might fall down, be unconscious, go stiff or jerk, lose bladder or bowel control, and be sleepy or confused afterwards.
• Absence seizures (previously called petit mal seizures) are also generalised seizures. Someone having an absence seizure is not aware of what is happening or responsive to interactions with people. They might stare, blink their eyes or make chewing movements with their mouth.

Some people have focal seizures where they display automatic movements and behaviours like picking at clothing, chewing, swallowing, staring, picking up objects or running on the spot.

The common thread is that the person can’t control what happens.

What causes seizures in infants and children?

A high fever (above 38°C) can sometimes cause seizures in young children. These are also called febrile convulsions.

Children can also have a seizure because of:

• an infection
• a brain injury
• a lack of oxygen to the brain

Certain triggers, such as flashing lights, can also lead to seizures in some children.

Most children won’t have another seizure. But children who have repeated and unpredictable seizures might have epilepsy.

What should I do if my child has a seizure?

If your child has a seizure, you should stay calm and:

• gently protect their body and head
• if they’re in water, keep their face out of the water and call for an ambulance
• time the seizure
• don’t put anything in their mouth
• after any convulsion ends, roll them on their side
• lay them on their side if there is fluid in their mouth
• make sure they are breathing normally afterwards

You should call an ambulance if:

• your child’s seizure lasts more than 5 minutes, or they have more than one seizure
• they are still unconscious or have trouble breathing after the seizure
• quicky have another seizure, or they have multiple seizures
• they had a seizure with food or liquid in their mouth
• they’re unconscious or not breathing normally
• it’s their first seizure
• the seizure happened in the bath or a pool
• they’re unconscious for more than 5 minutes afterwards, or not breathing normally
• your child also has an injury
• your child has diabetes
• you are going to give them medication to stop the seizure
• you’re unsure whether they need help

How are seizures diagnosed?

A doctor will assess your child. You should describe the seizure (how your child looked and behaved) to the doctor, or show them a video of the seizure, if possible.

If your child had a febrile convulsion, they may not need to undergo any tests, but they should still see a doctor.

However, if your child had a seizure, and especially if they had more than one, they might have tests such as an electroencephalogram (EEG), which is a reading of the electrical activity of the brain, blood tests, or a brain scan (such as a CT scan or an MRI).

Treatments for seizures in children

Following any seizure, perform first aid. Where a seizure continues for an extended period of time (more than 5 minutes), seek medical assistance. It might be necessary for a health professional to give medication to stop it.

Febrile convulsions aren’t usually harmful, but it’s a good idea to see a doctor to make sure your child doesn’t have a serious infection. However, children who have a febrile convulsion can be prone to having a seizure again in the future.

If a child experiences multiple seizures, regular medication might be needed. Several different medications might need to be tried to find one that is effective. Other treatments, such as surgery or vagus nerve stimulation therapy, are sometimes used.

Can seizures be prevented?

The good news is that many children grow out of seizures or epilepsy.

Febrile convulsions can’t always be prevented, and can happen before a fever is obvious.

Your child should avoid anything that is known to trigger their seizures.

If your child is on medication for seizures, it is important to avoid missing doses. Getting a good night’s sleep and regular meals can also help.

Risks and complications of seizures

Most children recover well after a seizure, although they might be sleepy and confused for a short while. It’s rare to die from a seizure, but there are risks if the seizure goes on for a long time (30 minutes, for example, or more) or if the child chokes on water or vomit.

What help is available?

Talk to your doctor about any concerns you have. You can also call Pregnancy Birth and Baby on 1800 882 436, or video call, for advice and support.

90,000 Early childhood epilepsy – causes and symptoms

Children’s Medical Center of Neurology and Pediatrics offers you a service – treatment of early epilepsy in children. Our specialists have many years of experience and great reviews!

Early epilepsy in children – is one of the types of epilepsy occurring in very young children on average from 1 to 3 years.

Causes of early epilepsy in children

There can be many reasons, but specific ones stand out:

• birth trauma;
• congenital brain abnormalities;
• chromosomal syndromes;
• hereditary neurocutaneous syndromes;
• hereditary metabolic defects;

90,015 infections;

• brain tumors.

Early epilepsy in children is one of the three most common diseases on earth, being one of the most common forms of chronic pathologies of the nervous system in our time. It should be noted that the term “epilepsy” is wide enough, its concept includes a huge number of different types of seizures, characterized by the same type and repetition. Unfortunately, most often the onset of the disease manifests itself precisely in childhood (in 75% of cases). This is most likely due to the immaturity of the brain in babies, as well as a predisposition to disorders of cerebral processes, but it is not worth talking about this with due confidence, because.to. to date, the causes of the onset of the disease have not yet been fully studied.

Diagnosis of early epilepsy in children

A neurologist is involved in the treatment of early epilepsy in young children. He will help find the cause of the disease. You can sign up for a consultation right now!

The main and most serious problem of early epilepsy in children is the diagnosis of syndromes and the validity of the selected treatment. At the moment, a huge number of different manifestations of the disease, epileptic syndromes and disorders similar in symptoms have been classified, and in each case, based on the individual characteristics of the child’s body, their own principles of therapy and personal predictions are selected.It is especially important for a wide variety of childhood diseases, various painful attacks of a differential nature, to discern the onset of the disease, not to miss the first manifestations of the disease. The younger the child, the more difficult it is to diagnose early epilepsy in children in the early stages of its manifestation, and this is extremely important, since due to frequent epileptic seizures in the child’s body, functional disorders develop briskly, which further lead to persistent disorders of speech, memory, behavior , mental and physical development slows down.

Early epilepsy in newborn babies is extremely difficult to diagnose because seizures are subtle, and convulsive movements are very similar to the usual motor activity of an infant. Symptoms of the manifestation of the disease in the first year of life are most often caused by brain damage due to birth trauma, hypoxia, intracerebral hemorrhage, or an infectious disease suffered by the mother during pregnancy (Rolandic epilepsy). Another common cause of early epilepsy in infants is genetic predisposition.In this case, we are not talking about damage to the cerebral cortex, the predisposition to the disease is transmitted with genetic information from the parents to the child.

During the first year of life, babies may experience major and minor epileptic seizures. Attacks come on suddenly, without any connection with external factors. They manifest themselves in the form of specific motor spasms, often against the background of an increase in temperature, can be with or without loss of consciousness. During the day, a child may have from 2-3 to 100 seizures.

Symptoms of early epilepsy in children

Signs of early epilepsy in infants are poorly expressed, moreover, the seizures do not always spread to the whole body, and it happens that the spasm binds only an arm or a leg. Therefore, parents should be more careful about the behavior of the little crumbs and do not miss the alarming symptoms.

Let’s list the main signs of small seizures:

• unnatural abrupt stretching of the trunk;
• Muscle tension throughout the body, spontaneous flexion of the limbs;
• sudden throwing back of the body or sharp bending forward;
• sharp, unreasonable jerks.

And the following signs of early epilepsy in children are even less noticeable, but require even greater sensitivity on the part of the parents, because it is easy to mistake them for groundless twitching of the baby:

• unexpected freezing of the child;
• a detached gaze, looking at “one point”;
• subtle head nods;
• Unobtrusive twitching of the shoulders.

Large attacks are more noticeable symptoms, they happen suddenly and very quickly:

• the head is tilted forward and the shoulder girdle is tilted;

90,015 legs bent, pulled up to the stomach;

• arms extended and raised up.

Treatment of early epilepsy in children

Treatment of early epilepsy in children of the first year of life is carried out in most cases quite successfully. After the doctor prescribes drug therapy, the attacks become less severe and occur much less frequently. The child grows, the brain processes are stabilized. It happens that in some cases, attacks of early epilepsy in children disappear altogether!

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Epilepsy in children.

Childhood absence epilepsy.

Cryptogenic epilepsy in children.

Rolandic epilepsy in children.

Neurologist for parents about children

What do a child who is afraid to go to the blackboard and an excellent student with skin allergies and tics have in common?

Between an impulsive child who is rude to teachers and beats his classmates, and a fearful and insecure C grade with headaches and impaired attention?

Between a restless, irritable, nervous child for any reason and his deskmate suffering from sleep disorders and enuresis, who is not interested in anything, who is not affected by shouts or deuces?

Many of these behavioral manifestations in children are based on disturbances in the mechanisms of development of the nervous system …

What explains the disturbances in the nervous activity in a baby if no visible changes in the brain are detected?

The fact is that an outwardly well-formed brain is not yet a guarantee of its normal functioning.Having experienced unfavorable influences in a critical period (in utero, during childbirth or in a newborn), the brain “leaves the schedule” of its development in the most critical phase. The formation of the most important functions does not have time to “fit” into the optimal age period allotted for this, in a kind of peak of the plasticity of the nervous system, and then, in addition to what has already been said, irreversible conditions may develop in the baby ….

But if everything that happens in childhood was irreversible, then childhood diseases of the nervous system would be incurable …

And this is not so!

How are brain diseases treated? Our children’s neurologists and psychoneurologists will answer this.

A pediatric neuropsychiatrist, in contrast to an adult neuropathologist, has to deal with almost all pathology inherent in the body:

• damage to the nervous system in utero and during childbirth as a result of various adverse factors
• disorders of motor development (from tempo delays in the formation of initial motor skills to paresis and paralysis)
• birth and household traumatic brain injury and their consequences
• epilepsy, etc.convulsive conditions
• sleep disorders, including paroxysmal
• cerebrovascular accidents (strokes) in both acute and chronic stages
• congenital and acquired hydrocephalus
• “rejuvenated” multiple sclerosis, brain tumors and other progressive diseases of the nervous system
• pains of various origins
• hereditary neuromuscular diseases, etc.genetic diseases with damage to the nervous system
• behavioral disorders, adaptation problems, neurotic reactions and habits (tics, stuttering, urinary incontinence, obsessions, fears, etc.)
• mental illness (early childhood schizophrenia, autism, mental retardation – intellectual disability of varying severity)
• disorders “accompanying” chronic somatic diseases

and many other disorders, except perhaps a very small range of age-related genetic conditions, but they also tend to rejuvenate …

Perinatal damage to the nervous system is a collective diagnosis, implying a violation of the function or structure of the brain (encephalopathy) and the spinal cord of various origins, arising in the perinatal period (from 28 weeks of intrauterine development, including childbirth, to the period corresponding to the first week of a child’s life with processes characteristic of it adaptation of a newborn to environmental conditions).The reasons influencing the onset of PPNS symptoms can be:

• intrauterine infections (rubella, herpes, cytomegalovirus, syphilis, etc.)
• exacerbation of chronic diseases of the expectant mother with unfavorable changes in metabolism
• intoxication
• effect of various types of radiation
• genetic condition
• long dry period
• absence or weak severity of contractions and the inevitable in these cases, stimulation of labor
• insufficient opening of the birth canal
• Rapid labor
• use of manual obstetric techniques
• Caesarean section
• umbilical cord entanglement of the fetus
• large body weight and size of the fetus
• neuroinfection
• injuries

The consequence of these reasons is a violation of breathing and blood circulation (asphyxia, hypoxia), energy deficiency of the heart and brain, failure of individual organs or functional systems (multiple organ failure), leading in some cases to irreversible phenomena.

Birth trauma of newborns is damage to organs and tissues of the fetus, which occurs during childbirth as a result of a discrepancy between the birth expelling forces (contractions, attempts) and the elasticity of the fetal tissues. Predisposing reasons include: toxicosis of pregnant women, cardiovascular diseases of the mother, infections suffered during pregnancy, metabolic disorders, undermaturity and prolonged pregnancy, etc. Intrauterine asphyxia (hypoxia) of the fetus plays a special role in the occurrence of birth trauma.

Sometimes injuries are accompanied by intracranial hemorrhages, cerebral edema with increased intracranial pressure, with the development of hydrocephalus (dropsy of the brain), fractures of the clavicles and humerus bones, spine, facial nerve injuries and paralysis of the brachial plexus, etc.

Traumatic brain injury (including household). Head injuries can be very different in severity, ranging from minor contusions to the soft tissues of the head to severe injuries to the skull and brain.In young children, even sometimes outwardly “harmless” falls from a small height can hide fractures of the skull, its inner platinum with damage to the brain tissue. Mechanical trauma to the skull leads to compression of the brain tissue, tension and displacement of its layers, and a temporary sharp increase in intracranial pressure. The displacement of the medulla may be accompanied by rupture of the brain tissue and blood vessels (hemorrhages), brain contusion. Usually, these mechanical disorders are complemented by complex changes in the brain and their consequences.

Epilepsy, a chronic neuropsychiatric disease characterized by a tendency to recurrent sudden seizures. There are various types of seizures (convulsive and non-convulsive), but all of them are based on very high electrical activity of the nerve cells in the brain.

Epilepsy has been known since ancient times. Epileptic seizures were noted in many prominent people, such as the Apostle Paul and Buddha, Julius Caesar and Napoleon, Handel and Dante, Van Gogh and Nobel.Its prevalence reaches 15–20 cases per 1000 people. In addition, about every twentieth child has had convulsions at least once with a rise in temperature. Distinguish between epilepsy as an independent disease, epileptic syndromes (in various diseases of the brain) and epileptic reactions to sudden external stimuli (poisoning, intoxication, the influence of environmental conditions, trauma, stress, etc.)

Paroxysmal sleep disorders (parasomnias).Paroxysmal sleep disorders have been known since antiquity and are described in the writings of Hippocrates and Aristotle. Some of them have similarities with epilepsy, both in manifestations and in diagnostic characteristics. To date, a large number of independent syndromes that arise in sleep are known, which are associated with the peculiarities of the development of the child’s nervous system (including general medical, neurological, emotional, social problems, environmental factors). These are enuresis, night fears and nightmares, autonomic disorders (excessive sweating, respiratory disturbances, attacks of suffocation and palpitations), bruxism (teeth grinding), excessive motor activity during sleep, flinching, sleeping, sleeping, paroxysmal night pains, convulsions in the extremities, disorders of awakening after sleep.

Along with these sleep disorders, there are also disturbances of the “sleep-wakefulness” rhythm associated with sleep disorders (dyssomnia), as well as sleep disorders with concomitant diseases (ARVI, rhinitis, various pain syndromes, teething period in children, etc.), sleep disorders can also be observed in psychiatric diseases, etc.

Cerebral circulation disorders in children. In children, it is possible to develop all types of cerebrovascular accidents, starting from their initial manifestations (in the form of headaches, dizziness, disturbances of consciousness, delays in intellectual development, etc.).) and ending with strokes. Diseases of the blood, brain tumors, abnormal development of the walls of the cerebral vessels themselves (aneurysms), diabetes mellitus, alcohol and drug use can lead to vascular diseases of the brain, both in adults and in children. The likelihood of their development is quite high in heart disease, heart rhythm disturbances, heart defects and inflammatory diseases of the heart muscle. Inflammatory diseases of the cerebral vessels – vasculitis – can also cause cerebrovascular accident.In children, vasculitis is more common with rheumatism. Cerebral circulation disorders of the brain and spinal cord in children can also be a long-term consequence of the birth trauma of the spine.

A nervous child is an irritable, naughty child who does not know how and does not want to control himself. Moreover, almost 90% of completely different children fall under this parental “diagnosis”. The birth of a nervous child may depend on the fact that the expectant mother was nervous, suffered from toxicosis, and had a hard time giving birth.But even in the case when there is none of the above reasons, and your child was born and grows up in favorable conditions, congenital insufficiency of certain brain structures can become the cause of nervousness. From the point of view of medicine, the concept of a “nervous child” can mean a child with increased emotional sensitivity, as well as with anomalies in character development, neurosis, and organic disorders of the brain.

A child also becomes nervous when he does not sleep enough, watches TV all day, listens to horror films, when the house is very noisy and crowded, the family quarrels when he is the only child in the family, and the adults who love him fulfill his every whim or desire, thinking that in this is true love.

If something worries you in the behavior of a nervous child, be sure to consult a doctor: a neurologist, neuropsychiatrist, clinical psychologist. In most cases, we are not talking about serious mental abnormalities, but about ordinary ailments, which, if they are “captured” in time, are quite easy to correct. Specialists will be able to find out the cause using various types of examination – ultrasound examination (ultrasound), electroencephalography (EEG), laboratory tests, neuropsychological and pathopsychological examination.Treatment of a nervous child is complex – medication (psychopharmacotherapy), psychosocial treatment (aimed at correcting the microsocial environment surrounding the child, at forming support and helping relationships), psychotherapy (aimed at correcting behavior),

Neurotic reactions are psychogenic disorders that appear due to quarrels, conflicts, “gnawing” feelings of loneliness, any fears. A neurotic reaction easily arises due to an experienced sad or terrible event for a person.The intense rhythm of modern life and school loads are also pushing them towards them, and more and more often they are found in the most unprotected – in our children. Of course, the life of a little man is not without problems. But the problems of children are different. It is one thing when they fit into the framework of the age norms of development. But some baby problems can only be solved by specialists, such as tics, stuttering, enuresis, attention deficit hyperactivity disorder sucking fingers and tongue, rocking the body and head (yakation), masturbation (masturbation), which arose in pre-pubertal age, nail biting (onychophagia) , hair pulling (trichotillomania), etc.

With mental retardation, assistance is provided by a child neurologist, neuropsychiatrist, and psychiatrist. Parents do not always realize the desirability of early contact with these specialists, although they can provide assistance in the child’s problems, including behavioral and emotional ones. Consultation of an endocrinologist, cardiologist is obligatory, because the reasons for the delay can lie in neurological, hormonal disorders, diseases of the cardiovascular system. The child may need additional studies – MRI (magnetic resonance imaging), computed tomography (CT), ultrasound (ultrasound), EEG (electroencephalography).For a more accurate understanding of the causes of the origin of the child’s problems.

According to the indications, medications can be prescribed that improve memory and attention, reduce excitability and develop perseverance. Children, unlike adults, have more reserves and capabilities of the body. With timely assistance, the phenomena of mental retardation are noticeably smoothed out in the future, good adaptation in everyday life occurs

What is attention deficit hyperactivity disorder (ADHD)?

“Hyperactivity” – this is restlessness, inattention and impulsivity, frequent night awakenings, occurs most often in childhood and affects the general atmosphere in your family and the social future of your child.This syndrome is a “hodgepodge” of various diseases, their cause must be found out.

Early organic brain damage in the perinatal period (for example, complications during pregnancy, birth trauma, hypoxia during childbirth), as well as genetic and socio-psychological factors (family conflicts, defects in upbringing, acute and chronic stresses that reduce the resistance of the nervous system to external and internal influences).

“Disaster children”, “difficult children” – these are the names of children with ADHD.Indeed, they cause so much trouble to their parents, they constantly find themselves in some kind of unpleasant situations, since they often do not have a developed sense of self-preservation and control over behavior. At school, they can not assimilate the educational material, be at the desk during the entire lesson. Moreover, such children most often do not show mental retardation or severe neurological disorders, although increased excitability can also manifest itself with various early lesions of the nervous system (head trauma, neuroinfection, etc.).etc.). Such children require an individual approach in the educational process, therefore, the recommendations of the teacher are important. These children should not be considered aggressive and dangerous to other children. With age, in the process of social interaction, the phenomena of hyperactivity become less pronounced. Sometimes such people become leaders, have increased efficiency.

With ADHD, a neurologist, neuropsychiatrist, psychiatrist, medical psychologist (clinical psychologist) can help, and even better – all together, because then doctors will have the opportunity to discuss a comprehensive treatment regimen that will be most effective.

So, it is imperative to find out what the state of physical health is, whether the characteristics of the child’s behavior are the result of organic disorders in the brain, ultrasound examinations (ultrasound), EEG (electroencephalography), MRI (magnetic resonance imaging), consultation of a neurologist.

It is important to assess the state of the cardiovascular system (consult a therapist, cardiologist), determine the level of hormones and consult an endocrinologist.

Treatment is complex – biological, psychological and social. Drug treatment (psychopharmacotherapy) is aimed at reducing motor restlessness, improving the functions of cognition of the surrounding world, and normalizing sleep.

Enuresis

Enuresis (the second name is urinary incontinence) – the inability of a person to “endure” to the toilet, a constant struggle with wet sheets.

Potty training is one of the stages in the general mental and physical development of the child.The age at which it is already possible to talk about enuresis in a child should be at least 4-5 years.

The causes of enuresis are very different – mental trauma, anomalies in the development of the urinary tract, underdevelopment of the lumbosacral spine, improper daily routine, inappropriate nutrition, endocrine disorders, delayed maturation of the nervous system.

Enuresis can be either an independent disease or a manifestation of any other disease.Distinguish between day and night enuresis, primary and secondary. In primary enuresis, there is a lack of prior control over the emptying of the bladder. Secondary enuresis is spoken of if a person controlled the urination process for at least 6 months, and then again began to urinate in his pants or bed, due to the influence of urological, neurological, mental or endocrine diseases.

With enuresis, persistent sleep disturbances, problems with falling asleep and waking up, excessively deep sleep, night fears, sleep-speaking and sleepwalking are noted.If such a child is violently awakened, then you can observe disorientation with motor excitement, fears.

Who will help with enuresis?

With enuresis, a neuropsychiatrist will help. Additionally, you need to be examined to exclude malformations of the urinary tract and spine, diabetes mellitus, and diseases of the central nervous system. You will need consultations with a pediatrician, endocrinologist, laboratory tests, ultrasound examination of the kidneys and bladder (ultrasound), EEG (electroencephalography).

Treatment of bedwetting is complex. Drug treatment (psychopharmacotherapy) is aimed at eliminating anxiety and fears, stabilizing mood. Psychotherapy – to eliminate emotional disorders and change behavior, in particular, adherence to the daily routine, eating and drinking regime – limiting fluids, eating foods with only a low fluid content. Other non-drug methods of exposure are acupuncture, manual therapy.

CHILDREN’S HEADACHE

Children often complain of headaches.For the most part, it is, as doctors say, benign and only in rare cases does it become a manifestation of a serious general or neurological disease. Therefore, it is important not to dismiss the timid complaint of the child, who sometimes still cannot clearly formulate what hurts him. The parental anxiety that prompts them to go to the doctor to identify the causes of the child’s ill health is understandable and justified.

Why do children have headaches?

Acute headache in children is primarily one of the main symptoms of acute neuroinfectious diseases, as well as paroxysmal conditions, while chronic headache is a frequent manifestation of vegetative dystonia and neuroses.

The most common VOLTAGE HEADACHE. It is based on painful contraction of the muscles of the soft tissues of the head (scalp) or cervico-occipital region. Tension headache is usually associated with emotional stress. And what are the stresses of the child? They are countless. This, for example, preparing for a test or exams, the disappearance of a beloved pet, a quarrel with a friend … A fat child who does not want to undress in the presence of classmates often complains of a headache before physical education lessons.The duration of such pain usually does not exceed 1 to 2 hours. Of course, the doctor cannot cancel the tests and exams at school, but parents, teachers, and a doctor must work hard to eliminate and mitigate stressful influences. The doctor usually prescribes prophylactic agents.

The most common type of vascular headache is MIGRAINE. This disease is associated with genetically determined changes in cerebral vessels. Migraine attacks in children, as well as in adults, provoke physical and mental overload, emotional stress, changes in atmospheric pressure, weather conditions, allergic reactions: for example, a child’s favorite cheese and chocolate can cause headaches.

More often, children have a simple form of migraine. The phase preceding the onset of a pain attack includes irritability, malaise, dizziness, nausea, blurred vision or spots in front of the eyes, and a sudden change in mood.

Parents should know: a child suffering from migraines has a particularly sensitive type of nervous system, which reacts to various stimuli with painful sensations along the vessels of the brain and scalp.Therefore, it is very important, with the help of a doctor, to identify as much as possible all the factors that provoke seizures, and, if possible, exclude them from the life of children.

Often, children are diagnosed with PSYCHOGENIC HEADACHE. It can be associated with depression, fear of going to school, increased with difficulties in mastering the school curriculum and lack of contact with peers or parents. Such children require the consultation of a neuropsychiatrist and a psychologist.

It happens that parents fear that their child’s headache is caused by BRAIN TUMOR.Although this is the most rare cause, it should be ruled out with careful examination. In children, tumors are localized mainly in the posterior cranial fossa, cause difficulty in the outflow of cerebrospinal fluid, increase its pressure. The pain is felt in the back of the head or neck, accompanied by nausea and vomiting. The child often looks lethargic, indifferent. There is unsteadiness in gait. The development of hemiparesis (weakness in the muscles of the left or right extremities) may indicate the development of a tumor in one of the cerebral hemispheres.The most informative diagnostic procedure for confirming or excluding a brain tumor is computed tomography, which is usually referred to the patient.

It is extremely rare in children that there is neuralgic pain that has a paroxysmal nature. These are short, consecutive attacks of piercing, cutting, burning pain localized in the face area (cranial neuralgia or prosopalgia) with the presence of zones, the irritation of which provokes an attack (touching, washing, eating, etc.)in particular, trigeminal neuralgia.

In addition, a medicinal headache caused by taking certain medications, such as antihistamines, antibiotics, etc., is isolated.

Headache associated with the abuse of various analgesics, more often non-steroidal anti-inflammatory drugs, as well as anti-migraine drugs, is called abusal, or ricochet. There is also known a headache of caffeine withdrawal in lovers of strong tea and coffee when it is impossible to drink their favorite drink again and again.

If a child has a headache combined with a high fever and tension in the neck muscles, which makes it difficult to bend the head forward, there is reason to suspect MENINGITIS. In such cases, contact your doctor immediately.

Mixed headache. Headache is only a subjective symptom that accompanies various diseases. To successfully treat a headache, it is necessary, first of all, to find out the mechanism of its occurrence, since different types of headaches require a completely different approach.

The examination of children with headaches begins with a thorough examination of complaints, history of the development of the disease and a careful medical examination. If the examination reveals symptoms of organic damage to the central nervous system, then special instrumental and laboratory studies are carried out to clarify the diagnosis. Neurologists and psychoneurologists provide help for headaches. For correct diagnosis, studies are important – vascular ultrasound (Doppler study), EEG, MRI, CT, examination by an ophthalmologist, etc.specialists according to indications.

You shouldn’t be afraid of them. On the contrary, do everything prescribed by your doctor without delay. For only then will the result of your child’s treatment be ensured as much as possible

Headache treatment. Our center uses a pathogenetic approach to the treatment of headaches. It includes not only drug therapy, but also non-traditional methods of treatment (acupuncture, manual therapy), psychological correction, rational psychotherapy and recommendations for lifestyle changes (behavioral medicine).

Epilepsy

Epilepsy is not a single condition, but a diverse family of disorders, the common feature of which is an abnormally high predisposition to epileptic seizures. Some authors prefer to talk and write not about epilepsy, but about “epilepsy”.

It used to be thought that a diagnosis of epilepsy could be made if a child had two spontaneous (unprovoked) seizures. Now the doctor has the right to diagnose epilepsy if the child has one epileptic seizure, but there is a high probability of its recurrence.As a rule, the doctor estimates the likelihood of repetitions based on the data of the electroencephalogram and the specific clinical situation (whether the child has a neurological disease, the appearance of seizures, etc.). In addition, it became clear that an attack may not always be spontaneous. So, with several epilepsies developing in adolescence, an attack can be triggered by lack of sleep in combination with stress.

An epileptic seizure is an event caused by nerve cells in a specific part of the brain becoming overexcited and working in a particular irregular rhythm.The activity of the brain is disrupted, and the person develops disorders of movement, behavior, perception, sometimes with impaired consciousness and a fall. The attack does not last long – from seconds to several minutes, although there are exceptions to their rule (very long attacks). In general, the attack does not always look as intimidating as it is shown in the movies. Sometimes the attacks are subtle.

An epileptic seizure is not always a symptom of epilepsy. Much more often than epilepsy, there are so-called febrile seizures (which are provoked by temperature).As a rule, they do not harm the child’s brain, very rarely turn into epilepsy, disappear as they grow older (after 6 years) and do not need constant treatment. In fact, they only look scary, but they are quite benign conditions with a good prognosis. Also, some newborn children have epileptic seizures, which may never recur, therefore there is a special term “neonatal seizures” (newborn seizures), and the diagnosis is formulated. There is another option when an epileptic seizure develops with neuroinfection (for example, with meningitis) or with traumatic brain injury.It does not always turn into epilepsy, that is, repeated seizures do not always develop.

Epilepsy is the most common severe disease of the nervous system, occurring worldwide, regardless of race, with a frequency of 0.5-1%.

Causes of epilepsy

Depending on the cause of epilepsy, three groups of epilepsy are distinguished:

Idiopathic epilepsy – those in which epilepsy is the only manifestation not associated with structural damage to the brain, other neurological symptoms are absent.It is assumed that these syndromes are of a genetic nature and usually age-dependent (occur and, sometimes, pass at a certain age). The International League Against Epilepsy (ILAE) currently prefers the term “genetic” epilepsy. The concept of genetic epilepsy is that epilepsy is the direct result of known or suspected genetic defect (s), and seizures are the core symptom of the disease

Symptomatic epilepsies are those in which epileptic seizures are the result of one or more identifiable structural damage brain.The International League Against Epilepsy (ILAE) currently prefers the term “structural / metabolic” epilepsy. The concept is that a patient with epileptic seizures has another structural brain damage or metabolic condition / disease that is associated with a significant risk of developing epilepsy.

Cryptogenic epilepsies (presumably symptomatic) – those that are suspected to be symptomatic, but the etiology cannot be identified.The International League Against Epilepsy (ILAE) currently prefers the term “epilepsy with an unknown cause”, that is, the cause is unknown at the time of diagnosis (it may be genetic or associated with some as yet unknown disease)

It should be said that epilepsy in children is extremely diverse. There are a variety of syndromes, from benign to malignant.

The meaning of the term “benign epilepsy” has undergone a certain evolution.Previously, an epileptic syndrome was considered benign if it did not cause impairment of intellectual functions and was easily treatable. Currently, an epileptic syndrome is considered benign if it is characterized by epileptic seizures that are easily treatable or do not require treatment, and pass without consequences. In some situations, it can only conditionally be called epilepsy, since a child can have only one epileptic seizure, and then it is more correct to define it as epileptic seizures, and not epilepsy.The report from the International League of Epileptic Classification and Terminology Commission (2010) also suggests that the term “benign” can create “false optimism” and unrealistic expectations for both the doctor and the child’s parents. It is known that cognitive and behavioral disorders, psychiatric disorders, migraines and even sudden death syndrome can occur in almost any form of epilepsy.

At the other end of the epilepsy spectrum are epileptic encephalopathies.These are severely recurrent epilepsies, as a rule, with frequent seizures, delay or even regression of mental development, which are difficult to treat with medication. These epileptic syndromes are often referred to as catastrophic, as their outcome (even with proper treatment) is most often mental retardation, disability, and sometimes even death. Epileptic encephalopathy can occur at any age, starting from the neonatal period. The concept of the development of epileptic encephalopathy is based on the recognition of the fact that epileptic activity itself (even without seizures) can have a negative effect on the developing brain, thereby causing intellectual and behavioral disorders.In fact, the developing brain of a child is constantly in a situation of status epilepticus, although this status is characterized not so much by seizures as by discharges.

Another special group of epilepsies is idiopathic generalized epilepsy. These epilepsies are highly responsive to drug therapy and most patients do not experience seizures when given adequate medication. But withdrawal of the drug without relapse is possible only with childhood absence epilepsy. With idiopathic generalized epilepsies starting in adolescence (juvenile myoclonic and adolescent absences), the withdrawal of the antiepileptic drug even with prolonged remission is not always possible, since there is a high risk of relapse of seizures.

An intermediate position between the two ends of the epilepsy spectrum (benign childhood epilepsies and epileptic encephalopathies) is occupied by symptomatic and cryptogenic focal childhood epilepsies, which can be either mild or severe, depending on the specific clinical case. The prognosis of the course depends on a combination of many circumstances: the presence of changes in the brain according to MRI data, motor and intellectual disorders, the severity of discharges on the encephalogram, the timeliness and adequacy of antiepileptic therapy, and a number of other factors.

Diagnostics of epilepsy

In the diagnosis of epilepsy, interviewing the patient, electroencephalographic examination, magnetic resonance imaging of the brain are of the greatest importance.

Interviewing the patient or his parents. Each type of epileptic seizure has its own clinical and encephalographic features. When interviewing the patient or his parents, the doctor clarifies everything regarding the various characteristics of the seizures:

1. Age at which the seizure developed.There are age-dependent forms of epilepsy with a characteristic age of onset of seizures of
2. Relationship of a seizure with the sleep / wake cycle – there are epileptic syndromes in which seizures are observed mainly during sleep or upon awakening
3. Presence of provoking factors – lack of sleep, watching TV programs, working on a computer, etc.
4. The duration of an attack in seconds and minutes is an extremely important characteristic of it
5. A detailed description of the course of attacks from the first symptoms to the last: whether the patient had a presentiment of an attack, what subjective sensations he had, whether he lost consciousness (in whole or in part), whether there was tension in the limbs and body (in which limbs), and in mimic muscles, whether the eyes were brought up (and where – up, in which direction), were there twitches and, if so, in which parts of the body.It is important how the patient got out of the attack, whether he remembers his / her feelings during the attack, whether he / she has speech and movement disorders, stunnedness after the attack, or sleep.
6. Frequency of attacks per day, per month, per year
7. Sometimes a patient has two or three types of seizures, and then each of them is described in detail
8. If treatment has already been carried out, it is specified how it affected the frequency and other characteristics of attacks

From a questioning with a doctor, as a rule, an impression is already formed about whether it is an epileptic seizure or not, about the type of epileptic seizure, and sometimes, an assumption is formed about a specific epileptic syndrome.There is a not very correct, but rather accurately reflecting the essence of the problem, a doctor’s statement: “How accurately you tell about the seizures, the more accurately you will be diagnosed.” The doctor himself rarely sees an attack. The percentage of errors in the description by non-specialists is quite high. Therefore, it is better to come even to the first consultation with the so-called. “Home video” (video recording of an attack made with a camcorder, camera or mobile phone). A simple viewing of the video will allow a qualified healthcare professional to determine whether it is an epileptic seizure and, sometimes, its type.

Electroencephalographic examination (EEG) is the main method for confirming the epileptic nature of an attack. The screening method for epilepsy is a routine EEG, which is recorded in a state of relaxed wakefulness. Typically, a routine EEG is short and takes 20 minutes. The routine EEG protocol necessarily includes an eye opening / closing test, rhythmic photostimulation and a hyperventilation test (the patient breathes frequently and deeply). All these tests are aimed at provoking epileptiform activity, if it is not obvious.Sometimes a routine EEG recording is used in the morning after sleep deprivation (short sleep duration), which, in certain epileptic syndromes, increases the information content of the EEG. It is not always possible to record a seizure or to obtain reliable epileptiform changes between seizures during the recording of a short routine EEG. At the same time, it is well known that evidence of the epileptic nature of an attack is the presence of epileptic discharges at the time of its onset or preceding its clinical manifestations.

A more informative, but also laborious research method is video EEG monitoring: long-term recording of EEG and video images during wakefulness and sleep, sometimes with simulation of real life situations (for example, watching TV by a photosensitive patient in order to select a method of non-drug protection). The duration of video EEG monitoring can vary from several hours to days. Quite often, monitoring includes not only wakefulness, but also the patient’s sleep (day or night).A longer recording duration is more likely to record the clinical manifestations of an attack, see epileptic changes on the EEG at this moment, and understand in which parts of the brain epileptic excitement is generated. The need for video EEG monitoring, its duration, the need to be included in the monitoring of the patient’s sleep is determined by the doctor, based on the specific clinical situation. Long-term video EEG monitoring plays a special role in pre-surgical preparation, when antiepileptic therapy is sometimes temporarily canceled to provoke seizures in order to localize their source.

As a rule, the data of the survey and electroencephalographic examination allow to establish the type of seizure, after which the doctor thinks about what kind of epileptic syndrome the patient has. In the diagnosis of individual epileptic syndromes, the age of the onset of epilepsy, the type of seizure (seizures), the patient’s neurological status (the presence of motor, speech and intellectual impairments – therefore, at the first consultation, the doctor should conduct a neurological examination of the patient), interictal and / or seizure EEG data play a role and magnetic resonance imaging of the brain.

MRI of the brain is widely used to clarify the diagnosis of epilepsy. In idiopathic (genetic) focal and generalized epilepsies, there should be no pathological changes on MRI. Therefore, the doctor, if he is sure of the presence of idiopathic epilepsy, may not refer the patient to this study. It is better to use high-resolution MRI. In case of drug-resistant epilepsy (which is difficult to treat with antiepileptic drugs), during MRI, they try to use a special epileptological mode (more frequent sections are made during the study).In preoperative preparation, positron emission tomography and tomography with the emission of a single photon are used to clarify the localization of the epileptic focus.

Additional research is needed if the doctor suspects that epilepsy is only a symptom of some other, usually serious illness. In children with epilepsy and delayed psychoverbal development, it may be necessary to study the karyotype, determine the spectrum of blood and urine amino acids, urine organic acids, molecular genetic studies, etc.

The whole range of studies is carried out with one goal – as accurately as possible to establish the cause of epilepsy and to determine the prognosis of its course.

Treatment of epilepsy.

The cardinal task of antiepileptic therapy is complete control over seizures in the absence of unwanted side reactions and negative impact on the patient’s quality of life. This goal is achievable in two thirds of all patients. Medical treatment of epilepsy is not very effective in about 20-30% of patients with epilepsy.Such epilepsy is called resistant epilepsy, the goal of treatment for resistant epilepsy will be different – to achieve the lowest possible frequency of epileptic seizures (and not completely get rid of them).

Chronic treatment is not prescribed for febrile seizures (against the background of fever), for isolated neonatal seizures (in the first 30 days of life), for acute symptomatic seizures (seizures associated with acute systemic disease, intoxication, alcohol or drug abuse or their cancellation , or an acute stage of brain damage), as well as with a single unprovoked attack.Rare nocturnal seizures in benign focal childhood epilepsy with centrotemporal adhesions (rolandic) may not be treated.

The decision to initiate treatment in patients with epilepsy should be made individually. In general, treatment should be started quickly if there is a possibility that the delay in treatment will harm the patient. The assessment of the likelihood of harm from delayed treatment depends on the epileptic syndrome and on the patient’s environment. It should also include the risk of sudden death in epilepsy, which potentially exists at any age.

The drugs used in the treatment of epilepsy are called antiepileptic drugs – abbr. AED (synonyms: anticonvulsants, antiepileptic drugs, anticonvulsants). There are more than 20 AEDs in the world, not all of them, unfortunately, are registered in Russia. A doctor who diagnoses and treats epilepsy, as a rule, is well aware of antiepileptic drugs, their mechanisms of action, doses, indications and contraindications, drug interactions, acute and chronic side effects.

The doctor chooses one AED (this tactic is called monotherapy), guided by the type of seizures and the patient’s specific epileptic syndrome. The selected AED should be most effective for this type of seizure and epileptic syndrome. As a rule, when choosing a drug, the doctor takes into account the presence of concomitant diseases and the specific financial situation (the presence of the drug on the preferential lists and the possibility of receiving it free of charge, the likelihood that the patient himself will be able to buy the drug, etc.), as well as the availability of the drug in the pharmacy chain.

The dose of all AEDs is increased gradually. It is believed that a gradual increase in dose improves tolerability of therapy. There are drugs with a fairly rapid dose escalation (for example, a therapeutic dose of valproate can be achieved within 1-2 weeks), with an average rate of dose escalation (for example, carbamazepine) and with a slow rate (lamotrigine, topiramate). With a slow increase in the dose, the therapeutic dose is reached after a few weeks.

The frequency of application depends on the dosage form of the drug. One and the same AED can be produced for ease of use in different dosage forms. So there are special dosage forms for children (they do not like to swallow tablets) – drops, syrups, solutions for internal use, microgranules for sprinkling food. The same drug can be produced in tablets with different content of the active substance. The active substance can be quickly released from the tablet, or it can be released gradually.If the release of the active substance is gradual, then such a dosage form is called prolonged. It is generally accepted that prolonged release forms are more effective and better tolerated. The frequency of admission is determined by the doctor in each case. As a rule, prolonged forms of AED are used 2 times a day, as well as drugs with a long half-life. The rest of the dosage forms are usually administered three times a day. There is no point in dividing the daily dose of AED by 4 or more times.

When determining the effectiveness of AED, it is necessary to monitor the number of attacks and the tolerance of the drug. The number of seizures is recorded in the seizure diary. Their nature is also indicated there, since the clinical manifestations of seizures can change during treatment. With the introduction of the drug, the therapeutic concentration in the blood is not created immediately, but several days after the dose is increased. Therefore, we do not expect significant improvement at low doses of the drug and immediately after increasing the dose.It is necessary to wait at least a few days for the drug to be distributed in organs and tissues, and a stable therapeutic concentration in the blood is created. Tolerability of the drug is assessed by the presence of side effects. All side effects are divided into two large groups – intolerance reactions and dose-dependent side effects. Intolerance reactions occur in the early stages of treatment and require discontinuation of the drug. As an example, one can cite the development of a severe allergic reaction in the form of Quincke’s edema or rash (such a reaction is possible for the administration of any medication).Dose-dependent side effects appear gradually as the dose increases and disappear as the dose decreases. As a rule, the doctor, when prescribing a specific AED, tells the patient or his relatives what undesirable effects are most frequent and how to deal with them.

The drug should be taken continuously. If the drug is not taken on time, then its concentration in the blood falls, and this is fraught with a relapse of an epileptic seizure. It is believed that the likelihood of developing an attack if the drug is missed is about 30%.Therefore, the doctor always emphasizes and sometimes writes in the conclusion that the treatment should be long and continuous. If the patient has forgotten to take the drug, then he should do it as soon as he remembers about the pass.

After the patient takes the drug for a certain time, he is sent for a control encephalographic study. It can be repeated as the disease progresses, the timing of the EEG is determined by the doctor. It is also useful and informative to determine the concentration of the drug in the blood; it can be prescribed from one to several times a year.The doctor monitors the likely side effects of AED according to patient complaints and laboratory tests (blood tests – clinical and biochemical, ECG, ultrasound of internal organs, etc.). Which analysis is assigned depends on the specific AED. For example, if the drug sometimes gives anemia, then it will be a clinical blood test. If the drug causes a decrease in the number of platelets, then this indicator will be monitored.

If one drug is not effective, the doctor will use an alternative drug.As a rule, they act in the following way – they introduce the second drug in a therapeutic dose, without reducing the dose of the first, and see what the result is. If the disappearance of the attacks is achieved, then the dose of the first drug can be reduced and, possibly, in the future, it can be canceled. Nevertheless, there are patients who have to take 2 (rarely 3) drugs for years.

The patient is an active participant in the treatment process. In recent years, the model of the relationship between the patient and the doctor has changed. From the authoritarian model of relationships (when the doctor rigidly dictated the conditions of treatment to the patient), the whole world is now gradually moving to the so-called “partner” (“collegial”) model, in which doctors and patients are equal participants in the treatment process.The doctor communicates truthful information to the patient or his relatives, ensures its understanding, creates conditions for the patient to make an adequate decision. If the decision is made jointly (by the patient or his parents and the doctor), then the efficiency of its implementation increases significantly. Then the patient and his relatives are motivated to strictly follow all stages of examination and treatment. For them, the process of treatment is very difficult, as it sometimes lasts for years. The longer the course of epilepsy, the more difficult it is to comply with all the prescriptions.Many patients (it is believed that about 30% of the total number) do not follow the doctor’s advice: they change the frequency of taking the drug, its dose, and allow the drug to be missed. Some go into self-medication. This is most often due to a lack of awareness in the field of epilepsy. Lack of “adherence to therapy” can play an unfavorable role in the effectiveness of treatment, as well as lead to a life-threatening situation (status epilepticus), and, sometimes, even death. On the other hand, the physician must also listen to the wishes and complaints of the patient, especially with regard to the tolerability of the AED.The partner (collegial) model of the doctor-patient relationship requires trust and high responsibility from both parties.

The duration of treatment depends on the specific clinical situation and is mainly determined by the type of epileptic syndrome the patient suffers from. There are epileptic syndromes (juvenile myoclonic epilepsy, juvenile absence epilepsy, eyelid myoclonus with absences, etc.), in which we cannot cure epilepsy, but only “control” it. The patient takes the drug and has no seizures, but withdrawal of the drug leads to a relapse of seizures in 80-90% of all cases.With such epileptic syndromes, treatment is long-term (years and decades). On the contrary, the short duration of treatment is adopted for the so-called benign childhood epilepsies – rolandic and occipital epilepsies with early onset (they are treated, as a rule, no more than 2 years). Treatment duration is one of the most difficult issues in epileptology. There are international recommendations that the question of drug withdrawal should be considered no earlier than after 2 years of remission (complete absence of epileptic seizures).At the same time, in a number of patients, mainly with symptomatic epilepsy, two years is too short a period to achieve a cure for epilepsy
The decision to discontinue the drug is made by the doctor in conjunction with the patient or his parents / guardians. The decision is made on the basis of an assessment of the risk of recurrence of epileptic seizures. The risk of recurrence depends on many factors. Factors such as normal intelligence, the absence of movement disorders, changes in the MRI of the brain and epileptiform discharges on the EEG, as well as the long duration of remission, reduce the risk of relapse.Slow withdrawal of the drug is believed to reduce the risk of relapse. How slowly to withdraw the drug is not a very clear question. In the international literature, there is a recommendation that the cancellation of the AED should not be carried out faster than 6-8 weeks. There are exceptions to this rule – phenobarbital and benzodiazepines are very slowly canceled. In domestic practice, AEDs are canceled more slowly than in international practice – the cancellation takes not weeks, but months. In most epileptic syndromes (with the exception of benign childhood epilepsies), AED abolition is best done under EEG control.The dose of the drug is reduced, after a while an EEG is done. If epileptiform discharges appear on the EEG, then it is advisable to return to the dose at which they were not present and not to cancel the drug. EEG is also indicated after complete discontinuation of the drug. The most dangerous in relation to the recurrence of seizures is the first year after the complete withdrawal of the drug

Lifestyle of a patient with epilepsy

All patients with epilepsy, their relatives, their caregivers, and doctors should strive for the maximum possible preservation of a normal lifestyle characteristic of healthy people.Of course, this is not always possible, especially in severe epilepsy, occurring with frequent seizures and impaired intellectual development. Nevertheless, you should always strive to ensure that there are no unnecessary and unnecessary restrictions. Epilepsy can have a negative impact on a patient’s lifestyle, but reasonable optimism can reduce this negative impact. The balance between striving for a normal lifestyle and minimizing possible risks is sometimes difficult to achieve.

Diet .Patients with epilepsy should receive a nutritious diet with sufficient amounts of fresh vegetables and fruits. There is a special diet called ketogenic that can reduce the number of seizures in patients with refractory epilepsy. It is quite difficult to use and cannot be carried out on its own due to possible complications.

Physical activity. General exercise usually does not provoke seizures (although this is extremely rare in individual patients).Sports are indicated for patients with epilepsy, they have a beneficial effect on mood and reduce the patient’s isolation from society. Exercise helps you avoid being overweight, which is sometimes a consequence of taking medications. In addition, physical activity allows you to strengthen bone tissue (its density can also decrease with the intake of certain antiepileptic drugs). There are several studies that do not show a link between a patient’s physical activity and the frequency of their seizures.Nevertheless, in each case, the issue is decided individually. The type of seizures is of great importance – if the patient loses consciousness during the seizure, then certain restrictions may be introduced. The risk of possible injury at the time of an attack is always taken into account, therefore, mountaineering, scuba diving, boxing and jumping on a trampoline are excluded. As a rule, swimming is not indicated for a patient with ongoing seizures. Water cramps lead to drowning. In some individual situations, in the absence of seizures or in rare seizures without impaired consciousness, the doctor may allow the patient to swim, but only in the presence of responsible persons who can provide emergency assistance if needed.You can ride a bike if there are no seizures, it is better to wear a protective helmet. The same goes for horse riding.

Work. In some cases, epilepsy can cause seizures that can interfere with certain work. In general, employers have a certain prejudice against workers with epilepsy, and this is not always true. Some legislation is needed to prevent discriminatory restrictions on employment.However, the presence of epilepsy can limit the choice of work or specialty – suffering from epilepsy, it is impossible to become a pilot, driver, professional military man, police officer, firefighter. Working with moving machinery and chemicals can be a potential hazard to a patient with persistent seizures. For a patient whose seizures are provoked by a lack of sleep, work at night is unacceptable

Sex. Many patients with epilepsy are sexually active and do not have any complaints.At the same time, certain types of epilepsy by themselves, as well as certain antiepileptic drugs, can reduce libido. If this happens, you need to tell your doctor about it.

Travel. For any travel, it is essential to stock up on an adequate amount of an antiepileptic drug. It is advisable to take with you a prescription for the drug with an indication of its international name, written out by a doctor. It is even better to have a short statement (letter from the attending physician) with recommendations along with the prescription.The drug must be kept with you (in hand luggage) in case the luggage is lost. It is compulsory to take out insurance while traveling abroad.

Emotional and psychological support is extremely important for patients. This also applies to the patient’s family, the school / college / institute in which he is studying, and the place of work. Everyone around should treat patients with epilepsy (adults and children) as completely normal people, albeit with certain problems.Patients and their relatives can also apply for support to special public organizations (associations), of which there are now quite a few. Some patients and their families need the help of a psychologist and psychotherapist.

Alcohol. Most patients with epilepsy can occasionally drink a glass of wine (100 ml) or beer (285-300 ml) or spirits (30 ml). Restrictions in alcohol intake are associated with the fact that large amounts of it reduce the effectiveness of antiepileptic treatment (relapse of seizures is possible).Alcohol abuse can also lead to a loss of control over seizures due to lack of sleep, missed use of the drug, or a decrease in its concentration in the blood.

Car driving. In our country, the legislation is very strict – if a person suffers from epilepsy, he cannot drive a car.

Television and computer games – certain restrictions exist only for so-called photosensitive patients. All of them are advised to avoid provoking factors.For this purpose, the wearing of sunglasses or polarizing glasses is recommended. The effectiveness of such protection can be tested by conducting an EEG. There is no need to prohibit patients with epilepsy from watching television, especially since reflexive “television” epilepsy does not exist (there are almost always spontaneous seizures).

The following precautions are recommended when watching TV:

• A small screen with good picture quality and a 100 Hz refresh rate is safer than a 50 Hz screen;
• the distance to the TV screen must be at least 2 m;
• use of the remote control;

90,015 watching TV in a lit room to reduce contrast;

• avoiding watching TV at an obtuse angle;
• if it becomes necessary to come close and look at the screen at a close distance, even for a short time, you must close one eye with your hand (just closing your eyes is not enough).

Recently, LCD TVs and computer monitors are safer than CRT designs.
90,000 Complications and reactions after vaccination! Is there a difference? – Children’s Medical Center Pollyanna

Complications and reactions after vaccination Is there a difference?

There are the most common vaccine reactions and vaccine complications.While there is no difference for most parents, you need to know how they differ.

Vaccination reactions are what parents and doctors often encounter, that is, natural and expected reactions from a child who has received a vaccine. These include:

• an increase in temperature that occurs mainly on the first day after vaccination. A high temperature after 2 days from the vaccination is more often the result of ARVI on the day of the doctor’s visit.

• Local reaction in the form of redness or swelling (edema) at the injection site. It usually lasts for several days and goes away on its own. A severe reaction in the form of edema of more than 8 cm is very rare.

• Piercing crying for 3 hours or more is more often associated with nerve injury at the injection site. It passes without consequences.

Complications are an unexpected and abnormal reaction of the body against the background or after the administration of the vaccine.There are several types of complications.

Complications due to individual sensitivity are the most common cause of reactions: allergic (rash, urticaria, shock), neurological (convulsions, encephalopathy).

Complications due to violation of the principles of vaccination: poor-quality vaccine, violation of storage or transportation of vaccines, violation of the technique of administering the vaccine or its dose.

Indirect situations associated with the introduction of vaccinations are also possible, for example, convulsions against the background of an increase in temperature after vaccination, i.e.That is, not for vaccination, but for a rise in temperature after vaccination.

Vaccination complications are serious and / or permanent health problems due to vaccination. These include:

• Vaccine-associated poliomyelitis is a rare but serious illness that occurs after vaccination with a live vaccine against poliomyelitis (the incidence rate, according to WHO, is 1 case per 1,000,000 vaccinated). In this regard, the issue of a complete transition to inactivated vaccines (non-living) is being resolved.

• Thrombocytopenia is a sharp and significant decrease in the number of platelets, which entails the risk of bleeding. Occurs after measles vaccination (3-4 cases per 100,000 vaccinated)

• Shock (anaphylaxis) may be associated with components of vaccines, but in most cases the cause is unclear. For DPT vaccine, the frequency is 1 case per 50,000 vaccinated, for other vaccines the risk is much less frequent – 1 case per 1,000,000 vaccinated. The reaction occurs after a few minutes, at least after 1-2 hours.

• Complications of BCG vaccination (tuberculosis) – ulcer, cold abscess, enlarged lymph nodes, even bone inflammation (osteomyelitis) with the release of mycobacterium tuberculosis from the inflammation focus. All complications of BCG occur in 85% with BCG vaccination and in 15% with BCG-M vaccination. Generalized BCGitis is a very serious illness of an immunocompromised child who has been vaccinated. It is extremely rare. Over the past 6 years, there have been 4 children in Russia.

Taking into account all possible complications and reactions, each responsible pediatrician must conduct a full examination of the child before vaccination, collect anamnesis, and also evaluate the results of blood and urine tests, and only then decide whether to vaccinate.

Lack of vaccinations can cause a serious infectious disease with various consequences, but the refusal of vaccination by parents will not affect the registration of the child in a child care institution, although in some cases it leads to certain restrictions.

Dear parents! There is a lot of information even in this small article, and it is quite difficult to get adequate knowledge on the Internet without a medical education. Therefore, if you have any questions or doubts, come to our clinic for qualified advice.

90,000 causes, symptoms, treatment. Doctor Komarovsky

Seizures in children occur at different ages. Parents have a responsibility to know why this is happening and how to provide quick help in such a situation. Be sure to contact a specialist, since this condition can cause negative consequences.

Why does this happen

Convulsions are muscle contractions. More often it concerns the limbs. Their appearance in the first years of life is associated with many factors.The presence of other diagnoses, the type of seizure and the age of the patient plays a role. The most common reasons are:

• intoxication;
• meningitis;
• asphyxiation;
• internal bleeding;

90,015 genetic diseases;

• tumors and cysts;
• phelepsy;
• diabetes and other metabolic pathologies;
• hysteria;
• craniocerebral and birth trauma;
• psychoemotional disorders;

90,015 CNS disorders and much more.

For example, such syndromes in a baby in the first days or months after birth can occur due to birth trauma, genetics, asphyxia or metabolic disorders. Children under one year old face a problem with a cold or after the next vaccinations.

Regardless of whether such phenomena occur regularly, or whether it was an isolated incident, you cannot ignore it. If limb spasms are caused by a certain pathology, then without timely therapy they can develop into cerebral palsy and other diagnoses.The sooner the cause is identified, the greater the chances of a speedy and complete recovery.

Varieties and Symptoms

There are several classifications of seizures. According to the generally accepted, they are divided into generalized or focal. In the first case, the spasm spreads to all muscles, which temporarily paralyzes the body completely, and in the second they are localized only in one area.

Seizures are also subdivided into clonic and tonic. With clonic muscles, muscle twitching and pulsation is observed, then everything is replaced by relaxation.And against the background of tonic tension can last a long time. There are also combined tonic-clinical contractions.

There is one more classification – these are febrile and non-febrile. They look like this:

• with febrile manifestations, the temperature rises sharply. Most often, they appear with a severe cold or flu and disappear after the underlying disease is cured;
• non-ferrile ones occur when the brain is dysfunctional, up to 3 years old they can appear in a dream. If such cases are isolated, you should not be afraid.But if this happens often, and especially after 3 years, and is accompanied by involuntary urination at night, then you should not delay contacting a therapist. The manifestations of epilepsy and loss of consciousness should be alerted.

When the contraction is strong, its characteristic symptoms are as follows:

• blue lips and skin;
• bedwetting;

90,015 teeth grinding;

90,015 epilepsy;

• Tension and clenching of arms or legs;
• twitching of the limbs;
• distortion of facial expressions;

90,015 eye rolls;

90,015 allergy symptoms;

• foam at the mouth or vomiting.

Diagnostics and therapy

Seizures, regardless of origin, are prone to almost all children, so parents should understand how to deal with such situations. In any case, it is recommended that after a single seizure contact a pediatrician to examine him and give him a referral to a narrower specialist – an endocrinologist, neurologist or neuropathologist.

If we are talking about febrile seizures, then they are most often observed against the background of another disease and go away with it.For non-ferrile patients, general diagnostics will be required. With its help, the condition of the child as a whole will be assessed and pathologies, due to which such syndromes began to torment him, will be identified. It includes the following activities:

• laboratory blood test – determines whether there is a deficiency or excess of this or that element in the blood;
• electroencephalography – assesses the state of the brain;
• MRI or computed tomography.

When a seizure starts unexpectedly, you cannot rely on medical help.Parents must independently provide first aid to the child. It all depends on where the spasm is located, and how intense it is. For focal contraction, muscle massage should be done.

The generalized state is much more dangerous. First call a doctor and do the following before he arrives:

• put the child on its side, put something soft under the head;
• remove all dangerous objects away from it;
• Hold a towel or clean cloth between his teeth;
• turn your head to one side so that when foam or vomiting appears, it does not choke;
• Unbutton your clothes.

Gritted teeth must not be opened. Until the attack is over, it is forbidden to give drink.

Depending on the cause of the development and other factors, the doctor prescribes one or another therapy option.

Depending on the main diagnosis and the severity of the course, the duration of taking barbiturates differs.If there is epilepsy, then the course should be as long as possible.

Preventive measures

Prevention of such conditions should be started even before the baby is born. The health of the future baby also depends on what lifestyle a woman will lead during pregnancy. When he is born, his harmonious development should be ensured in all respects – this is both physical and emotional balance.

Regular physical activity, frequent walks, and a varied and healthy diet are important.The diet should contain all the necessary elements and vitamins. But it is not always possible to use them in the form of certain products. Then it is worth trying to take special complexes for children, selected taking into account all their needs.

Doromarin and his features

Many vitamin complexes are sold in pharmacies, and it can be difficult to make the right choice. But Doromarin has a unique composition, due to which it has a complex effect on the growing body, protecting it from negative external influences and preventing many ailments.Compared to analogs, it has the following advantages:

• completely natural ingredients;
• absence of allergic manifestations even with regular use;
• pleasant taste;
• the presence in the composition of the maximum amount of useful elements and polysaccharides.

All components take into account what the body needs from the age of 3 to adulthood. The composition is approved by the Center for Biotic Medicine.

Ingredients take into account the needs during the growth phase, it can be taken not only in the presence of pathologies, but also for healthy children in order to prevent various diseases. It has the following properties:

• improves metabolism – with active growth, it is necessary that all useful elements are absorbed as quickly as possible;
• strengthens the immune system – a young body will be reliably protected from negative influences, in particular in winter;
• strengthens vision – this is especially true for schoolchildren and those children who spend a lot of time with gadgets.The eyes are under heavy strain and there are risks of impaired vision. You can reduce them thanks to the intake of therapeutic and prophylactic products;
• improves brain function, attention and memory;
• normalizes the work of the gastrointestinal tract – after active physical and mental activity, fast assimilation of food should be ensured;
• accelerates regeneration processes – while playing, they are constantly exposed to injury. Thanks to the reception, the wounds will heal faster;
• cleans the organs of harmful substances and toxins – they can accumulate for a long period and have a negative effect;
• normalizes cardiac activity – the heart will be able to cope even with strong loads;
• normalizes the work of the musculoskeletal system – the supplement is the prevention of osteoporosis, scoliosis and more;
• relieves cramps and numbness of the limbs and prevents them;
• removes the manifestations of sinusitis and prevents its appearance.

As a vitamin therapeutic and prophylactic product, the complex can be used not only by a child. It is also recommended for adult patients by both therapists and other specialists – obstetricians and gynecologists, radiologists, oncologists, endocrinologists, nutritionists and others.

To prevent a number of diseases and unpleasant syndromes in a child, including muscle involuntary movements, experts recommend taking Doromarine. It is especially important in the following situations:

• if he suffers from allergies or is sick a lot – this indicates a weak immune system and its urgent strengthening;
• in the presence of close contacts with peers who can act as carriers of infections and viruses, which is especially important during periods of epidemics;
• schoolchildren find it difficult to assimilate educational material – often this happens due to absent-mindedness;
• with poor nutrition and the use of vitamins and nutrients in insufficient quantities;
• moves a little and spends a lot of time in front of a TV, monitor or phone;
• he is very active and spends a lot of energy, as a result of which he gets tired quickly.

Children (both schoolchildren and the smallest) are regularly exposed to various kinds of stress. And the body is far from always able to cope with them on its own. Therefore, he needs “reinforcement” in the form of useful microelements. And the Doromarin complex contains them in the maximum amount.

But when seizures appear in babies, treatment must be comprehensive and include numerous therapeutic measures. But the most important thing is to start it on time, especially when it comes to newborns.Their organs are poorly developed, therefore, in the absence of treatment, ischemic encephalopathy, stroke can develop against them, even a lethal outcome is not excluded.

Whatever the reason for the appearance of a convulsive seizure in a patient, and regardless of its frequency, it is necessary to conduct a complete examination of the person and prevent the consequences that can be life-threatening.

Convulsions in a child: what to do? – Doctor Komarovsky

90,000 Causes of toe cramps and their treatment

Convulsions of the toes seem to pose absolutely no threat.However, in fact, this is a very unpleasant ailment that, suddenly arising, prevents a person from feeling confident in all life situations and continuing to lead an active lifestyle. In addition, seizures can be symptoms of more serious diseases in the body and only a specialist can determine their exact origin. So where do cramps come from, and how can they be dealt with?

Causes of occurrence

Virtually every part of the body has the potential to experience convulsive contractions.Toes suffer from this problem quite often, and there are specific reasons that cause this phenomenon in this particular part of the body.

Major causes of toe cramps are:

1. Lack of minerals. Calcium or magnesium can inhibit the adequate functioning of nerve fibers. With a lack of such minerals, convulsive contractions of the toes occur. Lack of minerals can be caused by previous illnesses, improper medication or pregnancy.
2. Malnutrition, persistent nutritional deficiencies caused by dieting or fasting. With a poor diet and a lack of vitamin D, finger twitching can also occur.
3. Severe stress – hypothermia, change in body weight, poisoning or illness.
4. Increased load. If the feet are uncomfortable from narrow shoes or high heels, from constant physical exertion, cramps can occur quite often.

How to relieve pain during an attack

Convulsions cause severe pain.You can remove such a spasm by cooling the affected area. People who often suffer from seizures keep special vessels with them for a cool foot bath. For easy pain transfer, it is better to place the feet above the body. In urgent cases, it is advised to prick the foot or toe. To prevent seizures, you need to maintain a balanced diet high in essential minerals – dairy products, nuts, and seafood.

First aid during an attack

People around you should understand that cramps really cause severe pain.To alleviate the condition of a person, first aid measures must be taken.

A basic seizure first aid set is as follows:

1. Injection of toes. It can be a pin or other sharp object – if there is a risk of cramping in the water, it is better to pin the pin to the swimsuit beforehand.
2. In case of a cramp, it is good to step on a cool surface – this stimulates the normal functioning of the nerve endings.
3. Better to stretch your fingers – this way the muscles will warm up faster.
4. Restoration of water balance – it is better to drink a lot of mineral water with salts during and first time after a convulsion.
5. Subsequent painful sensations are helped to remove the elastic medical bandage.

Complex treatment

An exclusively specialist has the right to prescribe a comprehensive treatment for convulsions. After diagnosis and examination, an individual plan for subsequent therapy is developed. As part of the treatment, the patient must be prescribed a balanced diet, additionally prescribed the intake of minerals and vitamins, the lack of which became the main cause of convulsive spasms.

To strengthen blood vessels, an external topical treatment with various ointments and gels is used. Horse chestnut-based products have proven themselves well. As a preventive measure, it is recommended to take foot baths with cool water.

This treatment is prophylactic and can significantly reduce the number of seizures.

Traditional medicine anticonvulsants

After consultation with the attending physician, the patient can also supplement the treatment with traditional medicine.It is recommended to use lemon juice and tinctures based on bay leaves and vegetable oil externally under the dressings. Celandine juice with petroleum jelly also soothes spasms. Tinctures of chamomile, yarrow and thyme can also be used externally. It is better to use raisins more often – it controls the work of nerve endings.

Correct treatment can reduce the number of attacks and improve the patient’s condition.

90,000 “The whole truth about vaccinations” or what should parents be afraid of when refusing to be vaccinated? (+ video!)

– Starting to read “Revelations about vaccinations from a pediatrician-neurologist who worked as a pediatrician in a kindergarten and vaccinated children”, I expected to see tragic stories with children who were vaccinated by the author himself, Dr. Yemelyanova, and who developed serious consequences.I have not read anything like this – the author does not give a single specific case , except perhaps the case of a child who died 3 days after vaccination. As a physician, she would have to tell what conclusion about the cause of death the commission finally came to. After all, all cases of side effects after vaccinations are carefully considered by a commission, so that none of them remains unexplored – especially in our time, when opponents of vaccination are looking for any reason to denigrate vaccinations.

So, sudden death of babies is a well-established diagnosis.At the age of 2-4 months of life, children suddenly die, both received and, more often than not, those who did not receive the vaccine. A pediatrician, especially an experienced one, should know that sudden infant death is the second most common cause of postneonatal infant mortality. And also the fact that, of the known reasons, smoking of parents, sleeping a baby on his stomach, sleeping in the same bed with his mother are in the first place. Parents should be warned about this. And it is simply impossible to die from the introduction of DPT , in 3 days this inactivated vaccine will not even begin to act on the immune system.

– In addition to unfounded statements, lack of facts, what features of the material would you also mention?

This is incompetence. The author does not write where and how long she studied as a neuropathologist after she stopped working in kindergarten. I don’t think the preparation was serious. For example, she points out: “It is known that latent or overt pathology of the nervous system after vaccination can manifest itself in the form of convulsive readiness. That is, vaccination can provoke epilepsy (the described complication of vaccination). “

Let me remind you that an epileptic seizure in a patient with epilepsy is much more likely to cause flickering on the TV screen than pain associated with vaccination. Can TV be banned? Yes, in a small proportion of children, fever after getting the vaccine can cause febrile seizures. But after all, 99 out of 100 children also have them with the development of an infection. In addition, the neuropathologist should not inflame the parents about this, but explain that febrile seizures are benign and do not threaten the child with anything.

The author also points out: “Once at the consultation there was a particularly difficult child threatened by cerebral palsy (in fact, already with cerebral palsy, but he will be diagnosed with such a diagnosis after a year), I forbade him to vaccinate, because against her background, cerebral palsy progresses sharply “.

This statement of hers looks quite wild – cerebral palsy is a congenital disease, a child is born with certain injuries, which may later manifest with motor or other disorders as the child grows (for example, the inability to sit until 6-8 months cannot be detected, as well as the inability walk until the age of 1 year), but not progress in any way.

Opponents of vaccination most often associate with vaccination damage to the nervous system. I would like to invite the author to delve into books on neurology and find there – among the causes of nervous diseases – vaccinations, and tell parents what diseases they are. Yes, even 10 years ago, live polio vaccine caused paralysis in children with congenital immunodeficiency (5-8 children a year throughout Russia) – but now they are vaccinated with an inactivated vaccine, so these complications have disappeared.

As for the lamentations that vaccination “is a serious immunobiological operation”, this was said long before Mr.Onishchenko; I think Dr. Yemelyanova will agree with me that, for example, eating many foods that cause allergies is much more frequent than vaccinations and a more “serious immunobiological operation”, since it sometimes causes severe injuries, up to anaphylactic shock, with a fatal outcome … That would be to explain to her parents what types of food it is better not to give to a small child.

– How could you comment on this statement: “all modern vaccination preparations are obtained by biotechnology methods using serums and animal cells.In animals, as we learn more and more, there are infections of the prion and retroviral type, which are extremely dangerous for humans. Is it fundamentally impossible to cleanse the vaccine from impurities potentially containing these infections?

Indeed, there are fears of transmission of retroviruses and prions through vaccines – this is, of course, a problem, but so far vaccine manufacturers are successfully dealing with it. Even ardent opponents of vaccination cannot cite facts of such diseases.

– Can vaccines really trigger serious autoimmune diseases?

The reason for them is not entirely clear at all, so it is easy to deliberately tie them to the topic of vaccinations.But this does not work either – in a number of countries the frequency of these diseases was calculated before vaccinations (for example, against human papillomavirus infection) and after – the numbers converge, indicating that vaccines were not involved in their development. In general, opponents of vaccination like to refer to individual cases, usually insufficiently examined, and do not give numbers. And they are interesting.

So, in the 80s, the coverage of DPT vaccinations went down – and since the 90s, an epidemic of diphtheria broke out in the countries of the former USSR – 120,000 cases with 6,000 deaths.Plus the growth of whooping cough and measles. Then the Ministry of Health asked infectious disease specialists – what to do? The only way out – mass vaccinations – and all 150 million Russians were vaccinated, some of them again. And, you know, this did not bring any particular troubles. And after 1995, mass vaccinations of children against poliomyelitis extinguished the outbreak, vaccinated everyone, so that when this infection was brought in from Tajikistan in 2010, only 8 children fell ill with poliomyelitis in Russia – and all of them were not vaccinated (6 of them with fictitious vaccination certificates ).

Who gets measles nowadays? Children whose parents listen to “the whole truth about vaccines.” And we still cannot cope with whooping cough properly due to the large number of people who refused vaccinations. Come to our clinic, talk to the parents of an unvaccinated child with whooping cough – which is 15-20 coughing fits a day with vomiting, and so on for 3-4 weeks. Due to the low coverage, children of the first months, who have not yet been vaccinated, become infected – they are very sick, and often the case ends in death.

My advice to doctors who organized anti-vaccination propaganda, turn your face to real problems and do not fool the heads of 20 million parents in Russia vaccinating their children against all infections. After all, the people of your circle at the end of the 18th century predicted that Jenner’s smallpox vaccinations would lead to the appearance of horns and udders in the vaccinated. Now you have replaced these passions with autoimmune diseases, diabetes, cancer. Already many generations of mankind have grown up with vaccinations (I am sure, and the authors of articles against vaccinations), vaccinations not only did not interfere, but also contributed, like no other medical measures, to improve the indicators of a person’s physical development, his abilities, reduce mortality and increase life expectancy – and in the future, they will contribute to improving health, whether opponents of vaccination like it or not.