Tuesday, October 16, 2012

CONVULSION

A  fit,  seizure or  convulsion  (the  terms are  synonymous)  is a  result of a disturbance  in  the  functioning of  the
brain. A convulsion may be minor and involve the simple twitching of one limb, or major in which the patient loses
consciousness, many muscle groups go  into uncontrolled  intermittent  spasm,  the patient  falls,  sweats profusely,

has a rapid heart rate, clamps their jaw shut and loses control of their bladder.
The  main  task  of  anyone  present  at  a  seizure  is  to  protect  the  sufferer  from  harm.  Do  not  restrict  their
movements, since  the spasms and  jerking are automatic and  trying  to stop  them may cause  injury. Simply move
any objects that may be a danger and, if necessary, remove false teeth (but do not prise the mouth open or force
objects  into  it). Protect  the head  from banging against  the  floor by putting something  flat and soft (such as  folded
jacket) under  it.  If necessary  loosen  the person's collar so  they can breathe more easily. Artificial  respiration will
probably be  impossible, and  the  sufferer will breathe normally again at  the end of  the  seizure, generally after a
minute or  so. The  sufferer may  fall  asleep  once  the  seizure  has  ended,  in which  case  place  them  in  the  coma
position (on side with legs bent) and allow them to wake naturally. There may be a card or tag on the person saying
what to do in case of a seizure - look for this and follow the instructions.
Although  relatively  uncommon,  and  very  distressing  when  they  do  occur,  there  are  scores  of  causes  for  a
convulsion that vary from the obvious to the extremely obscure.
Everyone thinks of epilepsy and other serious diseases when fitting occurs, but a simple faint, severe bacterial
and  viral  infections,  high  fever  and  a  sudden  shock  or  intense  fear  can  trigger  a  convulsion.  Overdoses  of
numerous  prescribed  and  illegal  drugs,  as  well  as  alcohol,  strychnine  and  cyanide  poisoning  may  also  be
responsible.
Children  sometimes  have  convulsions  because  of  a  sudden  rise  in  temperature.  These  febrile  convulsions
consist of body rigidity, twitching, arched head and back, rolling eyes, a congested face and neck, and bluish face
and lips. Generally the seizure will end quite quickly, but  the carer should ensure  that  the airway  is clear,  turn  the
child on  to  the side  if necessary,  remove clothing, bathe or sponge  the child with  lukewarm water, and when  the
convulsion has eased obtain medical attention.
Epilepsy  is a condition  that causes  recurrent seizures  (fits). Some people are born with epilepsy, while others
acquire the disease later in life after a brain infection, tumour or injury. Brain degeneration in the elderly, removing
alcohol from an alcoholic or heroin from an addict, or an excess or lack of certain chemicals in the body can also
cause epilepsy.   Fits can vary  from very mild absences  in which people  just seem  to  lose concentration  for a  few
seconds, to uncontrolled bizarre movements of an arm or leg, to the grand mal convulsion in which an epileptic can
thrash around quite violently and lose control of bladder and bowel.
A head injury from any cause may cause immediate or delayed fitting because of injury to the brain, or bleeding
into or around the brain. Bleeding may also be caused by the spontaneous rupture of a weakened artery or vein in
the skull, and the resultant pressure on the brain can have many varied effects.
The brain is supported and completely surrounded by a three layered membrane (the meninges), which contain BABIES A to Z
   
   
17
the cerebrospinal fluid. If these meninges are infected by a virus or bacteria (meningitis) the patient may experience
headache, fever, fits, neck stiffness and in severe cases may become comatose.
Encephalitis  is an  infection of  the brain  itself, which may be confused with meningitis. The symptoms  include
headache, intolerance of bright lights, fever, stiff neck, lethargy, nausea, vomiting, sore throat, tremors, confusion,
convulsions, stiffness and paralysis.
Severe  dehydration caused by excess sweating and/or lack of fluid in a hot environment, particularly if
exercising, may cause collapse and fitting. This may be combined with excessive body temperature (hyperthermia),
which aggravates  the problem. Marathon  runners who collapse and start  twitching are often suffering  from  these
problems.
Children who have behaviour problems may have severe temper tantrums, which can appear to be similar to a
convulsion. If the child is a very determined breath holder, the end stage may be collapse and fitting due to lack of
oxygen reaching the brain, which usually settles quite quickly. 
A  lack of oxygen  from near drowning,  suffocation or  smoke  inhalation may also have adverse effects on  the
brain that trigger fitting.
Uncommon  causes  of  convulsions  in  babies  include  a  tumour  or  cancer  affecting  the  brain  or  surrounding
structures  within  the  skull,  significant  liver  or  kidney  disease,  hydrocephalus,  and  a  lack  of  thyroxine
(hypothyroidism). Rapid shallow breathing may alter  the balance of carbon dioxide and oxygen in the lungs, and
thus the blood. The blood becomes more alkali, and irritates small muscles, particularly in the hands, which go into
spasm  and may  appear  to  be  a  convulsion.  This  is  known  as  tetany  (totally  different  to  tetanus  infection)  and
patients have fingers and sometimes wrist, forearms and feet, which are pointed in a firm spasm. 
Numerous rare syndromes, inherited conditions and congenital abnormalities may also be responsible.

No comments:

Post a Comment