Spasmophilia

Spasmophilia is a disease of young children characterized by a tendency to tonic and clonic-tonic convulsions due to hypocalcemia.

Etiology and pathogenesis. The calcium content in the serum in rickets decreases in the initial phase, with exacerbation and as a result of therapy. In connection with the drop in the level of calcium, the excitability of the nervous system increases significantly, up to the convulsive syndrome. With insufficient or excessive therapeutic dose of vitamin D or with increased insolation in the spring months, more calcium enters the bone than absorbed in the intestine. Calcium absorption is also impaired in digestive disorders and intestinal infections.

Clinical picture. Latent spasmophilia is revealed in the study of the symptoms of the hvostec (finger tapping at the exit point of facialis on the zygomatic arch and in the corner of the lower jaw causes a rapid contraction of the facial musculature), Tissot (compressing the arm with a cuff of the blood pressure monitor or fingers causes a spasm of the musculature of the hand - the "hand of an obstetrician" Peroneal and ulnar phenomena (retraction of the foot during effleurage in the region of the head of the fibula, flexion of the fingers when tapping in the region of the external condyle of the elbow). Manifestal spasmophilia is manifested by generalized tonic and clonic convulsions, carpoped spasm (the "hand of the obstetrician" and equinovarus position of the foot), sometimes laryngospasm attacks in the form of slight narrowing of the glottis or short-term, but complete closure.

The diagnosis is based on the presence in the child of signs of rickets and symptoms of increased neuromuscular excitability, as well as the detection of hypocalcemia, alkolosis.

Differential diagnosis is carried out with hypoparathyroidism, renal osteodystrophy, epilepsy.

Treatment. When laryngospasm is effective fresh air, spraying with cold water, vapors of ammonia, pats on the body, changes in the position of the body. In latent form, after determining the calcium level, a 10% solution of gluconate or calcium chloride, 0.3-0.5 ml / kg, is slowly injected into the IV. In clonic convulsions, seduxen (0.5% solution - 0.1 ml / kg IM), GHB (20% solution - 0.5 ml / kg) iv, magnesium sulfate (25% solution 0.2 Ml / kg w / m); At the same time, 10% calcium chloride IV solution is administered. Then 10% calcium chloride solution is prescribed for 1 teaspoonful or dessert spoon or calcium gluconate 2-3 g 3-4 times a day. After 2-3 days of taking calcium preparations, anti-rachitic treatment is prescribed (see Rickets).

The prognosis for timely treatment is favorable.

Prevention - see Rickets.