Convulsive syndrome (ICD R 56.0): causes and emergency care

Description

 Convulsive syndrome in children.

A nonspecific reaction of the child’s body to external and internal stimuli, characterized by sudden attacks of involuntary muscle contractions. Convulsive syndrome in children occurs with the development of partial or generalized convulsions of a clonic and tonic nature with or without loss of consciousness. To establish the causes of convulsive syndrome in children, consultations with a pediatrician, neurologist, and traumatologist are necessary; carrying out EEG, NSG, REG, radiography of the skull, CT scan of the brain, etc. Relief of convulsive syndrome in children requires the administration of anticonvulsants and treatment of the underlying disease.

Convulsive syndrome: code according to ICD 10, symptoms in children and adults, emergency care

Epilepsy is a severe chronic brain disease characterized by loss of consciousness and the appearance of tonic-clonic seizures. In the article we will talk about what epilepsy is, what symptoms are typical for it, what indicators to pay attention to when filling out an emergency hospital call card, and also give an example of filling out a call card during an epileptic seizure

Epilepsy is a serious chronic disease, the distinctive feature of which is repeated unprovoked epileptic seizures, characterized by disruption of almost all brain functions.

The main thing in the article

• Registration of a patient with epilepsy: cheat sheet
• Epilepsy, unspecified - example of writing a call card
• Diagnosis by the EMS team
• Treatment result

In the article we will talk about what epilepsy is, what symptoms are typical for it, what indicators to pay attention to when filling out an emergency hospital call card, and also give an example of filling out a call card during an epileptic seizure.

Call card: epilepsy, epileptic seizure (epileptic seizure) download / open >>

Sanitary education work EMS: First aid for epilepsydownload / open >>

Symptoms of an epileptic attack:

1. The appearance of an “aura” (flashes before the eyes, auditory or olfactory hallucinations, numbness of the limbs, blurred vision or complete loss of the ability to see, dizziness, loss of consciousness and other phenomena).
2. Cramps of all muscles or individual groups of them.

What is the provoking factor?

The main reason for the occurrence of epileptic seizures is the withdrawal of medications taken, the action of which is aimed at suppressing epileptic seizures. However, status epilepticus can occur not only against the background of epilepsy, but also due to brain lesions, including:

• head injury;
• intoxication;
• intracranial malignant tumor;
• circulatory disorders in the brain;
• infection;
• dropsy of the brain (encephalopathy);
• withdrawal syndrome;
• complications of diabetes;
• hematoma.

The incidence of epistatus without a predisposing factor - epilepsy is approximately 50%.

Causes

The occurrence of seizures or symptomatic epilepsy is facilitated by:

Seizures occur due to spontaneous discharges sent by the brain

• hereditary factor;
• congenital disorders of the central nervous system;
• brain tumors, both benign and malignant;
• traumatic brain injuries;
• hysteria;
• infectious diseases;
• fever;
• arteriovenous cerebral aneurysms;
• parasitic infestations;
• chronic alcoholism.

Types and stages of epistatus

The variability of the types of epileptic seizures determines the formation of various clinical forms of epileptic seizures. They are divided into two main groups - convulsive and non-convulsive seizures.

According to the classification, the following types of status epilepticus are distinguished:

1. Generalized SE - characterized by widespread tonic-clonic convulsions with an unconscious state.
2. Not completely generalized ES - characterized by atypical muscle spasms with complete loss of consciousness. Tonic status is most common among children with Lennox-Gastaut syndrome. Can be observed at different ages. Clonic status is observed with epilepsy in infants, as well as with convulsions with high fever in young children. Myoclonic status is characterized by constant or episodic muscle twitching.
3. The status of focal paroxysms proceeds according to the type of Jacksonian epilepsy with muscle contraction of a certain localization, for example, only the muscles of the face, one limb or half of the body. In this case, loss of consciousness may not occur.
4. Absence or non-convulsive status is accompanied by a complete loss of consciousness without muscle contractions. Such attacks are characterized by the mildest course, however, due to the absence of seizures, diagnosis can be difficult.
5. Partial status is characterized by unconscious and automatic actions with complete or incomplete loss of consciousness.

The stages of development of epistatus are also distinguished:

• pre-status - lasts 1-10 minutes;
• initial - lasts from 10 minutes to half an hour;
• expanded - lasts from half an hour to an hour;
• refractory - lasts more than an hour.

What types of pathology are there?

Seizures may be a sign of a serious disease of the central nervous system. They are divided into:

1. Localized seizures. Individual muscle groups are affected.
2. Generalized seizures. Covers all muscles. They are a typical manifestation of epilepsy.
3. Clonic seizures. Alternating spasms, during which alternating contraction and relaxation of the muscles occur.
4. Tonic convulsions. The muscle contraction is prolonged and is not followed by relaxation.
5. Tonic-clonic seizures. A combination of tonic and clonic.

The syndrome is manifested by sudden and involuntary muscle contractions

In addition, seizures can occur with:

• traumatic encephalopathy;
• vascular pathologies;
• brain oncology;
• liver failure;
• uremia (intoxication of the body as a result of impaired kidney function);
• hypoglycemic coma;
• neuroinfections (meningitis, encephalitis, polio, leptospirosis, herpes, neurosyphilis)

It is necessary to distinguish between epilepsy and convulsive syndrome (code according to ICD-10 - R56.0). Unlike epilepsy, this pathology is only a symptom and not a separate disease. Its characteristic feature is that after eliminating the underlying disease, the convulsive syndrome itself, which was only a sign of this disease, is also eliminated.

This syndrome can occur in the form of several seizures or even convulsive status (a series of convulsive seizures following one after another with a short interval, during which the patient does not regain consciousness).

What does it look like in real life

Symptoms of status epilepticus are determined by severe disorders in consciousness, respiratory system and hemodynamics, which are caused by a previous attack; the number of seizures during epileptic status can range from 3 to 20 per hour.

Consciousness by the time of the next attack does not clear up and the person is in a state of stupor, numbness or coma.

With prolonged ES, the comatose state worsens, becomes deeper, convulsions take on a tonic form, an increase in blood pressure is replaced by a sharp decrease, and increased reflexion is replaced by a lack of reactions. Hemodynamic and respiratory disorders become more pronounced.

The convulsions may disappear, and then the stage of epileptic prostration begins, which is characterized by external changes:

• pupil size changes;
• the gaze becomes unconscious;
• mouth slightly open.

It is very dangerous! In this condition, death can occur.

Epistatus necessarily lasts more than half an hour. This condition should be differentiated from episodic attacks, during the intervals between which there is a complete or almost complete clearing of consciousness, as well as a partial restoration of the patient’s physiological state.

The course of convulsive SE can be divided into two phases. At the first stage, compensatory changes occur to maintain blood circulation and the metabolic process.

This condition is characterized by:

• tachycardia;
• high blood pressure;
• vomit;
• involuntary urination;
• involuntary defecation.

The second phase occurs after half an hour or an hour and is characterized by a breakdown of compensatory changes. In this state, the following processes occur:

• lowering blood pressure;
• arrhythmia;
• respiratory dysfunction;
• thrombosis of the pulmonary artery and its branches;
• acute renal and liver failure.

Non-convulsive epistatus is characterized by various disorders of consciousness:

• feeling of detachment;
• immobilization.

In the case of ES of complex partial seizures, the following is observed:

• behavioral deviations;
• confusion;
• symptoms of psychosis.

Status epilepticus from A to Z:

Source: https://neuro-orto.ru/simptomy/neotlozhnaya-pomoshch-pri-sudorozhnom-sindrome.html

What is a seizure disorder?

Convulsive syndrome is the body’s reaction to external and internal stimuli, characterized by sudden attacks of involuntary muscle contractions

Convulsive syndrome in men, women and children is a nonspecific reaction of the body to internal and external stimuli. It is accompanied by involuntary contraction of muscle tissue.

The international classification of diseases includes convulsive syndrome. Its ICD-10 code is R56.8. This code is reserved for pathologies that do not relate to seizures of epilepsy or other etiology.

Convulsive syndrome often occurs in newborns. It affects adults of all ages. It is very important to find out the cause of the disorder in order to select an adequate course of therapy.

Reasons for violation

Convulsive syndrome is caused by various reasons. Quite often it develops due to congenital anomalies and pathologies of the central nervous system. Common factors also include genetic diseases, tumors in the body, and cardiovascular problems.

Common causes that lead to the appearance of the syndrome are presented in the table. They are divided by age groups.

Since convulsive syndrome in an adult or children has many causes, the methods of treating such a disorder differ. To achieve recovery, it is necessary to correctly determine the factor that led to the development of the disease.

Symptoms in children and adults

Convulsive syndrome in children and adults has similar symptoms. Pathology appears suddenly.

A typical seizure is characterized by eye floaters, wandering eyes, and loss of contact with the outside world.

The tonic phase of the attack is characterized by short-term apnea and bradycardia. The clonic phase is characterized by twitching of facial areas on the face.

With alcoholic convulsive syndrome, which often occurs in adults and adolescents, severe intoxication, loss of consciousness, vomiting and foam from the mouth appear.

Convulsive syndrome in young children and adults is localized or generalized. In the first case, during an attack, individual muscle groups are involved. In the generalized course of the syndrome, the child may experience involuntary urination and loss of consciousness. Due to pathology, all muscle groups suffer.

Convulsions are characterized by an acute onset, agitation, and changes in consciousness

Why is seizure syndrome dangerous?

Spastic pathology, which is the state of convulsive syndrome, poses a danger to human health and life. If the attack is not suppressed in a timely manner and treatment of the disease is ignored, it will lead to dangerous consequences:

• Pulmonary edema, which threatens complete cessation of breathing.
• Cardiovascular pathologies that can lead to cardiac arrest.

Manifestations of an attack can overtake a person while he is performing actions that require maximum concentration of attention. We are talking about driving a vehicle. Even walking can cause serious injury if an adult or child is suddenly disturbed by the signs and symptoms of a seizure disorder.

Diagnostics

Diagnosis of the disease, which is accompanied by seizures, is carried out in the clinic. The specialist must collect anamnesis and, during the conversation with the patient, determine the optimal algorithm for conducting a study of the body.

The following diagnostic methods help identify seizure syndrome in an adult, newborn or adolescent:

1. Radiography.
2. Electroencephalography.
3. Cerebrospinal fluid analysis.
4. Pneumoencephalography.
5. Blood analysis.

The research results help the doctor make the correct diagnosis of the patient, that is, determine whether he has a convulsive syndrome.

Treatment of seizure syndrome

To help the patient, it is necessary to urgently call an ambulance

Convulsive syndrome, which manifests itself in a child or an adult, cannot be ignored. Adequate treatment is required.

Before deciding on therapy, a specialist must find out the cause of the disease. It is for these purposes that diagnostics are used. The therapy offered by attending physicians is aimed at suppressing the symptoms of the pathological process and eliminating the negative factor that led to the development of the syndrome.

Urgent Care

First aid can be provided to a patient at the time of an attack by anyone. He must recognize the obvious symptoms of the disease and quickly respond to them. To avoid injury to the patient during seizures, it is necessary to act accurately and consistently.

First aid to a person with a convulsive syndrome helps him wait for the medical team to arrive and safely survive the painful condition. If infants, adolescents or adults experience symptoms characteristic of an attack, you should immediately call an ambulance. Next you need to do the following:

1. It is necessary to provide the victim with access to fresh air. To do this, if possible, remove tight clothing or unbutton his shirt.
2. It is necessary to place a small towel or scarf in the oral cavity so that the person does not accidentally bite his tongue or break his teeth.
3. The patient's head should be turned to the side. The same must be done with his entire body. This action will prevent him from choking on vomit.

All these actions must be done very quickly. Afterwards, all that remains is to wait for the arrival of doctors who will help the person get rid of the attack.

Drugs

Taking sedatives helps the patient reduce the occurrence of seizures

https://www.youtube.com/watch?v=A-hbsJChW-E

Emergency care for a person with a seizure disorder may include taking medications. Drug therapy is aimed at eliminating the attack and further preventing this condition.

For convulsions, agitation and epileptic seizures, patients are prescribed GABA derivatives, barbiturates and benzodiazepines. Medicines help calm the nervous system and reduce muscle tone. For acute conditions, antipsychotics may be prescribed.

For cramps in the limbs, vitamin complexes can be prescribed. This therapy is effective if the attack is triggered by hypovitaminosis.

Providing assistance for convulsive syndrome includes the use of oral and external agents. For seizures, the following medications are recommended:

• Vitamins B and D.
• Magnistad.
• Magnerot.

It is strictly forbidden to give a baby or an adult medicine that has not been prescribed by a specialist. Medicines can be taken strictly on the recommendation of the attending physician. Otherwise, such therapy may lead to complications.

External remedies for the treatment of attacks include ointments. For leg cramps, it is customary to prescribe:

• Hermes.
• Troxevasin.
• Venitan.

Ointments and creams reduce the severity of seizures, stimulate blood circulation in the problem area and improve the saturation of tissues with nutrients.

Diet

Diet is of great importance in the treatment of convulsive syndrome. Patients are advised to adhere to a special diet that helps reduce the frequency of attacks to a minimum.

Patients with this diagnosis should exclude baked goods, carbonated drinks, sweets, strong coffee, alcohol and organ meats from their diet. If a person is overweight, then he needs to constantly monitor the number of calories consumed per day.

To cope with the painful condition, you need to include fresh vegetables and fruits, fermented milk products and whole grain cereals in your diet. It is imperative to monitor your drinking regime. Patients are recommended to drink 1.5-2 liters of clean water per day. Teas, compotes and drinks are not taken into account in this case.

If a person experiencing cramps is unable to create a menu for the week, he can seek help from a nutritionist. The doctor will select the optimal diet for the patient, which will allow the body to function normally.

Physiotherapy

Therapeutic exercises should be performed every day in conjunction with the prescribed treatment.

Therapeutic gymnastics helps to cope with convulsive syndrome. To achieve results from it, you need to practice regularly. Exercise therapy is also actively used in the prevention of attacks. Simple exercises will help you cope with the painful condition:

• Lifting small objects from the floor using only the toes.
• Rolling with your feet a rubber ball, which is equipped with spikes.
• Pulling your toes towards you while sitting with your legs extended.

Each exercise must be performed for 2-3 minutes. You can increase the duration of the training if the patient’s condition allows it.

If cramps bother you too often, the patient should take barefoot walks on sand or grass. If desired, you can use a special massage mat.

Forecast

If a person suffering from convulsive syndrome was provided with timely medical assistance, then he will have a favorable prognosis. The chances of a successful recovery increase the correct diagnosis and the cause of the development of the pathological process.

If seizures occur periodically, it is imperative to undergo diagnostic testing at the clinic. Seizures may be a sign of a dangerous disease that has not yet had time to fully manifest itself. The study will make it possible to detect pathology and treat it in a timely manner, thereby preventing the development of serious complications that pose a threat to human life.

Ignoring attacks leads to dangerous consequences, including death.

Source: https://mozg.expert/sindromy/sudorozhnyy-sindrom/

Additional facts

 Convulsive syndrome in children is a common urgent condition of childhood, occurring with the development of convulsive paroxysms. Convulsive syndrome occurs with a frequency of 17-20 cases per 1000 children: 2/3 of convulsive seizures in children occur in the first 3 years of life. In preschool children, convulsive syndrome occurs 5 times more often than in the general population. The high prevalence of convulsive syndrome in childhood is explained by the immaturity of the nervous system of children, the tendency to develop cerebral reactions and the variety of causes of convulsions. Convulsive syndrome in children cannot be considered as the main diagnosis, since it accompanies the course of a wide range of diseases in pediatrics, child neurology, traumatology, and endocrinology.

Convulsive syndrome in children

Treatment of epilepsy

If emergency care for convulsive syndrome was provided correctly, and the patient immediately sought qualified medical help, the likelihood of developing dangerous complications is minimized. Modern medications can reduce the number of seizures in patients with chronic epilepsy by 70%.

Convulsive syndrome is not a reason for serious restrictions. Clinical recommendations relate only to some adjustments in the patient’s lifestyle. The patient will have to give up emotional and strong physical stress. However, it is quite possible to lead a normal life, attend work or school. Such patients are not prohibited from driving.

Source: fb.ru

Diseases and conditions

Causes

 Convulsive syndrome in children is a polyetiological clinical syndrome. Neonatal convulsions developing in newborns are usually associated with severe hypoxic damage to the central nervous system (fetal hypoxia, asphyxia of newborns), intracranial birth trauma, intrauterine or postnatal infection (cytomegaly, toxoplasmosis, rubella, herpes, congenital syphilis, listeriosis, etc.), congenital malformations brain (holoprosencephaly, hydroanencephaly, lissencephaly, hydrocephalus, etc.), fetal alcohol syndrome. Seizures may be a manifestation of withdrawal syndrome in children born to mothers suffering from alcohol and drug addiction. Rarely, newborns experience tetanus convulsions due to infection of the umbilical wound. Among the metabolic disorders that cause convulsive syndrome, one should highlight electrolyte imbalance (hypocalcemia, hypomagnesemia, hypo- and hypernatremia) found in premature infants, children with intrauterine malnutrition, galactosemia, phenylketonuria. Separately among the toxic-metabolic disorders is hyperbilirubinemia and the associated kernicterus of newborns. Convulsive syndrome can develop in children with endocrine disorders - hypoglycemia in diabetes mellitus, hypocalcemia in spasmophilia and hypoparathyroidism. In infancy and early childhood, the leading role in the genesis of convulsive syndrome in children is played by neuroinfections (encephalitis, meningitis), infectious diseases (ARVI, influenza, pneumonia, otitis media, sepsis), head injury, post-vaccination complications, and epilepsy. Less common causes of convulsive syndrome in children are brain tumors, brain abscess, congenital heart defects, poisoning and intoxication, hereditary degenerative diseases of the central nervous system, and phakomatoses. A certain role in the occurrence of convulsive syndrome in children belongs to genetic predisposition, namely, the inheritance of metabolic and neurodynamic features that determine a lowered convulsive threshold. Infections, dehydration, stressful situations, sudden excitement, overheating, etc. can provoke seizures in a child.

Causes of epilepsy

Convulsive syndrome (ICD R 56.8 or R 56.0) is the result of synchronous excitation of all cells of a separate area of ​​the cerebral cortex (epileptic focus). The disease is quite often inherited. Therefore, if relatives had to deal with such a pathology, the child must be examined at an early age.

Epilepsy can also be acquired. In a number of patients, convulsive syndrome begins to manifest itself after serious injuries, infectious diseases of the brain (meningitis, encephalitis), or poisoning. Every tenth alcoholic or drug addict suffers from epileptic seizures.

In epilepsy, seizures can manifest themselves in different ways. Sometimes there is only a short-term loss of communication with the outside world. People around may think that the patient thought for a second. The syndrome progresses very quickly. But in many cases, convulsive attacks are accompanied by twitching of all muscles and rolling of the eyes. In this case, it is important to provide the patient with the right help.

Classification

 Based on their origin, they distinguish between epileptic and non-epileptic (symptomatic, secondary) convulsive syndrome in children. Symptomatic ones include febrile (infectious), hypoxic, metabolic, structural (with organic lesions of the central nervous system) convulsions. It should be noted that in some cases, non-epileptic seizures can turn into epileptic seizures (for example, with a prolonged, intractable seizure of more than 30 minutes, repeated seizures). Depending on the clinical manifestations, partial (localized, focal) convulsions are distinguished, covering individual muscle groups, and generalized convulsions (general convulsive seizure). Taking into account the nature of muscle contractions, convulsions can be clonic and tonic: in the first case, episodes of contraction and relaxation of skeletal muscles quickly replace each other; in the second, there is a prolonged spasm without periods of relaxation. In most cases, convulsive syndrome in children occurs with generalized tonic-clonic seizures.

Convulsive epilepsy in children

According to statistics, childhood epilepsy occurs three times more often than a similar disease among the adult population.

Symptoms of the disease in children differ from those in adults. For example, the non-convulsive course of the disease is often perceived as ordinary childish absent-mindedness or play, since this type of epileptic state lasts only 5-20 seconds, or is perceived by parents as fainting (atonic attack).

A separate category is the absence form, which develops at the age of 5-7 years, mainly in girls, and completely disappears after puberty.

Adequate therapy makes it possible to stop the manifestations of epilepsy in children, thereby relieving young patients and their parents from the discomfort caused by the disease for the rest of their lives. But drug treatment is a rather lengthy process; taking medications can take more than one year.

Symptoms

 A typical generalized tonic-clonic seizure has a sudden onset. Suddenly the child loses contact with the external environment; his gaze becomes wandering, the movements of the eyeballs become floating, then the gaze is fixed upward and to the side. During the tonic phase of a convulsive attack, the child’s head is thrown back, the jaws close, the legs are straightened, the arms are bent at the elbow joints, and the whole body tenses. Short-term apnea, bradycardia, pallor and cyanotic skin are noted. The clonic phase of a generalized convulsive seizure is characterized by restoration of breathing, individual twitching of facial and skeletal muscles, and restoration of consciousness. If convulsive paroxysms follow one after another without restoration of consciousness, this condition is regarded as convulsive status. The most common clinical form of convulsive syndrome in children is febrile seizures. They are typical for children aged from 6 months to 3-5 years and develop against the background of a rise in body temperature above 38 ° C. There are no signs of toxic-infectious damage to the brain and its membranes. The duration of febrile seizures in children is usually 1-2 minutes (sometimes up to 5 minutes). The course of this variant of convulsive syndrome in children is favorable; Persistent neurological disorders, as a rule, do not develop. Convulsive syndrome in children with intracranial injury occurs with bulging fontanelles, regurgitation, vomiting, respiratory distress, and cyanosis. In this case, convulsions can be of the nature of rhythmic contractions of certain muscle groups of the face or limbs, or of a generalized tonic nature. With neuroinfections, the structure of the convulsive syndrome in children is usually dominated by tonic-clonic convulsions, and stiff neck muscles are noted. Tetany caused by hypocalcemia is characterized by cramps in the flexor muscles (“obstetrician’s hand”), facial muscles (“sardonic smile”), pylorospasm with nausea and vomiting, and laryngospasm. With hypoglycemia, the development of seizures is preceded by weakness, sweating, trembling in the limbs, and headache. For convulsive syndrome in epilepsy in children, a typical “aura” preceding an attack (feelings of chills, heat, dizziness, smells, sounds, etc.). The actual epileptic attack begins with a child’s cry, followed by loss of consciousness and convulsions. After the attack ends, sleep sets in; after waking up, the child is inhibited and does not remember what happened. Chills. Sweating. Vomit. Cramps. Tonic convulsions. Nausea.

Emergency care for seizures

A seizure in itself cannot lead to the death of the patient, no matter how scary the clinical manifestations of the pathological process may look. Incorrect actions of people nearby can provoke the development of complications. Under no circumstances should convulsive movements be forcibly restrained. There is also no need to perform artificial respiration and cardiac massage.

If an epileptic attack begins, the patient must be laid on a flat, hard surface; a cloth roll or a small pillow can be placed under the head. To prevent the tongue from sinking, the patient's head should be turned to the side. After the end of the convulsions, the patient should be allowed to recover normally and get enough sleep. Typically, seizures in epilepsy last no more than 30 seconds. When the seizure is over, you should call an ambulance.

Diagnostics

 Due to the multifactorial origin of convulsive syndrome in children, its diagnosis and treatment can be carried out by pediatric specialists of various profiles: neonatologists, pediatricians, pediatric neurologists, pediatric traumatologists, pediatric ophthalmologists, pediatric endocrinologists, resuscitators, toxicologists, etc. The decisive point in the correct assessment of the causes of convulsive syndrome in children is a thorough collection of anamnesis: clarification of hereditary burden and perinatal history, previous diseases, injuries, preventive vaccinations, etc. In this case, it is important to clarify the nature of the convulsive seizure, the circumstances of its occurrence, duration, frequency, exit from seizures. Instrumental and laboratory tests are important in the diagnosis of convulsive syndrome in children. An EEG helps assess changes in bioelectrical activity and identify the convulsive readiness of the brain. Rheoencephalography allows us to judge the nature of blood flow and blood supply to the brain. An X-ray of the child’s skull may reveal premature closure of sutures and fontanels, divergence of cranial sutures, the presence of digital impressions, an increase in the size of the skull, changes in the contours of the sella turcica, foci of calcification and other signs that indirectly indicate the cause of the convulsive syndrome. In some cases, neurosonography, diaphanoscopy, CT scan of the brain, angiography, ophthalmoscopy, and lumbar puncture help to clarify the etiology of convulsive syndrome in children. When a convulsive syndrome develops in children, it is necessary to perform a biochemical study of blood and urine for the content of calcium, sodium, phosphorus, potassium, glucose, pyridoxine, and amino acids.

Treatment

 If a convulsive attack occurs, the child must be placed on a hard surface, turn his head to one side, unbutton the collar, and ensure a flow of fresh air. If a child develops a convulsive syndrome for the first time and its causes are unclear, it is necessary to call an ambulance. For free breathing, mucus, food debris or vomit should be removed from the mouth using an electric suction or mechanically, and oxygen inhalation should be established. If the cause of convulsions is established, then in order to relieve them, pathogenetic therapy is carried out (administration of calcium gluconate solution for hypocalcemia, magnesium sulfate solution for hypomagnesemia, glucose solution for hypoglycemia, antipyretics for febrile convulsions). However, since in an urgent clinical situation it is not always possible to carry out a diagnostic search, symptomatic therapy is carried out to relieve convulsive paroxysm. Intramuscular or intravenous administration of magnesium sulfate, diazepam, GHB, and hexobarbital is used as first aid. Some anticonvulsants (diazepam, hexobarbital, etc.) can be administered rectally to children. In addition to anticonvulsants, to prevent cerebral edema, children are prescribed dehydration therapy (mannitol, furosemide). Children with convulsive syndrome of unknown origin, convulsions that occur against the background of infectious and metabolic diseases, or brain injuries are subject to mandatory hospitalization.