tongue bite
Introduction
Introduction Neonatal seizures are prone to tongue bites, suffocation, cerebral hypoxia and other complications. Neonatal seizures are a symptom of a transient disorder of central nervous system function caused by a variety of causes (production injury, hypoxia, metabolic abnormalities, infections, and congenital malformations, etc.), and some neurons in the brain tissue suddenly occur to varying degrees. Abnormal discharge leads to involuntary contraction of the whole body or local muscles.
Cause
Cause
Convulsions can only be caused by abnormal electrical discharges in the central nervous system, but this abnormal discharge can be caused by many primary intracranial lesions (meningitis, cerebrovascular accident, encephalitis, intracranial hemorrhage, tumor), or secondary to systemic or metabolic (such as ischemia, hypoxia, hypoglycemia, hypocalcemia, hyponatremia) disease infection can cause convulsions meningitis often convulsions, sepsis can also occur, but generally does not appear this Gram-negative bacteria often cause neonatal intracranial Central nervous system infections caused by systemic infections, cytomegalovirus, herpes simplex virus rubella virus, Treponema pallidum and Toxoplasma gondii often cause convulsions.
Convulsions caused by ischemia and hypoxia often occur at the time of delivery before delivery and after delivery, and often occur in preterm infants with respiratory distress syndrome.
Hypoglycemia is common in neonates with diabetic mothers who are smaller than gestational age and those with ischemia, hypoxia, and other stress. Full-term children with blood glucose <40mg/dl (2.2mmol/L), low birth weight infants <30mg/dl (1.7mmol/L) for hypoglycemia; newborns who are not at this level of blood glucose have symptoms that are long-term or recurrent low Blood sugar can cause permanent damage to the central nervous system.
Low blood calcium is defined as serum calcium level <7.5mg / dl (<1.87mmol / L) often accompanied by serum phosphorus > 3mg / dl (> 0.95mmol / L), and like hypoglycemia, can be asymptomatic low blood calcium often and premature birth It is related to dystocia. Low blood magnesium is not common but can cause convulsions when serum magnesium <1.4mEq/L. Low blood magnesium is often associated with hypocalcemia, and hypocalcemia should be considered when low blood calcium infants continue to be present after treatment with adequate calcium.
Hypernatremia or hyponatremia can cause seizures and oral infusion of sodium chloride overload can cause hypernatremia, excessive oral or intravenous infusion of water, or loss of sodium in feces or urine Causes hyponatremia.
Neonatal seizures can occur in congenital metabolic diseases such as amino acids or organic aciduria. Vitamin B6 deficiency or vitamin B6 dependence is a rare cause of convulsions, but is easy to treat.
Other causes of convulsions that are more difficult to diagnose and treat include intraventricular hemorrhagic sequelae, birth trauma, withdrawal syndrome, and central nervous system malformation maternal abuse drugs (such as cocaine, heroin, and diazepam) are more and more common causes. The baby is horrified after the birth due to acute withdrawal syndrome.
Examine
an examination
Related inspection
Blood routine white blood cell count (WBC)
1. Learn more about the pregnancy and childbirth history and family history of pregnant women.
2. Children with frequent episodes such as facial muscle twitching, eyeball deflection, tremor, blinking, sucking and chewing movements, abnormal breathing rhythm, etc., symptoms and conditions are not consistent; multifocal clonic hairy authors can see several limb mobility Attacks, even angulation, also have paroxysmal muscle tone, with pale, eyeballs.
3. Those who occur within 3 days after birth should consider perinatal injury, hypoglycemia, hypocalcemia, etc.; patients who develop after 1 week should consider purulent meningitis, sepsis and other infectious and metabolic diseases.
4. Perform relevant blood biochemistry and cerebrospinal fluid examination if necessary.
5. EEG can determine whether seizures occur and contribute to efficacy observation. CT and MRI can help diagnose most of the congenital central nervous system malformations and intracranial hemorrhage, and judge the prognosis.
Diagnosis
Differential diagnosis
The following identification is required when a tongue bite occurs:
1. Neonatal startle: For a large amplitude, high frequency, rhythmic limb shaking or clonic motion, passive flexion or displacement of the limb can be eliminated without eye movement or cheek movement. It is common in normal newborns when they are stimulated by external stimuli or when they are hungry. The convulsions are rhythmic twitching, the magnitude of which is not affected by stimulation or flexion of the limbs. The twitching limbs try to stop the seizures and still feel muscle contraction, often accompanied by abnormal eye cheek movements.
2, non-convulsive apnea: this attack in the full-term children for 10 to 15 seconds / time, premature infants for 10 to 20 seconds / time, with heart rate slowed more than 40% and convulsive apnea episodes, full-term children 15 Seconds / times, premature infants 20 seconds / time without heart rate changes, but with other parts of convulsions and EEG changes.
3, rapid eye movement sleep phase: there are eye tremors, short apnea, rhythmic movements, facial strange smile, body twisting. But disappeared after waking up.
