Leg cramps in a child

Cramps or spasms of the legs are manifested by involuntary contraction of the muscles of the lower extremities. Adults have come across this unpleasant and painful phenomenon more than once. It turns out that this can also be observed in children, only they are not always able to explain what is happening to them. Parents should pay attention and respond to complaints. [1]

Epidemiology

According to statistics, most seizures are observed in children of the first year of life. On average, per 1000 newborns account for 16 of those who have convulsive muscle contractions. In 75% of cases, the precursors of epilepsy appear in childhood. [2]

Causes Leg cramps in a child

Leg cramps occur for a number of reasons,  [3]including:

• uncomfortable posture during sleep;
• lack of calcium, potassium, vitamin D in the body;
• flat feet;
• intensive growth of the child;
• hypothermia;
• intoxication (with flu, colds, poisoning);
• hidden disease;
• abdominal cramps associated with exercise. [4]

Risk factors

Fatigue and lack of sleep, a heavy blanket during sleep can provoke convulsions. Other risk factors include poor nutrition, dehydration due to diarrhea, vomiting, prolonged exposure to cold water, increased arousal, tantrums, vaccination the day before, and genetic predisposition. An important role is played by the state of health of the mother during the bearing of the child, whether she took medications, how the pregnancy and childbirth proceeded. [5]

Pathogenesis

Sudden convulsive muscle contractions occur as a result of a non-specific reaction of the nervous system to internal and external factors. High neuronal activity of the brain, lack of inhibitory neurotransmitters lead to such a reaction. [6]

Symptoms Leg cramps in a child

The first signs may be completely unrelated to the shudder itself, muscle twitching. Anxiety, restlessness of the child, his bad mood and behavior are often the harbingers of spasms.

Often they appear at night in the legs, then the baby wakes up, cries, involuntary urination happens, and the mother can understand the reason by the tension of the calf muscles. Sometimes the arms are also involved in muscle contractions. If the legs are straightened, and the arms are involuntarily pressed to the chest, then this is highly likely to indicate epilepsy. [7]

There are convulsions from a high body temperature or a sharp drop in it, they are called fibrous. So the body reacts to a change in its state, while the lips become cyanotic, breathing may be interrupted.

Complications and consequences

Infrequent and short-term spasms of the limbs usually do not pose a threat to health, but are a signal to conduct an examination, because the child may fall and get a head injury unnoticed by the parents, or in his body there is a deficiency of nutrients necessary for growth and development.

It is the presence of primary causes that can cause consequences and complications, convulsions that appear after 6 years are dangerous, and epilepsy is not excluded.

Diagnostics Leg cramps in a child

In the diagnosis of convulsive seizures, a detailed clarification of the anamnesis is of great importance:

• how often seizures occur;
• how long do they last;
• under what circumstances;
• the course of pregnancy and childbirth;
• recent illnesses, injuries;
• whether there were vaccinations;
• hereditary diseases.

Such specialists as ophthalmologists, neurologists, surgeons, neurosurgeons, etc. Are often involved in the examination. 

Standard diagnostics includes the delivery of tests, including general clinical blood and urine tests and a blood sugar test. More in-depth research may require others.

Convulsive activity of the brain is determined using electroencephalography. Other instrumental methods include radiography, computed and magnetic resonance imaging, and angiography of cerebral vessels. [8]

Differential diagnosis

Differentiation of leg cramps occurs among all the above named possible causes. It is very important to detect epilepsy at an early stage in order to timely direct efforts to the cause of its occurrence.

Treatment Leg cramps in a child

The first action should be aimed at relieving spasm. To do this, adults need to massage the child’s leg, pat on it, pinch the muscle slightly, try to bend and straighten it, bend the fingers in different directions, rub it with a warming ointment, cover it warmly. Treatment with medications can only be prescribed by a doctor according to indications. [9]

Drug treatment

When establishing the causes of leg cramps, medications are prescribed, the action of which is directed to a specific disease. So, at a high body temperature, it is necessary to bring it down. For this, children are given paracetamol, panadol, efferalgan. For babies, suppositories, syrups, chewable tablets are more suitable.

Panadol (suspension) - its action is based on the inhibition of the synthesis of prostaglandins in the central nervous system, the active substance is paracetamol. If you need to bring down the temperature of a child up to 3 months, you should consult a doctor. From this age and up to 12 years, a single dose is calculated as follows: 10-15 mg per kilogram of body weight, the frequency of administration is 4 times a day.

Of the adverse reactions, hypersensitivity reactions are possible, manifested on the skin, nausea, pain in the stomach, the development of anemia, impaired liver function. The drug is contraindicated in blood diseases, pathologies of the liver and kidneys.

Food poisoning, which led to dehydration and convulsions, requires gastric lavage, sorbent intake. In this case, activated carbon, smectite, polysorb are effective. Probiotics will accelerate the removal of toxins from the body: linex, hilak, enterol. They are used after the cessation of vomiting.

Smecta - powder in a bag, diluted with water. Children under one year old are recommended to mix the contents of one package (3g) with 50ml of water and distribute the volume per day. Can be mixed into compote, cereals. From a year to two, the daily dose is 1-2 pieces, older than two - 2-3 pieces. It is not used for intestinal obstruction, hypersensitivity to the drug, may cause constipation.

With hypocalcemic convulsions, calcium gluconate is prescribed - calcium ions are involved in the transmission of nerve impulses, in muscle contractions. The tool is used from 3 years. A single dose for children 3-4 years old - 2 tablets, 5-6 years old - 2-3 pieces, 7-9 years old - 3-4 pieces, 10-14 years old - 4-6 pieces. The frequency of admission is 2-3 times in 24 hours. Contraindicated in hypercalcemia, increased blood clotting, sarcoidosis, severe renal failure. The drug can rarely cause disorders: nausea, epigastric pain, constipation, diarrhea, bradycardia, allergic reaction.

When it becomes necessary to treat with anticonvulsants, sibazon, seduxen, phenobarbital, hexenal are used.

Seduxen - calms the nervous system, relaxes muscles. At the age of 1 to 3 years, 1 mg at a time is prescribed (only 2 mg per day), 3-7 years - 2 mg (6 mg), older than 7 - 3-5 mg (8-10 mg). The drug causes drowsiness, fatigue, in some cases paradoxical reactions - sleep disturbance, agitation. [10]

Vitamins

Since the occurrence of leg cramps in a child is often associated with a violation of mineral metabolism, including calcium-phosphorus, the regulator of which is vitamin D, it is on it that the emphasis is placed, especially in winter with a shortage of sun.

Vitamin B6 also plays an important role, its minimal content leads to muscle dystrophy. In addition, for the full development of the child's body, vitamins A, E, C, B1, B9, minerals magnesium  [11] and potassium are necessary.

The nutrition of the child should be organized taking into account such a need and, in agreement with the doctor, be supplemented with vitamin and mineral complexes (Magne B6, Vion 3 kid, Vitrum kids, Pikovit).

Physiotherapy treatment

Contrasting foot baths, rubbing, massages, and acupuncture are used to enhance blood circulation in the legs and tissue lymphatic exchange. Physical education for the legs will also have a positive effect on the muscles. For a walking child, in the form of a game, you can offer to stand on your toes, spin a "bicycle" in the air, and others. [12]

Alternative Treatment

Of the alternative recipes, alternating cold and hot compresses are used. It is also believed that rubbing lemon juice on your feet twice a day will minimize muscle spasms. The same effect is attributed to the bay leaf, infused with unrefined sunflower oil.

Rubbing the limbs is also carried out with decoctions of onion peel, as well as herbs such as thyme, yarrow, chamomile, couch grass, nettle.

In the arsenal of homeopaths there are many remedies used for muscle cramps. Their selection is carried out taking into account the age of the child, his constitution, character. The list of drugs includes: plumbum, rus toxicodendron, sepia, silicea, sulfur.

Leg cramps that are not associated with any trauma that caused them do not require surgical intervention.

Prevention

Preventive measures to prevent convulsive phenomena in a child are:

• organization of a balanced diet with an emphasis on proteins and restriction of carbohydrates;
• sufficient drinking regime;
• avoidance of strong physical exertion;
• wearing loose shoes;
• limitation of excitatory drugs;
• the short duration of watching TV and being at the computer.

Forecast

Leg cramps in childhood in most cases go away safely, unless they are associated with epilepsy.