Symptoms of Khvostek, Trusso, Lust. Symptom of a toothache in children: treatment

In the disorder of calcium-phosphorus metabolism, accompanied by moderate or severe rickets, 4% of children develop spasmophilia, which is also called children's tetany. This pathology is accompanied by the spastic condition of the muscles of the limbs, face, larynx, and the emergence of common clonic and tonic seizures. It is detected, as a rule, from the age of three months to two years. One of the brightest manifestations of developing ailment are the symptoms of Khvostek, Tissaur and Lust, helping to find out the severity of the ongoing disease. About how these symptoms are determined and how they are treated, we will discuss later in the article.

How spasmophilic symptoms are checked

To conduct a check for the presence of the Khvostek symptom, which is also called the facial nerve phenomenon, the child is placed on a bed without a pillow. The legs should be straightened, and the hands should lie along the body.

The symptom is checked by lightly tapping the percussion hammer or fingers at the place of the trigeminal nerve exit (above the zygomatic arch). If the patient is involuntary jerking of the eyelid and the corner of the upper lip, then the symptom mentioned is considered positive. By the way, it is checked on both cheekbones.

The symptoms of hvostek have 3 degrees of manifestation:

1. Muscle contraction throughout the entire area of the innervation of the facial nerve.
2. Reduction of muscles in the corner of the mouth and the wing of the nose.
3. The contraction of the muscles is only in the corner of the mouth.

In the presence of obvious tetany, the child manifests the first degree of symptom, even from a slight touch in the area of the facial nerve.

Additional ways to check for antispasmodic symptoms

Not less indicative in terms of determining the severity of the condition of the baby are the symptoms of Tissaurd and Lust.

• The Trusso symptom is detected by the compression of the middle of the child's shoulder. In this case, the doctor should try to capture as much of the soft tissue of his hand. If as a result of this (approximately 2-3 minutes after the squeezing) the patient's fingers take a forced position called "the hands of an obstetrician" (that is, the thumb is brought to the palm, the index finger and the middle are unbent, and the ring finger and the little finger are bent), then the symptom Is considered positive. To test its presence in older children or in adults, you can use a cuff to measure blood pressure by pumping air into it until the pulse stops.
• The Lust symptom is checked with the help of a hammer, which is taped behind the head of the tibia, or by compression of the gastrocnemius muscle in the area of the Achilles tendon. If the patient is observed involuntary withdrawal of the foot ("ballerina's foot"), then the symptom can be considered positive. It is checked on both extremities.

Symptoms of Khvostek, Trusso, Lusta are considered spasmophilic. They become positive if a sick child has a change in the amount of calcium responsible for muscle contraction in the blood. This can lead not only to the presence of rickets, but also other diseases.

What is tetany

Symptoms of Tail and Tissue are signs of spasmophilia (tetany). This disease is characterized by increased nervous excitability, manifested by muscle cramps of limbs or larynx. Most often this pathology is observed in boys in the first six months of life.

And the biological basis of this disease is the low level of ionized calcium in the child's blood.

Than the symptom of Chvostek in children is dangerous

Photos of children suffering from tetany, let you understand what are the signs of the disease. The main one is laryngospasm, which is expressed by difficulty in inhaling, paleness of the face, sweating, and sometimes loss of consciousness. Periodic spasms of feet and hands (carpopedal spasm), which last sometimes for several hours, are also characteristic. There are also spasms of other muscle groups - respiratory, chewing, eye, etc.

But the most severe sign of the disease is an attack of eclampsia - clonic-tonic convulsions, starting with the twitching of the muscles of the face and passing into convulsions of the limbs and laryngospasm. The child thus most often loses consciousness, a foam appears on the lips, involuntary urination is observed. Eclampsia is dangerous for the ability to stop breathing or the heart.

Who can have tetany?

In the first days of life convulsive conditions and hypocalcemia most often occur in toddlers born premature, in twins, as well as in jaundice or infectious diseases.

The symptom of the tail in children of the first months of life can be provoked by a decrease in the intake of calcium in the child's body, and an increase in the secretion of calcitonin. This condition is also associated with a violation of the intake of phosphorus and calcium when the baby is suddenly transferred to be fed with cow's milk, and (in rare cases) with a lack of vitamin D and calcium in the mother's body.

As a rule, hypocalcemia manifests itself in children with neuromuscular excitability, convulsions, vomiting, tachycardia and respiratory symptoms.

Treatment of tetany

Attacks of eclampsia require urgent help to the child, and in case of stopping breathing or heart - and resuscitation.

For any manifestations of tetany, the child is prescribed anticonvulsant drugs (Sibazon intramuscularly or intravenously, Sodium oxybutyrate intramuscularly, Phenobarbital rectally in candles or orally, etc.). Intravenous administration of 10% r-ra gluconate calcium or intramuscular 25% r-ra magnesium sulphate is also shown.

Spasmophilia, which causes symptoms of Khvostek and Tissaur, usually has a favorable prognosis in most cases. The danger is only prolonged laryngospasm, threatening to stop breathing.

When the child reaches the age of 2-3 years, the pathological condition is eliminated as a result of stabilization in the blood of the level of calcium and phosphorus.

Hypoparathyroidism - a disease that is accompanied by a symptom of Khvostek

The symptom of the tail is also a clear sign of a pathological condition called hypoparathyroidism, in which a decrease in parathyroid gland functions is observed . Most often, this problem occurs as a result of surgery for a thyroid gland or if there is an inflammatory process in it. And sometimes dysfunction can be caused by infectious processes, such as measles or influenza.

In newborns, hypoparathyroidism develops in the case of congenital absence of parathyroid glands or when suppressed by the increased release of parathyroid hormone in the body during pregnancy.

The patient thus, as a rule, shows a decrease in the content of calcium in the blood in parallel with an increase in the concentration of phosphorus. And outwardly it is manifested already described tetany, intestinal phenomena, anomalies of the growth of teeth, nails and hair, as well as skin changes.

In such cases, the symptoms of Khvostek and Tissaur, along with laboratory studies, help to accurately detect the developed tetanic state and diagnose the patient.

Treatment of hypoparathyroidism

To treat this disease, it is important to consider the causes that caused it, as well as the severity of the symptoms. In the acute course of the disease with tetany, rapid administration of 10% calcium chloride or calcium gluconate intravenously is recommended. This is done slowly, taking into account that in the first mentioned solution contains 27% of the same substance, and in the second only 9%.

As a rule, in order to eliminate the symptoms of Khvostek, treatment with calcium preparations is required for at least 10 days. A good effect is having calcium intake, and doctors advise doing this by dissolving the drug in milk, to prevent the development of gastritis.

Chronic condition of hypoparathyroidism requires the intake of vitamin D, starting with a shock dose (200-300 thousand units per day), with mandatory control of the content of phosphorus and calcium in the blood, and after the normalization of their level, the dose is reduced to 50 thousand units. Per day in children up to a year or up to 125 thousand units. - in patients after a year.

At what other diseases are symptoms of Trusso and Khvostek

In addition to diseases caused only by the reduction for any reason of calcium in the blood plasma, the symptoms of Khvostek, Tissaur and Lust can also be found in other ailments. They include:

• Neurasthenia with an anxiety-hypothetical condition, manifested as a hyperventilation syndrome. The patient thus experiences a periodic disturbance of the rhythm of breathing, imitating suffocation, with a sensation of a coma in the throat, a lack of air, and sometimes with loss of consciousness and cramps.
• Dyscirculatory processes, combined with asthenic or asthenic-neurotic syndrome, characterized by a state of constant fatigue and nervous exhaustion, as well as headache, sleep disorders and dizziness.
• Hysteria, epilepsy and other diseases.

Prevention of impaired calcium in the child

As you probably already saw, with the diseases that accompany the symptom of Khvostek, in children the treatment is reduced to an indispensable restoration in the blood of a normal level of calcium and phosphorus. Therefore, the prevention of these pathologies also requires, first of all, control of the concentration of these substances, which are performed by district pediatricians.

It is important to create optimal conditions for the development of the fetus in a pregnant woman. To do this, if the future mother lives in unsatisfactory social conditions or is at risk (with diabetes, nephropathy, hypertension and rheumatism), she is prescribed vitamin D in the last 2 months of pregnancy. In the normal course of pregnancy, compliance with the regime is sufficient Nutrition and physical activity.

A newborn, so that he grows strong and healthy, it is important to have breastfeeding, timely introduction of complementary foods, daily outdoor activities, free diapering, massage, gymnastics and light-air baths.