A text-book on hygiene and pediatrics from a chiropractic standpoint

by J. H. Craven

CONVULSIONS

A convulsion is a violent involuntary contraction of muscles which ordinarily contract only under direction of the will. It may be either clonic or tonic. A clonic convulsion consists of a spasm of the muscles with alternating contractions and relaxations while the tonic spasm consists in constant rigidity of the muscles involved. The contractions may be confined to certain muscles or sets of muscles as, for example, the muscles of the face, the trunk or the extremities. In some cases the muscles of the entire body are involved.

During the first eighteen months of life the child is more susceptible to convulsions than at a later age, although the condition is rather common during childhood. Convulsions accompany many incoördinations and are considered adaptative to some other condition. Therefore the first thing to consider in a case of this kind is the primary condition or the incoördination to which the convulsion is adaptative.

The more common conditions with which convulsions are associated are: Incoördinations involving the nervous system, such as cerebra-spinal conditions; rachitis; and organic and functional disorders. Any condition which produces an irritation of the nervous system may result in a convulsion of more or less violence. For this reason children are often subject to convulsions during dentition and disorders resulting in slight temperature. Cerebral tumors, abscesses of the brain, hydrocephalus and meningitis are examples of cerebral conditions in which convulsions are commonly found.

Subluxations in the upper cervical region are often produced at the time of birth which cause cord pressure, making the child susceptible to all conditions that would irritate the nervous system.

There may be K.P. subluxations interfering with the process of elimination resulting in an accumulation of poison within the body, or there may be other subluxations resulting in the production of toxines within the body and these will produce an irritation of the nervous system resulting in convulsions. Disturbances in digestion, affections of the respiratory tract, a sudden rise of temperature and incoördinations involving the gastro-intestinal tract are often responsible for convulsions. Convulsions are quite frequent at the onset of acute dis-eases such as whooping-cough, measles and mumps. They are often associated with enlargement of the thymus gland.

During the convulsion there may be loss of consciousness with tonic and clonic spasms in various degrees of severity. The urine may be voided and the bowels evacuated. In the very young infant a single attack may prove fatal, although this is rather unusual. When death occurs in this way it is most often due to asphyxia, or when the convulsions recur in rapid succession death will result from exhaustion.

The clinical picture is quite typical. Usually there is pallor of the face which may be followed quickly with a twitching of the facial muscles, and sometimes those of the hands and feet. In most cases the attack comes on without warning; the eyes become fixed and rolled backward; the twitching usually begins in the face and very soon the entire body is involved. The face is distorted by muscular contractions, the head is drawn backward and the neck is thrown forward; there may be frothing at the mouth. The pulse is irregular and weak, the respiration is shallow and feeble while there is cold perspiration of the forehead and it may also be on the body. The thumbs are turned into the palms and the hands are tightly closed. There is rhythmical convulsive movements consisting of alternating flexion and extension.

The attack usually lasts from a few minutes to half an hour and sometimes longer. The patient is left in a more or less state of exhaustion and the attack may be followed by stupor and coma. Very often convulsions in children over two years of age indicate the onset of some acute condition such as pneumonia or scarlet fever. However, convulsions may mean very little with small children that are extremely nervous. During the first few days of life they may be the result of temporary circulatory disturbances in the brain from prolonged pressure in difficult labor.