TREATMENT-
The remedies that are mostly useful, are-Belladonna, Mag. Phos, Calcarea Carb, Chamomilla, Cimicifuga, Cina, Coffea, Opium, Stramonium, Hyoscyamus. Bell. is undoubtedly our first and best remedy. The child starts suddenly when asleep or stares about wildly. The pupils are dilated ; stiffness of the whole body or of one or more limbs. Red eyes and flushed face. The slightest touch sometimes provokes a new fit. The convulsions of Nux vomica are also renewed by least touch and followed by deep sleep but they are mostly caused by indigestion and lack in the wild look of the patient and the attendant congestive symptoms.
Indigestion of the mother or of the wet nurse may also cause spasms in a child when Nux v. should be given. Sopor after spasm ; or involuntary discharge of urine after return of consciousness. The fits are sometimes preceded by smiles or laughter. The child is very drowsy, but cannot sleep; sudden twitchings or jerks while asleep or awake. CIMICIFUGA [ The following brilliant cure with Nux vom. may be cited here- A child, aged 5 months, with two teeth, had from 25 to 30 convulsions a day.
Left arm and hand small and emaciated ; fits continuously clenched ; limbs emaciated and useless ; was deaf except when cramped ; voracious appetite ; and moaned every moment when awake day or night, with constant rolling of the head and shoulders ; had not smiled since the first attack ; had a calomel sore throat so that upon opening the mouth the saliva would pour out ; the sublingual glands were enlarged; the eyes looked bright. Nux v. 6 was given. No fits or spasms after the first dose was taken.] irregular motion of limbs worse left ; legs unsteady.
According to Hering, alternate tonic and clonic spasms are characteristic of this drug. Mag. Phos., is to be thought or where Bell. was apparently indicated but failed. There is excessive sensitiveness after the spasms, specially to touch and noise. Mag. Phos. is very useful for convulsions during dentition. Calc. c. generally needful after Bell. and useful for a scrofulous constitution and convulsions in rickety children. It is also useful for convulsions during dentition, specially when the teething process is either very slow or too rapid. CHAM. for convulsions during dentition and convulsions from anger, not only of the child but also from the anger of the mother or wet nurse.
The child makes itself stiff, bends backwards, kicks with his feet, convulsive jerking of limbs, grasping and reaching with hands twitch of muscles of the face and eyelids, constant motion of the head from side to side, constant moaning and screaming immoderately. Fits are followed by loss of consciousness and twitching and jerking in the limbs.
CINA, for intestinal irritation from worms ; the child suffers more from series of spasms than from a marked convulsion ; the arms and legs are thrown from side or the child stretches out the feet spasmodically ; the child is cross and has a variable appetite. COFFEA is frequently serviceable in weak and nervous children who are subject to convulsions without any apparent cause other than weakness. OPIUM after the failure of coffea. OPIUM is particularly useful in convulsions caused by fright, and attended by much trembling over the whole body, tossing of the foaming at the mouth, the face becomes dark-red or even purple and the body is often bathed in a hot sweat ; the child lies as if stunned and deep snoring sleep follows the spasms ; the abdomen is distended and all evacuations are suppressed.
Opium does little or no good for the protracted effects of emotion ; it is for the immediate effects of emotion that it should be used. Opium is very similar to Ignatia. The distinction from Ignatia lies in the fact that the Opium face is dark red and bloated and the spasms are more frequently associated with loud screams than under Ignatia. Dr. T.D. Pritchard reports of the case of a baby who was subject to spasms for about a year.
Afraid of strangers, cries at their approach ; holds its breath and goes into a spasm ; as soon as the spasms begin to abate he falls asleep. Opium cured permanently. STRAM. sudden convulsions from fright or with fever or form repelled eruptions ; convulsions with cries as if from the sight of hideous objects ; tosses the limbs, specially the upper ones ; involuntary stool and urine ; moving the fingers in sleep as if searching for something ; grinding of teeth, stammering when trying to talk ; desire for light and company. HYOSCYAMUS, sudden starting and twitching of muscles (more so than in Ignatia) ; convulsions starting with twitchings of muscles of face, specially about eyes ; pressing of gums together, putting fingers into mouth ; difficulty of swallowing ; the patient seems to be wild ; great deal of frothing at the mouth, bloated appearance of the face and deep sleep after the spasm passes off.
The other useful remedies for Infantile convulsions are-Cuprum met., CICUTA v. Hellebores, Platina, Verat a. and Zinc met. CUPRUM MET.- The spasms are preceded by violent vomiting, marked blueness of the face and mouth. The spasms begins with cramps in lower extremities with twitching of toes and clenching of fingers with much throwing out of the limbs ; frothing of mouth and choking in throat ; after one spasm the child scream, turns and twists and runs into another spasm ; there is rolling of eyeballs during convulsions ; unconsciousness comes early ; stupor fallows and is of long duration.
A very diagnostic symptom of Cuprum is – “any attempt to swallow fluids causes a gurgling in the throat.” Useful for convulsions after suppression of eruption. CICUTA V., the patient first becomes rigid, with fixed staring eyes, bluish face and frothing at the mouth and unconsciousness ; the jaws are locked and the patient bits the tongue ; violent shocks through the head, arms and legs, which cause them to jerk suddenly. The spasmodic symptoms are followed by profound exhaustion.
It is mainly useful for epileptic convulsions and convulsions caused by worms and dentition. HELLEBORES, for convulsions of children with extreme coldness ; constant chewing motion ; automatic motion of one hand and foot spasmodically ; boring head into pillow and rolls head. Constant craving for meat. PLATINA is specific for convulsions arising from anaemia ; there may be lock-jaw during the spasms ; also used for spasms caused by nervous excitement when they are preceded or followed by constriction of the oesophagus and respiratory embarrassment.
VERAT ALB. is suitable for convulsions after sudden, violent emotions ; face is cold and blue with cold sweat on forehead ; it will prove particularly useful in convulsions caused of a specific infectious disease. ZINC MET., the child is cross and peevish for days previous ; cries out during sleep as if awakened by fear and rolls its head anxiously from side to side ; automatic motion of different parts of the body, great prostration ; convulsions during dentition or from suppressed eruption.
The following two reported cases will further enlighten the reader on the subject :-.
Woodward reports the case of a baby who had been suffering with his teeth for more than a week. Salivation was copious ; he was constantly working at his mouth and crying piteously much of the time. He was extremely restless, had lost his appetite, could not sleep, and was getting very nervous. Finally, an attempt to eat induced convulsion involving the entire body ; for a time he was insensible. The spasms were repeated at intervals for several hours, until Mercurius was given ; this relieved the painful gums and in two days he was free from any convulsion.
Dr. Rummel had a brilliant cure of spasms in a child with Ipecac. A child aged 4, had most frightful spasms of the entire left side of the body. Paralysis of the convulsed side supervened. The eyes were fixed and pupils dilated and insensible. The lids opened and shut; there were occasional contractions of the right side of the face and also of the right arm. The pulse was feeble and frequent ; tracheal rale constant with some coughing ; respiration regular ; inspiration short, followed by slow, sighing expiration, as if each one would be the last. Skin hot ; much dark mucus in the mouth. Ipecac was given in the mornings and in the afternoon the child was convalescent.
