Nervous system and convulsive syndrome
In pediatric practice, seizures are recorded in 5–10% of children, whereas classical epilepsy is diagnosed in only 1% of cases. There is a direct age-dependent correlation: the younger the child, the higher the probability of convulsive seizures.
The main prerequisites for this are:
- Morphological and functional immaturity of the brain and nerve fibers.
- Increased permeability of the blood-brain barrier (BBB).
- The tendency of the nervous system to generalize any pathological processes.
- Neurotransmitter imbalance with a predominance of excitatory glutamatergic influences over inhibitory GABAergic ones.
Features of the course of poisoning in childhood
The toxic effect of most poisons aims to damage cellular enzyme systems. This process triggers an irreversible cascade of metabolic disorders, leading to severe multiorgan failure with an impact on the central nervous system, liver, and kidneys.
In children, poisonings are more severe due to the following factors:
- High lability of metabolic processes.
- Increased permeability of histohematic barriers, facilitating the penetration of toxins into tissues.
- Decreased overall tolerance of the body to xenobiotics.
Respiratory and skeletal systems
The anatomical and physiological features of the larynx and trachea in young children predetermine the tendency to acute upper airway obstruction. This manifests as croup syndrome, stenoses of various etiologies, and the risk of asphyxia, acting as an important link in emergency conditions.
The skeletal system is a dynamically growing tissue. It is characterized by heterochrony — the non-simultaneous development of individual parts of the skeleton. Extremely high growth rates require an intake of vitamin D and phosphorus-calcium salts. The imbalance between the needs of the skeleton and the possibilities of providing for them lies at the heart of metabolic disorders, primarily rickets.
The younger the child, the higher the risks: the brain is immature, barriers are permeable, and metabolism is labile.
Class and exam questions
What is the frequency of convulsive syndrome in children compared to epilepsy?
Convulsive syndrome is observed in 5–10% of the pediatric population, while true epilepsy is diagnosed in only 1%.
Why do poisonings proceed more severely in young children?
This is due to metabolic lability, increased permeability of histohematic barriers, and low tolerance to xenobiotics.
What is heterochrony in the development of the skeletal system?
This is a physiological pattern consisting in the non-simultaneous growth and development of various sections of the child's skeleton.
What else to study on this topic
- Age-related features of the blood-brain barrier
- Mechanisms of neurotransmitter imbalance in children
- Pathogenesis of croup syndrome in airway obstruction
- The role of vitamin D and phosphorus-calcium metabolism in rickets
- Critical periods of skeletal ossification
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Other topics in "Chapter 13. Main syndromes requiring emergency care"
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