Thursday, 24 July 2014

Convulsion in children

Fri, 08/31/2012 - 12:07 -- Sylvanus Agbo
Written By: 
Wabuji Kefas Dore

Convulsion in children is commonly known as febrile convulsion or febrile seizure, febrile meaning a rise in the temperature of the body; frequently a symptom of infection.

 
 
Convulsion in children is commonly known as febrile convulsion or febrile seizure, febrile meaning a rise in the temperature of the body; frequently a symptom of infection. Febrile seizures are common in babies and young children. They are brief seizures, or fits, that happen because your child has a fever (a high temperature). Most occur with common illnesses such as ear infections, coughs, colds, flu, and other virus infections. Serious infections such as pneumonia, kidney infections, meningitis, etc, are less common causes.
About 3 in 100 children have a febrile seizure sometime before their 6th birthday. They most commonly occur between the ages of 18 months and three years. They are rare in children under six months and over the age of six years.
What are the symptoms?
The symptoms can be alarming. Your child’s body twitches or shakes and your child loses consciousness. They won’t look at you or react to your voice. They may foam at the mouth, vomit, or wet or soil themselves.
Most children who have a simple febrile convulsion twitch or shake evenly on both sides of their body. Or they may go rigid, holding their arms and legs stiffly. It will be over in a couple of minutes.If one side of your child’s body twitches harder, or if the convulsion lasts more than five minutes, they may be having a complex febrile convulsion. These are more serious. If your child gets these symptoms, take them to see their doctor or to hospital. Children often go into a very deep sleep after their convulsion.
What first aid should I do for a febrile seizure?
·           Note the time it started.
·           Lie the child on their side with their head in line with the body or slightly lower (the recovery position).
·           Do not put anything into their mouth or shake the child.
·           When the seizure stops, try to lower the child’s temperature to make them more comfortable. To do this take off their clothes (if the room is warm). Then, when they have recovered enough to swallow, give a drink and some paracetamol or ibuprofen.
What should happen after immediate first aid?
The child should be seen by a doctor as soon as possible after a seizure for a check over to rule out serious illness. However, call a doctor or go the hospital urgently if:
·           The child does not improve quickly once a short seizure is over.
·           A seizure lasts more than five minutes (this includes small twitching movements even if large jerking movements have stopped).
·           Another seizure starts soon after the first one stops
·           The child has difficulty breathing.
·           The child was not fully conscious before the seizure or one hour afterwards.
·           You suspect a serious illness is the cause of the fever, for example, if you suspect meningitis.
No treatment is usually needed for the seizure itself if it stops within a few minutes. (However, treatment may be needed for the infection causing the fever.)
Can febrile seizures be prevented?
It may seem logical that if you keep a child’s temperature down during a feverish illness it may prevent a febrile seizure. However, there is little scientific evidence to prove that this is so. (It is unclear what triggers the seizure. It is possibly some body chemical that is released during certain feverish illnesses rather than the temperature itself. Most children with a high temperature do not have a seizure.) However, it is common practice to keep a child cool when they have a feverish illness. This will make them feel more comfortable. Therefore, if a child appears hot, then the following will help to reduce the temperature:
·           Keep the child very lightly dressed, or take all their clothes off if the room is warm.
·           Give paracetamol, (for example, Calpol, Disprol, etc), or ibuprofen.
·           Give lots of cool drinks.
Will it happen again?
Only one seizure occurs in most cases. In about 3 in 10 children who have a febrile seizure, a second seizure occurs with a future feverish illness. In less than 1 in 10 children who have a febrile seizure, three or more further seizures occur during future feverish illnesses. A future febrile seizure is more likely if the first occurs in a child younger than 15 months, or if there is a family history of febrile seizures in close relatives (father, mother, sister, brother). Once the child is past three years old, the chance of a recurrence becomes much less likely.
Therefore, recurrences are not common, but it is best to be prepared. For example, practice putting your child into the recovery position.
Does a febrile seizure cause any permanent damage?
Usually not, full recovery is usual with no after-effects. (Sometimes the infection causing the seizure causes complications, but the seizure itself does not usually cause any damage.) Rarely, a seizure which lasts 30 minutes or more may cause some injury to the brain.
References:
·           http://clinicalevidence.bmj.com
·           www.patient.co.uk

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