Convulsions
Q. How to deal with a child who has Convulsions?
A. Convulsions, also known as seizures, in babies and young children can be terrifying for parents. Though, convulsions often do not cause serious health problems, a child who gets convulsions at home or anywhere outside the hospital needs immediate first-aid. While giving first-aid treatment one should prepare to take the child to the hospital. Sometimes in infants and toddlers fever can trigger convulsions.
Q. How convulsions/seizures present in a child?
A. Seizures can present many forms, from staring spells and not responding to anyone, twitching to involuntary jerky movements of the arms and legs. It can also present as muscle spasms. The child may pass out. The child can have frothing from mouth and uncontrolled peeing or pooping.
Q. What are Febrile Seizures?
A. Febrile seizures are convulsions that happen in some children with fever. They usually affect kids 6 months to 3 years old. They usually happen on the first day of the fever and at the time when fever is rising. In most children febrile seizures stop on their own. Febrile seizures do not have any adverse effect on brain.
Q. What to do if the child has a seizure?
A. Your initial efforts should be directed first at protecting the child from additionally injuring himself or herself. The child should be made to lie down on his side, preferably in a flat, non-crowded area. This will help prevent the child from inhaling any possible vomit. The head should be protected. Tight clothing should be loosened. Glass or any other harmful object should be removed from the area. Nothing should be put in child’s mouth.
Once the seizure has stopped, immediately check if the child is breathing. If the child is not breathing or looks blue, we should put him on his back and start giving mouth to mouth rescue breaths and seek the medical help or leave for the hospital immediately. Giving rescue breathing during the seizure may injure the child and rescuer.
One should avoid giving anything including medicine by mouth during the seizure and immediately after the seizure unless the child is fully awake. It is also important to try and keep track of how long the seizure lasts.
The child may be sleepy or may take a while to get back to normal after the seizure. It is advised to stay with the child until he or she is awake and aware.
Q. When should I take the child to a doctor?
A. Any child who has seizures lasting for more than 5 minutes, has seizures involving some parts of the body, turning blue, has breathing problem, falls on head, remains unconscious for more than few minutes after the seizure has settled or has another seizure within 24 hours should be taken to the doctor immediately.
In addition if a child gets convulsions while was in water, he should always be taken to the doctor. If parents are unable to describe the problem but feel that the child is just not normal, it is better to take the child to the doctor.
Q. Can I prevent febrile seizure?
A. No one knows why febrile seizures happen and who can get it. Hence, it is not possible to prevent the first attack. But, once a child gets febrile seizure, he would be prescribed a medicine by the doctor to give in future along with Paracetamol on the first 2 days of fever till the child turns 3 years of age. This is strictly a prescription medicine.
Q. Is it advisable to keep some medicine at home in case of an emergency?
A. While a child has seizure nothing should be given orally. In case of a child who is known to have seizures the doctor can prescribe some medicine to be kept ready at home that can be instilled in the nose to control seizure during the attack. This is strictly a prescription medicine.
Q. Does every child with first attack of seizure need long term medicine?
A. Unless a specific cause of the seizure is found, most children with first-time seizures will not be placed on long term medications. This is because many times the doctor is not sure if it was a seizure. The medicines for seizures have side effects and many children may get seizures only once.
Q. When should I do the brain scan?
A. Febrile seizure does not need any investigation. A focal (convulsion affecting only a part of the body) convulsion needs brain scan. It is best left to the doctor to decide who needs brain scan or any other investigation.
Q. What precautions should I take if my child is on medicines for seizures?
A. Once the child is started on medicine for seizures, he should be taken to the doctor for follow-up at regular intervals. It takes time to adjust optimal dose of anti-convulsion medicines. The doctor may advise blood test to check drug levels and adjust the doses accordingly. Sometimes, the child may need more than one medicine to control seizures.
The prescribed seizure medicines should be given on time.