Practice diagnosis and treatment of seizures in children

2021-03-25 12:00 AM

You can consult a doctor to stop taking anticonvulsants if your child no longer has seizures within 2-3 years.

A child with temporary loss of consciousness, uncontrolled twitching of his limbs, usually lasts a few minutes but can also take longer. Seizures are quite common in children. There are convulsions without a fever and other convulsions that occur with a high fever. Statistics show that 1 out of 20 children has had a seizure due to a high fever, often called a period.

Seizures are not caused by fever

For children under 6 months old, when a non-fever seizure occurs, it is necessary to be monitored and treated in hospital.

Older children with non-fever seizures are often associated with neurological problems, and should be referred to a neurologist for diagnosis.

Cycling should not be allowed by children who have had epilepsy. Children may be allowed to swim, but adult supervision is required.

More than 60% of seizures in children tend to get better on their own. You can consult a doctor to stop taking anticonvulsants if your child no longer has seizures within 2-3 years.

In the event of a seizure, the following immediate measures are required:

Make sure to keep the child's airways clear.

Use diazepam slowly intravenously at a dose of 0.3mg per kilogram of child's body weight, or rectally at a dose of 2.5mg for children under 1 year, 5mg for children aged 1-3 years, and 10mg for children 3 years older.

Seek immediate medical attention if seizures persist.

Febrile convulsions

Febrile convulsions - or menstruation often - are fairly common, with about 5% of children affected. Febrile convulsions can occur in babies between 6 months and 5 years of age, but are most common by the age of 2 years.

The cause of high fever causing seizures in children is due to the immature brain's thermoregulation mechanism, so the body temperature can rise too quickly when the child has infections. A sudden rise in body temperature stimulates brain cells, releasing impulses to the muscles and contracting them. Febrile convulsions have no accompanying brain damage, need differential diagnosis from seizures caused by encephalitis or meningitis, when the central nervous system is damaged by infection.

Due to the mechanism just explained above, so high fever causing convulsions in children usually comes from an infectious cause, most commonly an upper respiratory tract infection. However, it is also necessary to immediately eliminate cases of acute infections.

Diagnosis excludes meningitis. Carefully examine the ear and throat for signs of infection. Chest examination, abdominal examination.

Urine samples may need to be sent for culture.

Immediately transfer to the hospital in the following cases:

Children under 18 months old.

There are signs of suspicion of meningitis.

A seizure lasts more than 10 minutes.

Children show signs of very tired.

There are persistent neurological signs.

During a fever but up to 2 or more seizures.

Children can rest at home if the seizure lasts no more than 10 minutes and then fully recovers.

About 30-40% of children with a febrile convulsion are at risk of having the next seizure within 6 months after that. Seizures can be prevented by keeping the child's body temperature from getting too high, namely:

Timely treatment of infections.

As soon as there are signs that the child starts to have a fever, put the child in cool clothes, use a warm water-absorbent towel to wipe the face and wipe all over the body, use a fan to cool the child, helping the child to drain heat quickly. Place the child in a cool room.

Give the child paracetamol at the correct dose. A second dose can be continued after 4-6 hours if the fever is not gone.