Patient's question:
My son is two years old and is prone to seizures during high fever. This has happened 3 to 4 times. After each episode, the treatment involves first reducing the fever and then administering antibiotics for inflammation.Could you please advise on:
1. How can we effectively prevent childhood seizures?
2. What should be done in emergency situations when a seizure occurs?
Doctor's answer:
Hello: To prevent recurrence, some have also proposed long-term medication, meaning that medication should be taken daily regardless of whether a fever is present. However, febrile seizures have a high incidence, while severe sequelae only affect a small number of cases. Mandatory long-term medication would impose unnecessary burdens on most patients, and phenobarbital can also cause side effects such as drowsiness, restlessness, and hyperactivity. Therefore, the following indications for long-term medication have been proposed. (1) Complex febrile seizures. (2) Cases with risk factors, and after the second episode. Long-term medication can be chosen from phenobarbital, primidone, sodium valproate, or carbamazepine.Emergency home care: 1. During an episode: (1) Acupressure or thumb massage: Renzhong (GV26), Baihui (GV20), Hegu (LI4), and Shenmen (HT7). (2) Active cooling, while ensuring ventilation, warmth, and loose clothing. Use alcohol or lukewarm water to bathe the neck sides, armpits, and groin areas. (3) Loosen the collar to maintain airway patency. Lie on the side to prevent aspiration of vomit or secretions. If the child has not yet developed clenched teeth, a cloth or folded towel can be placed between the upper and lower teeth to prevent tongue biting. (4) Administer antipyretics and anticonvulsants (e.g., phenobarbital tablets). (5) After simple emergency care, immediately transport the child to the hospital for treatment. 2. For children with recurrent episodes or a family history of high-temperature febrile seizures, antipyretics and anticonvulsants should be given at the onset of fever or during vaccinations to prevent seizures. For some high-temperature febrile seizure patients, medication should be continued for 2–3 years or until the age of 4–6.