Patient's question:
Detailed medical condition and consultation purpose: My son is two years old and prone to seizures during high fever. This has occurred 3 to 4 times. After each episode, the treatment involves first reducing fever and then administering antibiotics for inflammation. Please ask: How can we effectively prevent childhood seizures? 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 are only a minority. Long-term medication would impose an unnecessary burden 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 seizure.
Long-term medication can include phenobarbital, primidone, sodium valproate, or carbamazepine.
Emergency Home Care:
1. During a seizure:
(1) Acupressure or thumb massage: Points such as the philtrum (renzhong), baihui, hegu, and shenmen.
(2) Active cooling, while ensuring ventilation and warmth. Loosen clothing and bedding. Use alcohol or lukewarm water for bathing (sides of the neck, armpits, groin).
(3) Loosen the collar to maintain airway patency. Lie on the side to prevent vomiting or secretions from being inhaled. If the child's jaw is not yet clenched, a cloth or folded handkerchief can be placed between the 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 cases with recurrent seizures or a family history of high fever seizures, antipyretics and anticonvulsants should be given at the onset of fever or during vaccination to prevent seizures. For some high fever seizure patients, medication should be continued for 2–3 years or until the age of 4–6.