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 pediatric 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 every day regardless of whether a fever is present. However, febrile seizures have a high incidence, while severe sequelae only affect a minority. 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 seizure.
Long-term medication can be chosen from phenobarbital, primidone, sodium valproate, or carbamazepine.
Emergency Home Care:
1. During a seizure:
(1) Acupressure or thumb massage: Renzhong (GV26), Baihui (GV20), Hegu (LI4), and Shenmen (HT7).
(2) Active cooling, while ensuring ventilation and warmth. Loosen clothing and bedding. Use alcohol or lukewarm water to bathe the neck sides, armpits, and groin.
(3) Unfasten the collar to keep the airway clear. Lie the child on their side to prevent vomiting or secretions from being inhaled. If the child has not yet developed clenched teeth, use a cloth or a folded handkerchief or spoon handle 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 take the child to the hospital for treatment.
2. For children with recurrent seizures or a family history of high-temperature convulsions, antipyretics and anticonvulsants should be given at the onset of fever or during vaccination to prevent seizures. For some high-temperature convulsion patients, medication should be continued for 2–3 years or until the age of 4–6.