Observation and Management After Pediatric Seizures

Patient's question:

Main symptoms, Accompanying symptoms, General condition

Doctor's answer:

Convulsions, also known as febrile convulsions or seizures, are acute symptoms caused by temporary disruption of the central nervous system. The younger the age, the higher the incidence. Approximately 2-8% of children have experienced high fever seizures. The incidence in children under 6 is 10-15 times higher than in adults. Due to the underdeveloped central nervous system in children, excitability caused by various factors or etiologies can easily spread, leading to seizures. The symptoms of childhood seizures include sudden loss of consciousness, fixed or upwardly rolling eyes, head extension, limb convulsions, clenched jaw, foaming at the mouth, apnea, and bluish discoloration of the face and lips. There are many factors or etiologies that can cause childhood seizures. High fever seizures in children are the most common type. When children suffer from upper respiratory infections, acute tonsillitis, or other diseases, persistent high fever increases central nervous system excitability, which can trigger seizures. The characteristics of such seizures are that they cease once the fever subsides, and they usually only recur once. Additionally, acute infectious diseases and severe infections such as purulent meningitis, conjunctivitis, tuberculous meningitis, toxic pneumonia, bacillary dysentery, typhoid fever, sepsis, pertussis, and hemorrhagic enteritis can also cause seizures. These seizures may be accompanied by meningeal irritation symptoms and infection symptoms, and the condition is generally severe. Moreover, some diseases with feverish symptoms can also lead to seizures, such as intracranial hemorrhage in newborns, intracranial tumors, epilepsy, hypoxia, trauma, infantile tetany caused by hypocalcemia, drug and food poisoning, etc. Regardless of the cause, seizures in children are dangerous. Prolonged seizure duration can lead to cerebral hypoxia, brain cell death, and neural cell damage. Therefore, it is essential to seek medical attention to identify the cause and receive active treatment.
Medical Advice: If a child has a seizure at home, parents should not panic. They should observe the child's symptoms to determine the type of seizure and then promptly take the following emergency measures:
1. Maintain a quiet environment and avoid unnecessary stimuli. Loud noises can trigger recurrence in cases of encephalitis or epilepsy.
2. Quickly unbutton the child's clothes (especially the collar) and lay them flat. Seizures can cause cerebral hypoxia, and impaired breathing may lead to brain cell hypoxia and death.
3. Prevent physical injury. Place a gauze-wrapped tongue depressor or a chopstick between the upper and lower molars to prevent tongue biting, but do not force it in if the child's jaw is clenched. Turn the head to one side to prevent vomit or secretions from causing suffocation.
4. Press the Zhongwan (GV26) point between the eyebrows with fingers. If acupuncture needles are available at home, they can be sterilized and used to puncture the tips of the ten fingers (ShiXuan points) to draw 1-2 drops of blood from each fingertip.
In cases of high fever seizures, tetany, or epilepsy-induced seizures, symptoms usually subside after initial treatment. However, if the seizure is caused by encephalitis, even if it temporarily stops, it may recur. In any case, the child should be rushed to the hospital for further evaluation.
If the child has epilepsy, it is advisable to keep anticonvulsant medication at home, such as phenobarbital or phenytoin. If the child shows signs of a seizure, medication should be administered promptly to prevent it.
If the child has high fever seizures, antipyretic medication like paracetamol or aspirin should be kept at home. If the child develops a fever, antipyretics should be given immediately. Do not wait until the fever becomes severe to administer medication, as this may lead to recurrent seizures.