For any parent, witnessing a child in seizure is a nightmare. Just the sight of it can bring shivers down the spine, so to speak. When this happens at home, parents usually tremble with fear; and they usually forget to do the right thing during this situation.
It is comforting for parents to know that the commonest seizure in childhood is benign in nature. This disorder is called Benign Febrile Seizure (BFS). This occurs between 3 months and 5 years of age, associated with a fever but without evidence of intracranial infection or defined cause.
Typically, a high fever (102º to 104º F) precedes the convulsion. Seizures show a tonic-clonic pattern, oftentimes associated with upward rolling of eyeballs. This usually lasts for 15 to 20 seconds and there are no more than 5 to 7 episodes in the child’s life. There usually is a history of other family members having had similar convulsions during childhood.
Because these convulsions arise with high fever, they are largely preventable. If a family history of convulsions is known, parents should be extra vigilant when a child has fever. Acetaminophen must be given to keep fever below 101ºF (38.4ºC). If Acetaminophen can not control the fever, sponge the child with tepid water to help reduce the fever quickly.
If a seizure has occurred at home, remain calm and follow these important points.
a) Move away furniture or any sharp object from the child.
b) Turn the child’s body and head gently to his side to prevent aspiration of unswallowed mouth secretions.
c) Do not restrain the child other than to keep his head turned to the side so that mouth secretions continue to drain. Restraining the child could result in injury.
d) Do not attempt to place a stick or padded tongue blade while the child is in seizure. You could break the tongue blade or loosen his teeth.
e) Ask the onlookers or spectators to move away from the convulsing child.
f) Be aware that the child may have some slight cyanosis or bluish discoloration during convulsive stage, but this stage is so short that administering oxygen is not needed.
g) After a seizure, the child will be in a drowsy state. Do not attempt to give oral Acetaminophen because the child might aspirate the medication. Instead, apply tepid sponge bath to the child to keep the fever low. Alcohol and cold water is not advisable. Alcohol can be absorbed by the skin or its fumes inhaled in toxic amounts, compounding the child’s problems. Extreme cooling by using cold water, on the other hand, can cause shock to the child’s immature nervous system. If sponging attempts are unsuccessful, you can put a cool wash cloth on the child’s forehead, axillary, and groin area. Then, transport the child, lightly clothed to a health care facility for immediate intervention.
h) If the child should pass rapidly from one convulsion to another (known as status epilepticus), telephone immediately the emergency medical service number. The child may need supplemental oxygen and anticonvulsant drugs such as Diazepam.
i) Following any single convulsion at home, telephone your primary care provider and notify him of the incident so arrangement for follow-up can be made. The occurrence of fever itself even without seizure still warrants a medical evaluation to determine the source of infection, so antibiotics will be given if necessary.
Many parents need to be assured that febrile seizures do not lead to brain damage. The child is almost always completely well afterward, so this condition is not that serious as it looks.