Convulsions In ChildrenPosted on 2013-06-04 22:00:49
Dear Doctor, Last week as I was at the clinic with my child waiting to see the doctor, a frightened woman rushed into the department shouting and holding a child who was shaking excessively. The woman definitely turned out to be the mother of the child .The boy, who was around 4 years boy was clinging to the mother’s chain on her neck shaking uncontrollably which he eventually managed to cut as he was shaking. The boy was definitely convulsing although the mother did not understand what was happening and was panicked and shaken! Handing over the child, more like throwing the child to the nurse, the mother was reassured that the child wasconvulsing and that she needed to remain calm while the medical team attended to her son. My question is what are the causes of convulsions in children? What do I do when my child starts convulsing? Worried Mother, Dear Worried Mother, This is also not a common case where the convulsions take place near or at the medical facility. Convulsions commonly occur at home, enroute to health facilities when the child begins to feel unwell and sometimes unfortunately in long waiting queues at the medical providers. A convulsion is simply described as a period whereby there is involuntary contraction of the muscles. After the period of convulsion there may be profoundlethargy, confusion and even sometimes sleep. With convulsions, the muscles contract and relax in quick succession and one has no control over them. First time mothers can be a scared lot upon seeing their children convulse for the first time and rightfully so. Seizures are normally symptoms of very many disorders that can be affecting the brain. When occurring in children, the convulsions normally occur in children under 5 and are much less hereafter. Neonatal seizures occur within 28 days of birth though they are not very common. Most occur soon after the child is born. They may be due to a large variety of conditions. It may be difficult to determine if a newborn is actually seizing, because they often do not have the common presentation of convulsions with the jerking motions. Instead, the child’s eyes may appear to be looking in different directions or they may have lip smacking or periods of no breathing. Infantile spasms will commonly occur in children who are younger than 18 months. At times they are often associated with mental retardation and may consist of sudden spasms of muscle groups, causing the child to assume a flexed stature. Fever (temperature above 380C) is one of the most common causes of convulsion in children. This might arise from infection, either viral or bacterial. Throat infections and ear infections, common cold, flu and malaria are examples of some of the infections that lead to fever. The convulsions also have a possibility of recurring in future illnesses where there is fever. This type of convulsions is also referred to as febrile convulsions. Low blood sugar also referred to as hypoglycaemia is also a known cause of convulsions and more so in diabetic patients. For diabetic children it is advisable to have blood sugar checked regularly in order to ascertain the sugar levels control is adequate. Children with epilepsy are known to have convulsions. Epilepsy is defined as a neurological condition, which affects the nervous system. It is usually diagnosed after a person has had at least two seizures that were not caused by some known medical condition. The incidence of epilepsy is 3 times higher in the first year of life compared to mid-adulthood. Epilepsy is also known as a seizure disorder and the patients are usually on epileptic medication.At times for patients who are epileptic they normally have information bracelets showing how their particular type of seizure can be treated.Other causes of convulsions also include a change in the heart rhythm, emotional stress and poisoning. During the seizure the child may become stiff or floppy; the child may become unaware of their surroundings and may display twitchy and jerky movements. Sometimes the child may have difficulty in breathing. When the child is convulsing there may be involuntary release of urine that occurs and tongue biting can also occur. According to Mr. CedrickLusimba; a Senior Paramedic with E-Plus and a trainer in Advanced Cardiac Life support and Advanced Trauma Life Support and a trainer with the Amara Initiative, when having a child who begins to convulse,the parent should stay calm and stay with the child. The area around the child should be cleared of any dangerous, sharp objects and also make sure that the child has a pillow or blanket beneath their heads. The child should also be made to lie on their side so that incase of vomiting, which happens often when convulsing, the child may not choke on their vomit. As mentioned above, convulsions frequently happen due to very fever in children..If the child suffered convulsion due to fever, the parent or caregiver should give the child paracetamol which helps to reduce the fever or if no medication is available it helps to put a lukewarm cloth over the child’s skin which can help to bring down the body temperature so as to reduce chances of repetitive convulsions Once the convulsions have eased the child should be rushed to hospital.An ambulance can be called if a child continues to convulse for more than 5 minutes, if the child was convulsing under water or if the child is no longer breathing well or not breathing after the convulsions and is turning skin color. Depending on the cause of the seizure, there are different ways that a seizure can be managed or treated. Medical tests are normally an important part of diagnosing seizures. The doctor does a physical exam and also carries out blood tests to find out possible causes of the convulsions. An EEG can also be ordered in order to check for the electrical activity in the brain and also request a brain scan if needed. A sure way of preventing seizures is ensuring that for children who are coming on with fevers due to infection that the treatment for the infection is completed. It is important to keep the temperature of the baby under control as further management from hospital is sought. For those on epileptic treatment it is important to ensure they take their regular medication in order to avoid onsets of seizures. Seizures in themselves are not harmful, but children with seizures or even adults with seizures may injure themselves, have falls which may have or bring further complications. In Conclusion more awareness should be made about convulsions to parents, especially first time parents and the care givers who spend a lot of time with the children. One should know what to do when the convulsion happen and especially staying calm at all times to take care of the child. So go on and recommend this article to someone you know with children. It is the first step to making a difference.