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Febrile Seizures in Children

Posted Nov 04 2009 10:00pm

I had a recent frantic call from a grandmother saying her three-year-old granddaughter, who lived in another state, had just been taken to an ER after a probable seizure. The child's mother later sent me an e-mail detailing not one but apparently a past history of three other seizures. I couldn't understand why the child's pediatrician had not sent the child to a pediatric neurologist prior to the last seizure whch sounded as though it was a grand mal or tonic-clonic seizure. The child was unresponsive and lost both bladder and bowel control. Apparently all four seizures had been accompanied with a slight fever. I advised the mother that a pediatric neurologist whould be seen as soon as possible. Certainly an EEG should be done and the possibility of an apnea monitor considered.

When a child has a seizure, immediate measures should be not to use any restrains  but put the child on a flat surface and remove any sharp objects that might cause harm. Calling 911 and a child's doctor are both important. The big risk is meningitis and if there is a fever and stiff neck then a spinal tap must be done. This is a simple procedure and one I have done many times. Meningitis is very treatable if it is diagnosed early.

When there is no family hisory of seizures, no trauma or fall, and the child is under five, most children  outgrown these seizures. There are other types of seizures that may occur later on, particularly if there is a family history of seizures. A seizure is a very scary thing for parents and others to observe. I was walking on the streets of Munich, Germany with a friend and a policeman fell to the ground at my feet and had a seizure. There were no other medical people around, so my friend said, "He is all yours to take care of!"  Fortunately, the man quickly responded to my care and an ambulance soon arrived. Not my favorite overseas day!

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