[닥터DJ]What should I do if my child has a fever and convulsions? How do parents respond in this case? : international newspaper

Photo = YouTube channel Doctor DJ capture

A febrile seizure is a condition that causes convulsions with fever. It is the most common neurological disease in children, but parents of young children are at a loss as to what to do. Lee Bo-ryun, a professor of pediatrics at Inje University Busan Paik Hospital, who appeared on Doctor DJ, a medical YouTube channel run by the International Newspaper, said, “When a child is suspected of having febrile seizures, it is necessary for guardians to take appropriate measures without panicking.” If convulsions last for more than 5 minutes and consciousness does not return quickly, it is important to visit the nearest emergency room.”

Below is the full text of the interview with Professor Lee regarding ‘febrile convulsions’.

– febrile seizures
▶ Febrile seizures are one of the most common neurological disorders in childhood and occur between the ages of 3 months and 6 years. Fever is a disease caused simply by fever in the absence of a nervous system infection such as meningitis or encephalitis or other causes.

The root cause of febrile seizures is not well known, but it is thought to be caused by the immature brain being vulnerable to fever. For typical generalized tonic-clonic seizures lasting less than 5 minutes, febrile seizures are not serious in developing children without a preceding neurologic disorder. Here, generalized tonic-clonic seizures refer to a form of convulsions in which consciousness is lost, arms and legs are stretched out, and then the limbs are shaken regularly.

– characteristic
▶ A typical febrile seizure usually occurs with a sudden rise in core body temperature. Convulsions are more likely to occur at the beginning of a fever, with regarding 44% of patients having seizures within 1 hour of the onset of fever, and only regarding 10% of patients having seizures following 24 hours. The form of convulsions is usually manifested in the form of generalized tonic, tonic-clonic, or drooping hypotonic seizures. Convulsions usually last from a few seconds to 5 minutes and are followed by short-term drowsiness.

– heredity
▶ Febrile seizures are not necessarily, but there is a genetic tendency. If one of the parents had febrile seizures as a child, there is a 30 to 50% chance that the child will have febrile seizures. However, a family history of febrile seizures is not a bad thing. The fact that the parents are currently okay suggests that the child can grow and develop without any problems like the parents.

Photo = YouTube channel Doctor DJ capture

– First aid
▶ When convulsions occur, profuse saliva or vomiting may occur. To prevent choking by this saliva or vomit, lay the child on its side or turn its head to one side to allow secretions from the mouth to flow to the side. It is necessary to determine the duration and pattern of seizures. It is important to check the time by looking at the watch as soon as a cramp occurs. Because it is painful for parents to see their child twitch, it is common for the duration of a twitch to feel longer than it really is. Also remove dangerous objects from nearby areas and loosen tight clothing. Do not put objects or fingers in the mouth just because your child is biting their tongue or clenching their mouth tightly. Most are over within 5 minutes, but if it lasts longer than 5 minutes, call an ambulance and go to the emergency room.

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– IQ
▶ Febrile convulsions do not reduce intelligence or cause epilepsy. However, convulsions lasting longer than 15 minutes, convulsions occurring 2 or more times within a day, or local convulsions, i.e. convulsions in only one part of the body, such as shaking only one arm or leg or turning only the eyes, are called complex febrile seizures. The recurrence rate is also high and the possibility of later transition to epilepsy is higher than that of typical simple febrile seizures. In addition, if there is a family history of epilepsy or if the child already has a developmental delay or neurological disease, it is highly likely that epilepsy will occur.

– Antipyretics
▶ Acetaminophen, commonly known as Tylenol, and ibuprofen, known as ibuprofen syrup, are widely used to treat fever in children. Aspirin is no longer used as an antipyretic for reasons such as Reye’s syndrome, platelet dysfunction, gastritis and gastrointestinal bleeding, and exacerbation of asthma. The minimum recommended age for acetaminophen is 3 months and the minimum recommended age for ibuprofen is 6 months.

– Prevention
▶ For the purpose of preventing febrile convulsions, continuous use of anticonvulsants is not recommended. Anticonvulsant prophylaxis is helpful in suppressing the recurrence of convulsions, but it is not used well because of the risk of cognitive decline and liver toxicity. Instead of continuous prophylaxis, children with frequent relapses may benefit from giving anticonvulsants, such as diazepam, only during fever. However, the problem is that the sudden fever and convulsions occur in the early stages of fever, so taking anticonvulsants is often missed. Prophylactic antipyretics have not been shown to reduce the risk of recurrence in large studies. Since febrile seizures occur mainly in infants aged 18 to 24 months and do not occur following 4 to 5 years of age, it seems important to follow preventive measures to prevent infections that cause fever as much as possible in early childhood.

– Don’t do this.
▶ If a child bites his tongue or bites his mouth during febrile convulsions, there are cases where he tries to forcefully open his mouth by inserting objects or fingers into the mouth. At this time, the child may bite and injure the guardian’s fingers, or the child may vomit and block the airway. Do not put your fingers in your child’s mouth. Also, do not pick your child’s fingers with saliva when the baby is twitching, as this will do nothing to stop the child from twitching.

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