Febrile convulsion : Prevention and care

Scary as it goes, convulsion or fits (seizure) is the commonest scary experience for mother to witness a child have, they chant all sorts of names. Jesus, Jehovah, doctor, Yepa, Oh! Ha! Just to mention a few.

I have witnessed them pee themselves but that is fine. What bothers me and affect these children more than the convulsion are the wrong interventions  and the insults we inflict on them during this process.

This brings us to today's blog tittle.

"Care and Prevention of Febrile Convulsion in Children"

What is Febrile convulsion?

It is a convulsion (fit) or seizure in children when they are having fever, occurs usually in children between the age 6 months  and  60 months (5yrs).

Convulsion may be characterized (but not restricted to) by abnormal movement of any part of the body usually jerking, pedaling, abnormal blinking of the eyes, upward rolling of the eyes, stiffening of the body, etc.
It is quite a common place in children.

Fever is defined as elevated body temperature, subjectively and rather unreliably checked by placing the back of the palm on the forehead in this part of the world.

The reliable method is by using a thermometer, a specimen is shown below.

Off mode

Default value when switched on.

Reading after measurement

Temperature greater than  37.5 Celsius measured from the armpit (there are other places one can check) is referred to as fever.


What are the causes?

The causes are mostly from infections, that may affect any part of the body except the brain. These include but not limited to :

Malaria
Catarrh and cough (flu, pneumonia)
Infection in the throat (tonsillitis and pharyngitis)
Infection in the passage for urine (urinary tract infections)
Infection in the ear (Otitis)
Like I said, infection anywhere in the body except the brain may be a cause . If the infection is in the brain, the outcome is worse and the associated fit is not called febrile convulsion.

What to do during a febrile illness to avoid febrile convulsion?

1. Have a thermometer to measure your children temperature. This can be done by anybody and everybody.A digital thermometer displays the temperature of the body on its screen.

Switch on the thermometer and simply put in the ampit for 2 minutes or till it alarms, Check the number displayed thereafter,If lesser than 37.5 Celcius, no problem, Values greater than 38 Celsius are particularly disturbing and requires care that may include

a) Complete exposure of the child
b) Fanning
c) Bathing with lukewarm water
d) Toweling with wet napkins (wet with warm water)
e) Administration of Paracetamol (only if the above methods fail and temperature is greater than 38 Celsius).
   Paracetamol should not be used routinely in any child to prevent fever (it damages the liver and the kidney if used excessively).
Such child should at least be reviewed by a family physician or a paediatrician(babies doctor)

What to do during convulsion

Convulsion for one minute is like eternity to an helpless mother, so any form of intervention will do. Anything done to stop the convulsion is usually welcomed and appreciated though most of these interventions are needless and harmful as we shall soon see , the following are recommended steps of interventions

1. Remove all clothing and allow proper ventilation

2. Put to lie on the left side

3.Follow steps a to e of prevention written above

4. If available, insert a rectal diazepam. This is a gel that can be placed in the body through the anus and hastens abating the seizure

4. It is also Paramount to see a doctor (babies doctor)

May I quickly add that febrile convulsion usually does not leave a child damaged, There is no long term outcome. It is our wrong interventions during this period that damage these children.

What not to do.

1. Do not pee on the child. This is rather a common practice. Please, do not do it. The  danger is the child run a greater risk of aspirating the urine(breathing in urine) and suffer lung infections and may even die from choking.

2. Do not give COW Urine,sounds funny or you say barbaric, people do it, and it is a very common practise.
The first problem here is cow urine, the second is that it is used alongside onion and garlic making a concoction that potentially lowers the blood sugar making the child to have more convulsions and subsequently suffer permanent brain damage.

3. Do not put their leg(s) in fire, Yes, people do it,in the last one month, I have seen a couple of cases.

The fact here is that fire can only worsen convulsion, It does not stop it,the child is then left with a damaged foot, prolonged hospital stay, more psychological effect the extent of which can not be quantified.

4. Do not insert spoon, or anything in their mouth while convulsing,  you may remove their teeth , injure the mouth structures and the child may choke.

5. Don't give anything by mouth while a patient is convulsing or sleeping after convulsion, It is dangerous.

Most of the above interventions are instituted by Neighbours, grandparent, friends etc but not by the mother who is at the time of event practically " brain dead".
This is a case where doing nothing ( if u do not know what to do )is far better than doing useless stuff.

Please share this information , it will definitely help some poor children somewhere.

Leave your comments , suggestions , additions and questions in the comment box below.