Febrile Seizures - 2015

When returning from an afternoon walk with his parents, a four-year-old boy weighing 14 kg (31 lbs) tells his mum he feels sick. He is restless, he has a sore throat, coughs slightly, and there is an apparent serous secretion from his nose. The parents take his temperature at 7 PM (37.7 °C or 99.9 °F) and administer him a Paralen 250 mg PO. At 11 PM they observe twitching in his face, spasming of the extremities, clenching his fists, holding his breath and rolling his eyes back for the first time. The condition progresses to a generalized tonic-clonic seizure. What steps do we take as parents to a boy whose older brother underwent similar spasms in early childhood?

Help

It is undoubtedly an epileptic seizure. We lay the child down and remove all harmful objects nearby. It is not necessary to call an ambulance service because we are certain that the seizure will end spontaneously.

Mother administers the child an anticonvulsant drug (Valproat PO) which she takes for her personal use.

Now we are not able to judge this situation correctly that is why we call an emergency service immediately and mind protection of the child from injury.

Mother has her own experience with the spasms and remembers her older son´s spasmodic seizure which he has once undergone in connection with an incipient cold. Due to this fact, she does not take any action and waits until the spasms stop because she believes this condition will not occur again.

Examination

Anamnesis: FA: mother has epilepsy father is healthy boy's older brother had an attack of febrile seizures when he was 3 years old. PA: perinatal complications: spontaneous vaginal delivery, arrived at 33 weeks of gestational age, birth weight 2030g (4.47 lb), birth body length 45 cm, APGAR score 5-7-9, necessity for a 5-day incubator placement, physiologic neonatal jaundice not requiring phototherapy, exclusive breastfeeding for 4 month, postpartum adaptation, adjustment and psychomotor development with respect to perinatal complications meet the norm. Monitored by a neurologist for perinatal complications and his positive family anamnesis.

Glycaemia

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