Care for children during epileptic seizures

Written by Hu Qi Feng
Pediatrics
Updated on September 20, 2024
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During an epileptic seizure, it is crucial to control the seizure promptly by using sedative and anticonvulsant medications. While administering these drugs, it is important to closely monitor for consistent breathing. Additionally, during a seizure, it is necessary to ensure that the airway remains clear, provide oxygen, and, if required, use mechanical ventilation to maintain airway patency. Prevent biting injuries to the tongue and position the head to one side so that secretions can flow out of the corner of the mouth, preventing reflux of stomach contents and risk of choking. Protect brain function and vital organs, and prevent cerebral edema. After the seizure has stopped, long-term administration of antiepileptic drugs should be continued to prevent recurrence.

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Neonatology
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What are the early symptoms of epilepsy in children?

Epilepsy is a particularly common chronic disease in life. If the brain is underdeveloped and there are neurological disorders, it can cause epilepsy. What are the early symptoms of childhood epilepsy? The manifestations of a child's epileptic seizure are diverse, but all have the characteristics of sudden onset, sudden cessation, and periodic attacks. Common types in children include major seizures, absence minor seizures, and benign childhood epilepsy. During a major seizure, the child suddenly loses consciousness, breathing stops, the complexion turns cyanotic, the pupils dilate, the limbs stiffen, and the hands clench into fists, then switching to paroxysmal convulsions, foaming at the mouth, with the attack generally lasting 1-5 minutes. Children with absence seizures appear to suddenly lose consciousness, stop their activities, and stare upward or roll their eyes, but they do not fall down or convulse, lasting 1-10 seconds, with consciousness quickly recovering after the attack. Benign childhood epilepsy seizures often involve twitching of one side of the face, lips, and tongue, possibly accompanied by abnormal sensations in those areas, inability to speak, and drooling, typically with clear consciousness, and more frequently occurring at night.

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Neurology
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Can epilepsy patients drink water frequently in their daily life?

Patients with epilepsy can often drink water in their daily lives, but they should pay attention to the amount of water they drink and not consume too much at once. Drinking too much water in a short period can lead to increased urination, and an increase in the frequency of urination could potentially trigger a seizure. Additionally, patients should try to reduce their water intake during a seizure episode. Drinking water during a seizure can easily cause choking or even suffocation. Therefore, patients with epilepsy need to pay attention to adjusting their diet and lifestyle. Moreover, patients need to take long-term medication to prevent seizures, including commonly used drugs such as carbamazepine and sodium valproate. In hot weather, patients with epilepsy still need to hydrate appropriately; otherwise, dehydration and low blood pressure can occur, which can also easily trigger a seizure.

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What are the initial symptoms of sleep-related epilepsy?

The initial symptoms of sleep-related epilepsy mainly include sudden opening of the eyes and panic symptoms at the onset of sleep. A few patients may exhibit aggressive behavior towards others, and some may experience movement disorders and abnormal muscle tone. For these patients, it is necessary to promptly receive examinations and treatment in neurology. Diagnostic methods mainly include video EEG, ambulatory EEG, cranial CT, and MRI, among others. Once diagnosed, timely intervention should be provided. For some patients, if it is the first seizure and not frequent, interventions through lifestyle and sleep adjustments can be implemented without immediately resorting to medication. If these adjustments are ineffective or if the patient frequently experiences seizures, appropriate medications should be administered in a timely manner, including drugs such as sodium valproate, carbamazepine, oxcarbazepine, and levetiracetam, among others. (Medication should be taken under the guidance of a doctor)

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Written by Liu Shi Xiang
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What can severe epilepsy lead to?

Severe epilepsy can cause many complications, such as cerebral edema, brain herniation, upper gastrointestinal bleeding, etc. Therefore, severe epilepsy can seriously threaten the patient's life. If the patient's epilepsy is not controlled in time, it can easily lead to a state of status epilepticus. Status epilepticus is a very dangerous central nervous system disease. Patients may experience sudden respiratory and circulatory arrest and uncontrollable massive gastrointestinal bleeding. For severe epilepsy patients, it is necessary to promptly administer medications such as diazepam and sodium valproate to terminate the seizures. If status epilepticus occurs, the patient needs to be urgently sent to the ICU for observation and treatment, and effective interventions for various complications must be provided. For example, in the case of cerebral edema caused by epilepsy, medications such as mannitol and glycerol fructose are needed to dehydrate and reduce intracranial pressure. If epilepsy causes acute upper gastrointestinal bleeding, treatments to suppress acid, stop bleeding, and maintain blood pressure are required.

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Can acquired epilepsy be treated?

Acquired epilepsy can be treated. Most cases of acquired epilepsy are due to some organic lesions, also known clinically as secondary epilepsy, primarily treated by addressing the underlying disease. Common clinical conditions include brain organic lesions such as cerebral hemorrhage, cerebral infarction, brain tumor, encephalitis, and brain parasitic infections. Systemic diseases like diabetes and hyperparathyroidism can also lead to epilepsy. If epilepsy persists or if there is a major epileptic seizure, it can lead to brain cell hypoxia and even brain edema in severe cases. When necessary, treatments to protect the brain and reduce intracranial pressure are required. Medications for brain protection include Cytidine Diphosphate Choline and Lacosamide, while drugs to lower blood pressure mainly include Mannitol, Glycerol Fructose, and Furosemide. Most patients potentially can be carefully cured through the treatment of the underlying disease, and if seizures persist after the treatment of the primary disease, antiepileptic drugs should be administered. (The use of medications should be under the guidance of a physician.)