Hello,
Thank you for your query at DoctorSpring.com
I can understand your situation. A child with febrile seizures is always a worry for the parents.
I advise the following things: (I am assuming that your child weighs 14-15 kg. The doses prescribed for the above weight)
1. Syp. CROCIN-DS 5 ml Q 6-8 hourly
2. Syp. HONITUS 5 ml Q8 hourly
3. INSED spray (Midazolam spray) - Keep it at hand to administer intranasally, if the child throws a brief seizure- Just for emergency purposes. Not to be used routinely
4. Tab CALMPOSE (diazepam) 1 mg ( 1 tab = 2 mg; Half tablet) once daily at bedtime to decrease the risk of febrile seizures. This medicine may be used for the first two days of a febrile episode.
Please note that there is no direct correlation between fever control and risk of seizures, meaning that despite adequate use of sponging and paracetamol, the child may still throw a seizure. So please do not try to control the fever too aggressively. Just be prepared to manage a seizure of an episode occurs. Emergency management of a seizure includes positioning laterally, ensuring that there are no sharp/pointed objects nearby that can hurt the child, administering intranasal midazolam spray, if seizures persist beyond 2 minutes and being in contact with a nearby pediatric emergency specialist for help if seizures pro not respond to intranasal midazolam.
Regards
Dr. Saptharishi L G
Dr. Saptharishi L G
Patient replied :
Frisium 5 has been given 1 tab twice daily for three days as prescribed by local pedritician. Sir weight of child 12 kg. Sir. Pls. In brief apout the spray. HOW to apply in emergency it will applied or what. And which part of the body is to be applied. Sir pls. Tell about diet in present situation. Normaly my child does't like to take food. Vaccination is up to date given. Sir. This fevric convulsionhas happened two times before one year. It has any risk or diffcuilties in future. What are the measures we can take. Upto what age it carrys. My child suffers very much in shardi jukham fever through out the year. Doctor said don' t worry his immunization power is low. Sir. What medicines or else we can take for this. Thank u. With regards. Waiting for reply.
I can understand your concerns. Let me explain to you a few things about febrile seizures...
Febrile seizures are a benign manifestation of the tendency of the brain (of children) to throw a seizure when exposed to higher temperatures. This tendency is usually gone by the age of 5-6 years as the child grows up. Simple febrile seizures are associated with no significant increase in risk for epilepsy or any significant neurological sequelae in later life. But, the question is - Does your child have 'simple febrile seizures'??
For the diagnosis of simple, febrile seizures, the following points are essential:
1. Characteristic age group: Children aged 6 months - 6years; In your child's case, this seems to be satisfied.
2. No underlying neurological illness/ developmental delay. Child should have achieved all her developmental milestones on time.
2. No history of any seizures in the past (afebrile seizures).. Please ask your relatives and parents for any such history in the family.
3. No family history of epilepsy or neurological disorders... Please ask your relatives and parents for any such history in the family.
4. Seizure - single episode of generalized tonic clonic seizures occurring within twenty four hours of onset of fever and lasting less than 10 minutes - Does this description of seizure fit your child?
If it is indeed a simple, febrile seizure, then there is absolutely no need to worry. Just be aware that your child could develop seizures if there is fever. But, there is no reason to get unduly worried as most children have short-lasting seizures with no serious problems and these abort spontaneously.
You should understand that 2-5% of perfectly normal children develop febrile seizures and that is quite a large number and I must tell you that there is enough evidence to show that there are no long term adverse events of simple febrile seizures (even if they recur). The risk for occurrence of subsequent epilepsy is around 1% or lesser.
Moving on to the use of MIDAZOLAM intranasal SPRAY..
Use it only when the seizures last more than 2 minutes. For your child the dose would be 2 puffs on each side of the nose. Use is very simple. Once you procure the medicine, you would realize how simple it actually is. STEPS: Remove the cap. Shake the bottle. Every first time you use the pump spray, you may have to “prime” it, squirting a few times into the air until a fine mist comes out. Hold the pump bottle with your thumb at the bottom and your index and middle fingers on top. Squeeze the pump. Repeat these steps for the other nostril. If you are using more than one spray in each nostril, follow above steps 2 again.
No dietary restrictions are needed. No syrup or tonic can help prevent frequent upper respiratory tract infections in your child (sardi, jhukam, khansi). It only means that child's hand hygiene and overall hygiene at home is poor. Please work on improving that.
Regards.