Resolved question:
Should we as parents pursue a cause of child's first seizure that lasted 25-35 minutes and only stopped once medicated w/ 3 doses of valium?
Details: My 17 month year old son had a first seizure last Tuesday that lasted about 25-35 minutes.
911 was called and ambulance showed up shortly afterwards. The decision was made to life flight my son to St. Francis Children's Hospital since the seizure had been ongoing so long and still hadn't stopped. After 3 doses of Valium and a dose of Ativan, the seizure finally came to a stop while on the helicopter on the way to the children's hospital. Since he had to have so much sedative to stop the seizure paramedics had to also administer Atropine restart the heart since it dropped so low.
No seizures have occurred since and he was discharged from the hospital the next day after going through a battery of tests. Tests included, CAT scan, Urine screen, blood tests, EEG, chest x-ray which they said wasn't that clear since he was moving around. The attending physician after running all these tests said they are not able to find anything wrong with him so "we are going to consider this one (this seizure) a freebie." That didn't sit well with my wife and I
So we are asking weather we should pursue a cause of this first seizure? We live in the Tulsa, OK area and are considering taking him to a specialist in Memphis, TN (about 6 hour drive) to see what we can find.
Are we just over concerned parents? Should we just forget it ever happened and hope it doesn't happen again? Or should we pursue a cause by taking him to a leading specialist?
Submitted:
4 Days
Category:
Pediatrician
Dear parent,
I can understand your concerns. Seeing one's child seize is the worst nightmare of any parent.
The sequence of events that you have described is definitely a seizure that has been long-lasting and difficult to control. This would qualify for what is called as STATUS EPILEPTICUS. However, I have a few questions on my mind before I can come to any reasonable conclusion.
1. Was the child having fever prior to or during or immediately after the episode of seizure?
2. At 17 months age, is your DON developmentally and neurologically normal for his age? How have been his developmental milestones?
3. Is there any family history of febrile seizures, seizures, epilepsy or any other neurological disorders? It could distant relatives on both father or mother's side with history of neurological illnesses.
4. Does he have any history of recent vaccination? Is there any other history that I should know of?
Regards
Dr. Saptharishi L G
1. He did not have a fever at the time or immediately after the seizure. Paramedics immediately checked temperature when they arrived and got a 99.1 F termperature.
2. Neurological development has been normal. No red flags have been raised on his normal check ups.
3. I am the father and I have a history of febrile seizures as a baby. But as stated above a fever was not presented at the time of the seizure in question.
4. He is on the normal vaccination schedule but has not had any recently. Like I mentioned, the seizure occured last Tuesday and his last vaccination was administered at 15 months, so aproximetely 2 months ago.
The only other medical issues that my son has had are minor ear infections and he did have a very minor ear infection when the seizure occured, but doctors rulled it out since there wasn't any increased white blood cell count or couldn't find infection in the blood.
The only other concern that we have is the posibility of autism. I have done a little bit of research on autism and seizures can occur in autistic children. We have noticed that our son likes to bend at the wriste and twist hands back and forth repeadely. This is the only small sign that might be autistic. What are your thoughts?
Dear parent,
Thank you for providing the answers to my queries. This has definitely clarified a number of issues.
Based on all the information provided, it is most likely not a febrile seizure. As there must be documented fever prior to or during or immediately after the seizure for a child to be labeled so. Secondly, most febrile seizures are self limiting, short lasting ( <5 min) and occur on day one of fever, during the acute rising phase of fever and hence are called TYPICAL FEBRILE SEIZURES. Febrile seizures that are long lasting like in your son's case may still fit into an ATYPICAL FEBRILE SEIZURES, but your son never had fever. So that diagnosis also does not stand its ground.
The fact that you had febrile seizures puts him into a slightly higher risk of the same. In fact, it also puts him at a slightly higher risk for epilepsy. Looking at the whole clinical picture, evolution of symptoms as well as the family history, I would definitely recommend a visit to the pediatric neurologist and a CE-MRI of the brain.
Wishing your son a speedy recovery.
Regards
Dr. Saptharishi L G