PNG Medical Blog

Seizures, also commonly referred to as “fits,” are episodes of abnormal, excessive, and synchronized electrical activity in the brain. This electrical disturbance can lead to various symptoms, ranging from minor twitching to intense convulsions. In children, seizures can be caused by factors such as fever, infections like meningitis or encephalitis, head injuries, congenital brain defects, genetic disorders, and metabolic imbalances like low blood sugar or electrolyte disturbances.

One dangerous misconception is the belief that you should put a spoon or other object in the mouth of someone having a seizure to prevent them from swallowing their tongue. This is not true. Trying to force something into the mouth can cause serious harm, such as broken teeth, jaw injuries, or choking. It is impossible for someone to swallow their tongue during a seizure, and trying to put something in their mouth does not help.

Knowing what to do when a child is having a seizure can help ensure their safety and provide reassurance. First, stay calm as your calmness can help keep others around you calm as well. Gently guide the person to the ground if they are standing and clear away any dangerous objects from their surroundings to prevent injury. Place something soft, like a folded jacket, under their head to protect it. Do not try to hold the person down or stop their movements, as this can cause injuries to both you and the person having the seizure. Carefully loosen tight clothing, especially around the neck.

If possible, time how long the seizure lasts. Most seizures last less than five minutes. If the seizure lasts longer than five minutes, seek medical help immediately. Remain with the person until the seizure ends and they are fully awake. After the seizure, they may be confused or tired. Reassure them and explain what happened. Once the seizure stops, if the person is unconscious, gently roll them onto their side to keep their airway clear and prevent choking if they vomit. Clear any fluids from the mouth or nose.

It is important to seek medical attention if the seizure lasts longer than five minutes, the person has trouble breathing or appears to be choking, another seizure follows immediately after the first one, the person does not regain consciousness after the seizure, the person is injured during the seizure, or the person has never had a seizure before.

For seizures caused by high fever in infants and children, perform a scene survey and then do a primary survey. Call a doctor immediately and follow their advice. If the doctor cannot be reached, give acetaminophen (paracetamol) or children’s ibuprofen (Advil, Motrin) according to the directions on the label to bring down the child’s temperature. Encourage the fully conscious child to drink clear fluids. If the temperature does not go down, sponge the child with lukewarm water for about 20 minutes. Do not use cold water, as this may cause more serious problems. Dry and dress the child in comfortable but not overly warm clothing. Monitor the child’s temperature and repeat steps as necessary until medical help is reached.

Epilepsy is a disorder of the nervous system characterized by recurrent seizures. Many people with epilepsy take medication to control the condition. Other causes of seizures include head or brain injury, stroke, brain infection, drug overdose, and high fever in infants and children. With epilepsy, the person may know that a seizure is about to occur because of a brief sensation called an aura, which can be a hallucinated sound, smell, or a feeling of movement in the body.

A typical generalized seizure has two phases. The “tonic” phase involves a sudden loss of consciousness causing the person to fall, and the body becomes rigid for up to a minute. The face and neck may turn bluish. In the “clonic” phase, convulsions occur, breathing is noisy, frothy saliva may appear around the mouth, and the teeth may grind. A major seizure can come on very suddenly but seldom lasts longer than a few minutes. After the seizure, the muscles gradually relax, and the person regains consciousness. They may appear dazed and confused and feel exhausted and sleepy.

Epilepsy and seizures can be managed with proper care and understanding. Dispelling myths, such as the need to put something in the mouth during a seizure, is crucial for the safety of those affected. Knowing how to respond when a child is having a seizure can make a significant difference in their safety and well-being. Always remember to stay calm, protect the person from injury, and seek medical help when needed. By spreading accurate information and promoting safe practices, we can help those with epilepsy lead healthier, safer lives.

Sources:

• Shann, F., Biddulph, J., & Vince, J. (2003). Paediatrics for Doctors in Papua New Guinea. Paediatric Society of Papua New Guinea. Available at: Paediatrics for Doctors in Papua New Guinea
• Paediatric Society of Papua New Guinea. (2016). PNG Standard Treatment Book, 10th Edition. Available at: PNG Standard Treatment Book
• St. John Ambulance. (2019). First Aid Reference Guide, Fourth Edition. St. John Ambulance Canada. Available at: First Aid Reference Guide