www.tidewaterreview.com/features/health/sc-health-1219-child-health-seizure-20121219,0,3204283.story

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Child health: Here's what to do when child is having a seizure

Positioning the body correctly, timing the episode are important

By Danielle Braff, Special to Tribune Newspapers

7:35 PM EST, December 19, 2012

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On a recent rainy, seemingly uneventful Wednesday afternoon, my friend started screaming. This was unlike any scream I had ever heard, and for good reason: She thought her 10-month-old baby, Declan, was dying.

I turned to Declan and instantly thought I might puke. His eyes were rolled back, and he was convulsing and foaming at the mouth. I thought he had a few seconds left to live.

As his mom screamed and cried, I frantically dialed 911 and begged them to hurry.

We then took little Declan out of his stroller as he convulsed and placed him on his back on the floor. By then, a crowd of moms had surrounded Declan (this happened outside a gymnastics class for 3-year-olds), and they all cried, screamed and paced helplessly.

The ambulance arrived swiftly and whisked the baby to the hospital, where he was later diagnosed as having had a febrile seizure — the most common type of childhood seizure. He would be fine.

But our reaction, while somewhat expected, wasn't the most helpful.

Seizures and epilepsy affect nearly 3 million Americans — and 200,000 new cases occur annually, according to the Epilepsy Foundation. One out of every 10 people will have a seizure, and febrile seizures occur in 2 to 6 percent of children under age 5.

When you see one, know what to do — our reaction needed work.

"You didn't do everything wrong," said Dr. Jonathan Charney, a neurologist at Mount Sinai Hospital in New York.

We didn't put a spoon in Declan's mouth to prevent him from biting off his tongue — a myth associated with seizures that can do more harm than good. We called 911, which was the right move.

But we didn't time the seizure to make sure it didn't go past the 5-minute mark.

"Most seizures are relatively brief (under 2 minutes), but many feel like an eternity in the heat of the moment," said Dr. Shaun Hussain, a neurologist at the Mattel Children's Hospital at UCLA. "A long seizure (more than 5 minutes and especially more than 30 minutes) is a medical emergency."

While the seizure is happening, it's essential to flip the person — child or adult — onto his or her side to prevent choking on fluids or vomit, Charney said.

We did that only after instructed to by the emergency dispatcher.

Declan's seizure was a result of a fever. Febrile seizures are the most common form of seizure for children younger than 5, and they're typically harmless, said Dr. Alexander Rotenberg, assistant professor of neurology at Harvard Medical School and epileptologist at Boston Children's Hospital.

Childhood seizures likely result from brain connectivity and hyper-excitability, Hussain said. The molecular and cellular phenomena that help infants' cognitive development also come into play when they have a fever, sometimes resulting in a febrile seizure.

There is a link between seizures and autism, he said. About one-third of children with autism also suffer from epilepsy. "To the extent that autism is on the rise, seizures associated with autism are also on the rise," Hussain said.

While seizures rarely do long-term harm, they can be scary to witness and hurt the person or others if the seizure involves a fall or driving.

Drugs, a high-protein/low-carbohydrate diet called the ketogenic diet, surgery and implantable devices are all used to help prevent seizures, Hussain said.

For nonepileptic seizures, doctors try to figure out the cause — and stop it. So parents of those with febrile seizures should carry around a fever-reducer to stop the fever as soon as it starts.

Declan's diaper bag now holds a fever-reducer and anti-seizure medicine to be administered rectally. The bag is heavier, but his mom sure doesn't mind.

sunday@tribune.com