Classification of febrile convulsions
Clinical manifestations can be divided into simple type and complex type. Simple type characteristics: 1, age: between half a year and four years old, rare after five years old. 2, fever: generally due to acute fever at the beginning of a cold, convulsions often occur when the body temperature suddenly rises to 38.5℃ to 39.5℃. Seizure: loss of consciousness, generalized symmetrical tonic seizure, or binocular gaze, strabismus and upturn. 4. Duration: Duration: lasting for several seconds or minutes, generally not exceeding 15 minutes. There was no recurrence within 24 hours, and consciousness quickly returned to normal after the attack. 5, EEG: 2 weeks after the body temperature returned to normal, EEG examination was normal. 6. Family history: there is an obvious family history. Simple febrile convulsion has a good long-term prognosis and has no effect on intelligence, learning and behavior. With the growth of age, the brain develops gradually, and generally there will be no more febrile convulsions. Characteristics of complex type: age > 6 years old, body temperature < 38.5℃ at the time of seizure, limited seizures, convulsions lasting for more than 15 minutes, repeated seizures within 24 hours, and EEG was still abnormal after 2 weeks of normal body temperature. The prognosis is poor, about 1% ~ 2% can turn into epilepsy.
Prevention of febrile convulsion
First, febrile convulsions are more common in children from 6 months to 5 years old, accounting for about 95%. Children of this age should pay special attention to strengthening nursing, paying attention to nutrition, enhancing physical fitness and minimizing fever and illness. Second, children with febrile convulsions should be given oral antipyretics (such as aspirin) and sedatives (such as Lumina) in advance when they have a cold or have a febrile disease, or use physical cooling to prevent sudden increase in body temperature. Third, for the authors who have repeatedly sent it in the past, some doctors advocate taking luminol for a long time to prevent recurrence. When there is a risk factor for febrile convulsion to turn into epilepsy, you should go to the hospital for further examination, and the doctor will decide whether you need to take medicine for a long time.
When children have febrile convulsions, parents should do the following work.
1. Be calm and quiet, and don't give your child any unnecessary stimulation. 2. Keep the respiratory tract unobstructed. Put the child flat, head to one side, clean up the secretions and vomit in the mouth in time to avoid inhalation of trachea, causing suffocation or aspiration pneumonia. 3. When severe cyanosis occurs in convulsion, oxygen should be inhaled immediately to reduce hypoxic brain damage. 4. In the absence of anticonvulsants, you can press Renzhong and Hegu, and be careful not to use too much force, so as not to damage the skin and bring unnecessary pain to the child. 5. Complex convulsion should be sent to hospital for diagnosis and treatment. After the first febrile convulsion, about 40% children will relapse. The risk factors of recurrence are: (1) young onset age; (2) Relatives have a history of febrile convulsions or epilepsy; (3) Complex febrile convulsion at the first onset. Children's repeated convulsions are very harmful to the brain, so it is necessary to avoid brain damage caused by repeated convulsions and lead to mental retardation. (1) Try to avoid fever. Usually do more outdoor activities, so that children can gradually adapt to the cold and hot changes in the external environment. However, we should also pay attention to the change of temperature and increase or decrease clothes in time to prevent colds. (2) Pay attention to reasonable dietary configuration to enhance children's physique. (3) Once you have a fever, you should control your temperature below 38℃ as soon as possible. First of all, take antipyretics. There are many kinds of antipyretics at present. Here, we recommend Alben. The ingredients of this medicine are aspirin and phenobarbital. The former can cool down, and the latter can soothe spasms. And immediately give physical cooling, use 25% ~ 50% alcohol to wipe the bath, and pay attention to it when using alcohol to wipe the bath. It is forbidden to wipe the neck, chest, feet, neck, armpit, groin and other places with large blood vessels. Drug cooling is slower than physical cooling. (4) The children diagnosed as complex type must take drugs regularly and regularly for a long time, and 3 ~ 5mg/kg/ day of lumina can be taken orally for three years from the date of the last attack.