Seizure and Epilepsy

"Seizure" is a general term that refers to a sudden malfunction in the brain that causes someone to collapse, convulse, or have another temporary disturbance of normal brain function, often with a loss or change in consciousness. Altough seizures can be frightening, many last only a few minutes, stop on their own, and are almost never life-threatening. Seizures can take many forms, from staring spells to involuntary movements of the arms ad legs. 

Seizures are quite common, especially among children, and they have a wide range of causes:

· EPILEPSY.

· HIGH FEVER.

· HEAD TRAUMA.

· PROGRESSIVE BRAIN DISEASE.

· CONGENITAL CONDITIONS (Children who are born with various congenital conditions, such as Down's Syndrome, Angelman's Syndrome and some forms of autism)

SIGNS AND SYMPTOMS:

· Unusual sensations or twitching before seizure.

· Uncontrollable muscle spasms. 

· Loss of consciousness.

· Uncontrolled urination or bowel movement.

WHAT TO DO:

Some seizures require immediate medical care while others can be managed at home. If a child has a seizure:

· Place the child on the floor or ground, and remove any nearby objects.

· Loosen any clothing around the head or neck.

· Do not try to prevent the child from shaking (this will not stop the seizure and may make the child more uncomfortable).

· Do not put anything in the child's mouth. The child will not swallow his or her tongue, and forcing teeth apart could cause injuries.

· Roll the child onto his or her side. If the child vomits, keep him or her on the side and clear out the mouth with your finger.

· Do not give the child anything to drink.

· Let the child sleep after the seizure.

· Call the child's doctor. 

CALL IMMEDIATELY TO THE AMBULANCE IF THE CHILD ...

· has a seizure lasting more than 5 minutes or is having repeated seizures.

· has difficulty breathing,

· has a bluish color on the lips, tongue or face.

· remains unconscious for more than a few minutes after a seizure.

· falls or hits his or her head before or during a seizure.

· seems to be ill.

· has any symptom that concerns you.

EPILEPSY:

Although epilepsy can begin at any time of life, is most common in children under 5 years old. This disorder varies from person to person but in most children's cases, the seizures respond well to medication and children can enjoy a normal and active childhood. More than half of children with epilepsy can overcome the seizures as they get older, however, in other cases, seizures continue into adulthood. 

RECOGNISING EPILEPSY IN CHILDREN:

Seizures are not always recognised in children when they first occur. Seizures can be subtle and short,in which the child has brief episodes of decreased awareness and responsiveness. Some childhood events that may be confused with seizures are:

· Fainting spells

· Breath-holding spells

· Normal sleep jerks

· Daydreaming

· Night terrors in young children

· Migraine

· Heart and gastrointestinal problems

· Psychological problems. 

EPILEPSY SYNDROMES:

Once seizures are confirmed, the next step is to clarify the types of seizures and the possible cause. EEG (Electroencephalography) can help to determine the type of epilepsy the child has and thanks to the MRI, we can know if the child has a brain lession. If the epilepsy fits a particular pattern or syndrome, the doctor could select the best treatment. 

Some epilepsy syndromes include:

· Childhood and juvenile absence epilepsies.

· Benign rolandic epilepsy.

· Juvenile myoclonic epilepsy.

· Infantil spasms.

· Lennox-Gastaut syndrome.

· Temporal lobe epilepsy.

· Frontal lobe epilepsy.

TREATMENT OF EPILEPSY:

Medication can often prevent seizures from recurring. However, it is not prescribed for every child who has a seizure.If the child has or not to take medication or what type of medication he or she has to take, will depen on:

· The type of epilepsy the child has.

· Whether her/his doctor thinks there is high risk of further seizures.

· The age of the child.

· The presence of developmental or behavioural problems.

· The attitude of the child and the family.

EYE INJURIES

Most eye injuries are minor, like getting soap in the eye, but others, such as those that happen during sport activities, can be serious and require medical attention: eye injuries are the most common preventable cause of blindness, so when in doubt, do not hesitate to call the doctor.

 

 

SIGNS AND SYMPTOMS

 

• Redness
• Stinging or burning
• Watering
• Sensitivity to light
• Blurred vision
• Swelling of the eyelids
• Discoloration around the eye

 

WHAT TO DO

 

ROUTINE IRRITATIONS

• Wash your hands thoroughly before touching the eyelids to examine or flush to the eye.
• Do not touch, press or rub the eye itself and try to avoid the child from touching it.
• Do not try to remove any foreign body except by flushing: there is a high risk of scratching the surface of the eye, specially the cornea.
• Tilt the child's head over a basin or sink with the affected eye pointed down and gently pull down the lower lid, with his or her eyes opened as wide as possible.
• Gently pour a steady stream of lukewarm water from a pitch or faucet over the affected eye.
• Flush for up to 15 minutes, checking the eye every 5 minutes to see if the foreign body has been flushed out.
• If the irritation continues afterward, the eye should be examined by a doctor, because a particle can scratch the cornea and cause an infection.
• If a foreign body is not dislodged by flushing, it will probably be necessary a professional to flush the eye.

EMBEDDED FOREIGN BODY

• Call for emergency medical help or go to the emergency room.
• Cover the affected eye with a small cup taped in place: keep all the pressure off the eye.
• Keep the child as calm and comfortable as possible until help arrives.

CHEMICAL EXPOSURE

• If a kid gets a chemical in the eye and you know what it is, look on the product's container for an emergency number to ask for instructions.
• Flush the eye with lukewarm water for 15 to 30 minutes. If both eyes are affected, flush them in the shower.
• Call for emergency medical help or your local poison control center for specific instructions. Be ready to give the exact name of the chemical, if you have it. Nevertheless, do not delay flushing the eye first.

BLACK EYE, BLUNT INJURY or CONTUSION

For a black eye:

• Apply cold compresses intermittently: 5 to 10 minutes on, 10 to 15 minutes off. If you use ice, cover it with a towel to protect the delicate skin on the eyelid.
• Use cold compresses for 24 to 48 hours, then apply warm compresses intermittently.
• If the child feels pain, give acetaminophen. Do NOT use aspirin or ibuprofen: they can increase bleeding.
• Use an extra pillow to sleep at night and encourage the kid to sleep on the uninjured side of the face.
• Contact your doctor, who may recommend an in-depth evaluation to rule out damage to the eye.

CONTACT THE DOCTOR URGENTLY IF there is...

• increased redness
• drainage from the eye
• persistent eye pain
• any changes in vision
• any visible abnormality of the eyeball
• visible bleeding on the white part of the eye, especially near the cornea

PREVENTING EYE INJURIES

If the child is involved in sports, provide him or her with protective goggles or unbreakable glasses. Keep chemicals and other potentially dangerous objects out of the reach of children.


Here you are some interesting explanations on eye injuries:

 

GLOSSARY

GLOSSARY 

- ACETAMINOPHEN: a drug used to reduce pain and fever.

- APPLESAUCE: (American English) a thick sauce made by cooking apples and sugar in a small amount of water.

- BEAD: a small usually spherical piece of glass, wood, plastic, etc, with a hole through it by means of which it may be strung with others to form a necklace, etc

- BELLY: he part of the body below the chest.

- BLADDER: an organ that is shaped like a bag in which liquid waste (= urine) collects before it is passed out of the body.

- BLISTER: a swelling on the surface of the skin that is filled with liquid and is caused, for example, by rubbing or burning.

- BLISTERING: extremely hot in a way that is uncomfortabl.

- BLUISH: fairly blue in colour.

- BLUR: to make perception less clear.
 
- BOWEL:  the tube along which food passes after it has been through the stomach, especially the end where waste is collected before it is passed out of the body.

- BROTH: thick soup made by boiling meat or fish and vegetables in water.  

- BRUISE: a blue, brown or purple mark that appears on the skin after somebody has fallen, been hit, etc.

- BRUISING: difficult and unpleasant, making you feel tired or weak.  

- BUDDY: an informal word for friend.

- BUGS: any small insect. 

- BUMP: a lump on the body caused by a blow.

 

- CAP: something that protects or covers, esp a small lid or cover.

 

- CHARRED: burnt and black.

 

- CHOKE: to hinder or stop the breathing of (a person or animal), esp by constricting the windpipe or by asphyxiation.

 

- CALAMINE LOTION: a pink liquid that you put on burnt or sore skin to make it less painful.

- CASUALTY: a person who is killed or injured in war or in an accident. 

- CLAMMY: damp (slightly wet) in an unpleasant way.

 

- CLEAR THE DECK: to prepare for action, as by removing obstacles from a place.

- CONFINED: small and surrounded by walls or sides. 

 

- COUGH UP: to bring into the mouth or eject (phlegm, food, etc) by coughing

- CRAMP: a sudden pain that you get when the muscles in a particular part of your body contract, usually caused by cold or too much exercise. 

 

- DECREASED: To become or make something become smaller in size, number, etc.

 

- DISLODGE: to remove from or leave a lodging place, hiding place, or previously fixed position.

- DIZZY: feeling as if everything is spinning around you and that you are not able to balance. 

- DOSE: an amount of a medicine or a drug that is taken once, or regularly over a period of time. 

- DROWSY: tired and almost asleep.

 

- EYELID: either of the two muscular folds of skin that can be moved to cover the exposed portion of the eyeball.

 

- FAINTING: feeling weak and tired and likely to become unconscious.

- FINGERNAIL: the thin hard layer that covers the outer tip of each finger.

- FLAMES: a hot bright stream of burning gas that comes from something that is on fire. 

- FLUSHED: red; with a red face.

 

- GASP: to draw in the breath sharply, convulsively, or with effort, esp in expressing awe, horror, etc

 

- GAUZE PAD: a type of thin cotton cloth used for covering and protecting wounds. 

- GREASY: covered in a lot of grease or oil. 

- GROIN: the part of the body where the legs join at the top including the area around the genitals (= sex organs). 

 

- HIVES: a nontechnical name for urticaria.

- HORNET: a large wasp (= a black and yellow flying insect) that has a very powerful sting.

 

- ITCH: to have an uncomfortable feeling on your skin that makes you want to scratch; to make your skin feel like this. 

- ITCHY: having or producing an itch on the skin.

- JERKS: spasms.

- JOINT: a place where two bones are joined together in the body in a way that enables them to bend and move. 

 

 

 

 

- LAYER: a quantity or thickness of something that lies over a surface or between surfaces.

                - Underlying layer: the layer that is under the surface.

- LEATHERY: that looks or feels hard and tough like leathe.

 

- LIMB: an arm or a leg.

 

- LUKEWARM:  moderately warm; tepid.

 

 

- MOIST: slightly wet.

 

 

 

- OINTMENT: a smooth substance that you rub on the skin to heal a wound or sore place.  

- OOZING: if a thick liquid oozes from a place, or if something oozes a thick liquid, the liquid flows from the place slowly.

- OVERCOME: to succeed in dealing with or controlling a problem that has been preventing you from achieving something.

- OVER-THE-COUNTER pain reliever: medications without prescription. 

 

- OVERSTRETCH: to do more than you are capable of. 

 

 

 

- PAT: to hit (something) lightly with the palm of the hand or some other flat surface.

 

- PAD (Padded): a thick piece of soft material that is used, for example, for absorbing liquid, cleaning or protecting something.

- PAIN RELIEVERS: painkillers, pills to remove or reduce an unpleasant pain. 

- PINCH: to hold something tightly between the thumb and finger or between two things that are pressed together.

- PULL OFF the skin: strip/strip off the skin.

 

- RADIATE: if something radiates heat, light or energy or heat, etc.radiates from it, the heat is sent out in all directions.

 

- RASH: an area of red spots on a person's skin, caused by an illness or a reaction to something.

- RECOVERY POSITION: the postion of becoming well again after an injury or accident.

- REDDER: having the colour of blood or fire. 

- RESTLESS: without real rest or sleep.  

 

- RUB: to apply pressure and friction to (something) with a circular or backward and forward motion.

 

-  SCRAPE: to remove something from a surface by moving something sharp and hard like a knife across it.

- SEIZURE: a sudden attack of an illness, especially one that affects the brain.

- SIP: to drink something, taking a very small amount each time. 

- SLUGGISH: moving, reacting or working more slowly than normal and in a way that seems lazy. 

- SNAP: to break something suddenly with a sharp noise. 

- SODA: a sweet fizzy drink (a drink with bubbles). 

- SPLINT: a long piece of wood or metal that is tied to a broken arm or leg to keep it still and in the right position. 

 

- SPRAIN: to injure a joint in your body, especially your wrist or ankle, by suddenly twisting it.

 

- STEADY: regular, habitual.

- STICKING OUT: project, protrude.

- STING/STINGER: the sharp pointed part of an insect or creature that can go into the skin leaving a small, painful and sometimes poisonous wound.

- STOOL: a piece of solid waste from your body. 

- STRAIN: an injury to a part of your body, such as a muscle, that is caused by using it too much or by twisting it.

- STUNG: past tense, past participle of STING. 

 

-SUBTLE: not very noticeable or obvious.

- SURGERY: medical treatment of injuries or diseases that involves cutting open a person's body and often removing or replacing some parts; the branch of medicine connected with this treatment.

- SWALLOWING: to move the muscles of your throat as if you were swallowing something, especially because you are nervous. 

- SWEATY: making you become hot and covered with sweat.  

 

- SWELLING:  a place on your body that has become larger or rounder than normal as the result of an illness or injury.

- TENDER: painful when you touch it. 

 

- THOROUGHLY: carried out completely and carefully.

- THROBBING:  to feel a series of regular painful movements.

 

- THRUST: to push (someone or something) with force or sudden strength.

 

- TILT: to incline or cause to incline at an angle

 

- TORN (Past Participle of "tear"): to damage something by pulling it apart or into pieces or by cutting it on something sharp; to become damaged in this way. 

- TRAP: an unpleasant situation from which it is hard to escape. 

 

- TRIGGER: a small projecting lever that activates the firing mechanism of a firearm.

- TUMMY: the stomach or the area around the stomach (used especially by children or when speaking to children).

- TWEEZERS: a small tool with two long thin parts joined together at one end, used for picking up very small things or for pulling out hairs. 

- TWITCHING: if a part of your body twitches, or if you twitch it, it makes a sudden quick movement, sometimes one that you cannot control. 

 

 

- WASP: a black and yellow flying insect that can sting.

 

- WHEEZE: to breathe or utter (something) with a rasping or whistling sound.

- WORSEN: to become or make something worse than it was before.

- WRAPPED: to cover something/somebody in material, for example in order to protect it/them. 

 

- YELLOW JACKET: (American English) a type of small wasp (= a black and yellow flying insect).

 

ELECTRIC SHOCKS

Children can suffer electrical injuries after placing objects in electrical outlets or electrical appliances or chewing on electrical cords.

Electrical shocks always need emergency medical attention (even if the child seems to be fine afterward).

WHAT TO DO:

· Turn off the power. If you can't turn off power: stand on something dry and non-conductive, such as dry newspapers, telephone book, or wooden board. Try to separate the child from current using non-conductive object such as wooden or plastic broom handle, chair, or rubber doormat.

· Separate the child from current's source. Never touch the child receiving the electric shock until the electricity is switched off and you are sre it is safe to do so. If you touch them, you could get an electric shock or be electrocuted yourself.

 · If the injured child is CONSCIOUS and seems unharmed, he/she should be told to rest.

· If the injured child is UNCONSCIOUS, open the airway and check breathing; be ready to resuscitate if necessary. Place the casualty in the recovery position and call to the ambulance.

(RECOVERY POSITION)

                                                       

 · If the child is bleeding, apply pressure. Elevate the wound if it's in an arm or leg.

· There may be a fracture if the shock caused the child to fall

· If the child has some burns, see the section dedicated to burns:  BURNS treatment.

CHOKINGS

When an object (usually a toy or food) is lodged in the trachea (the airway) and is keeping air from flowing normally into or out of the lungs and the child is not able to breathe properly, he or she is choking.

Most of the time, the food or the object only partially blocks the trachea and it is likely to be coughed up and that breathing will be restored easily. If a kid seems to be chocking and coughing but is still able to breathe and talk, he or she probably will recover unassisted.

A CHILD MIGHT BE CHOKING IF HE OR SHE...

• is gasping or wheezing
• cannot talk, cry or make noise
• begins to turn blue
• grabs at his or her throat or waves arms
• seems to be panicked

WHAT TO DO

If a child is choking, call the emergency phone right away. If you are able to do abdominal thrusts (the Heimlich maneuver), do it immediately.

Never reach into the mouth to grab the object or pat the child on the back: it could push the object farther down the airway or make the situation worse.

• If a kid is gagging and coughing but is able to breathe and talk, the airway is not completely blocked. Therefore, it is best to do nothing.
• If a child was choking and is now unconscious and no longer breathing, call for help and immediately perform cardiopulmonary resuscitation (CPR) if you know the procedure. If not, call the emergency phone.
• If the child is having difficulty breathing or swallowing, there is a persistent cough or wheezing or it has been a serious choking episode, take him or her for medical care.

PREVENTING CHOKING

All kids are at risk for choking, but those younger than three are especially vulnerable. Young children tend to put things in their mouths, have smaller airways that can be easily blocked and do not have much experience chewing and often swallow things whole.

Here you are some easy tips to prevent choking:

• Children younger than four should avoid eating foods that are easy to choke on such as nuts, popcorn and candies. Cut food into small pieces.
• Make sure they sit down, take small bites and do not talk or laugh with mouths full while they are eating.
• Pick up anything off the floor that could be dangerous to swallow like pen caps, coins, beads or batteries. Keep toys or gadgets with small parts out of reach.

Take the time now to become prepared. CPR and first-aid courses are a must for parents, teachers and other caregivers.


You may find all the information given more clear in the following videos:

 

 



Strain, sprain and broken bones

A sprain occurs when the ligaments are overstretched and partially torn. Although sprains and strains generally cause swelling and pain, most of them can be treated at home after a proper medical evaluation. You have to take into account that there can be bruises around the injured area.

                                 

If you see that your child heard or felt a bone snap, that he/she has difficulties moving the injured part or that the injured part moves in an unnatural way (or is very painful to the touch), suspect that it could be a broken bone.

                                        

These steps are the ones that you have to follow when you have to deal with a sprain, strain or broken bones:

· What to do: for a suspected broken bone

1. If the injury involves your child's neck or back, do not move him unless the child is in imminent danger because, movement can cause serious nerve damage. Call to the emergency medical help. If you must have to move your child, firstly, the neck and back must be completely immobilized. Keeping your child's head, necks, and back in alignment, move the child as a unit.
2. If your child has an open break and he is bleeding, apply pressure on the bleeding area with a gauze pad or a clean piece of clothing or other material. You should not wash the wound or try to push back any part of the bone that may be sticking out.
3. If you have to move your child, apply splints around the injured limb to prevent further injury (can be made by using boards, brooms, a stack of newspapers, cardboard, or anything firm, and can be padded with pillows, shirts, towels, or anything soft). You have to leave the limb in the position you find it and you have to apply them in that position. Splints must be long enough to extend beyond the joints above and below the fracture.
4. Place cold packs or a bag of ice wrapped in cloth on the injured area.
5. Keep your child lying down until medical help arrives.

· What to do: for a suspected sprain or strain.

1. If the injury involves your child's neck or back, do not move him unless the child is in imminent danger because, movement can cause serious nerve damage. Call to the emergency medical help. If you must have to move your child, firstly, the neck and back must be completely immobilized. Keeping your child's head, necks, and back in alignment, move the child as a unit.
2. It may be difficult to tell the difference between a sprain and a break. If there is any doubt, call to your doctor or take your child to the nearest hospital emergency department, because an X-ray can determine if the bone is broken or not.
3. First aid for sprains and strains includes rest, ice, compression, and elevation (known as RICE).

· Rest:  the injured part of the body.

· Apply ice packs or cold compresses for up to 10 or 15 minutes at a time every few hours for the first 2 days to prevent swelling.

· Wearing an elastic compression bandage (for at least 2 days): will reduce swelling.

· Keep the injured part elevated above the level of the heart as much as possible to reduce swelling.

4. Do not apply heat in any form for at least 24 hours. Be careful because the heat increases swelling and pain.
5. Your doctor can recommend you an over-the-counter pain reliever such as acetaminophen or ibuprofen.

Children First Aid: Broken Bone (British Red Cross video)