▷ FIRST AID: for CONVULSION. WHAT is? TREATMENT in ADULTS and CHILDREN

The most common cause of seizures in children is the onset of a high fever, scarlet fever, measles, ear inflammation, encephalitis, pneumonia, nasopharyngitis, etc.

The most common causes are digestive tract disorders caused by inadequate or excessive nutrition (indigestion) or intestinal infections such as enterocolitis.

Seizures are sometimes a manifestation of a brain condition, such as meningitis, encephalitis, brain tumors, abscesses, hemorrhage, epilepsy, etc.

Sometimes it is poisoning by substances formed by the organism itself (uremia) or brought in from outside (mother who has smoked, or taken alcohol, strychnine, belladonna, etc.

Convulsions can also be caused by tetanus, intestinal parasites, phimosis, foreign bodies in the ears, nose or digestive tract. In addition, convulsions are observed in almost any serious illness when it approaches an unfavorable end.

It is important to remember that in a high percentage of cases, convulsions in children are not serious.  

Epilepsy is one of the most common causes of convulsions in adults. When they do not have this origin, they may be due to uremia, brain conditions (brain tumors or abscesses, meningitis, head trauma), poisoning (by strychnine, acute or chronic alcoholism, belladonna, etc.), infectious diseases (tetanus, rabies, etc.).

The arrival of a very small amount of blood to the brain in the disease called Stokes-Adams can cause seizures. In a woman who is in advanced pregnancy or at the time of delivery or shortly after, the most common cause of seizures is eclampsia.

Also, hysterical attacks can produce seizures.

The symptoms of a convulsion usually begin suddenly. However, symptoms that precede and announce the attack can be observed quite frequently, such as agitation, small involuntary contractions of the muscles of the face, delirium, etc.

Suddenly the person turns pale, loses consciousness, rolls his eyes upward and his head back, becoming rigid all over, usually with his arms bent. Breathing may be suspended at this time and the skin may turn bluish.

Sometimes at the beginning of a seizure, there is a scream. Often, there is involuntary loss of urine and feces.

After a short period of tonic contraction (which seems very long to bystanders), clonic convulsions usually appear, with disordered eye movements, grimacing and grinding of the teeth, which then spread to the upper limbs, where rapid extension and flexion movements of the forearms are observed, and then to the rest of the body.

The intermittent contraction of the respiratory muscles and the glottis makes breathing labored and difficult, often with signs of asphyxia. Then the convulsions cease, breathing becomes regular and the child usually falls asleep, exhausted by the attack.

There are partial forms in which the convulsions affect only some muscle groups but are accompanied by loss of consciousness and the pallor typical of these states. The convulsion may be repeated.

The first aid for convulsion in children is the following:

• Place the child lying down in a warm bath (36º to 37º C or 97º to 99º F) with the whole body submerged in water, except the head, and place a cold, wet cloth on the forehead, which should be changed frequently.

• The child can be left in the bath for 15 to 20 minutes.

• If the child has a high fever, the temperature can be gradually lowered to 33º C (91º F) or to 32º C (89º F) at the end of the bath.

• This bath usually produces sedation of the attacks, as well as lowering the fever. It can be repeated each time the child's rectal temperature reaches 39.5º C (103º F) or rises even higher.

• If there is no bath thermometer, set the water to a temperature of less than 37º C (99º F) and then gradually add the warm water, stirring well while monitoring the water temperature with a clinical thermometer (the one used to take the child's temperature).

• If there is no such thermometer, make the bath "warm" so that the person preparing it can tolerate the temperature well when placing the elbow and its crook in the water.

• While the child is still in the bath, it is advisable to prepare and administer a cool enema to cleanse the intestines, which will help lower the fever, help prevent the attacks from recurring, and will leave the intestines clean in case the doctor wants to prescribe a small enema to hold with anticonvulsant substances.

• While all this is being done, a doctor will have to be called urgently, who will prescribe the rest of the treatment for the convulsion and that corresponding to its probable cause.

• If asphyxia or syncope occurs with lack of breathing, slap the face with a handkerchief soaked in cold water, and if this does not work, give artificial respiration "mouth to mouth."

The first aid for convulsions in adults is the following:

• Loosen the collar and any other clothing that compresses.

• Prevent the child from hurting himself by removing objects that could injure him or by removing him from a dangerous place. Place a pillow or a folded piece of clothing under his head so that he does not hurt his head during convulsions.

• To prevent him from biting his tongue, insert an object between his teeth (a piece of wood, a pencil wrapped in a handkerchief, a cork held in place with a thread or a handle to prevent him from bringing it up and blocking the airway, a handkerchief or other rolled-up material, or any other object that cannot break the teeth).

• In the case of an epileptic who has nocturnal attacks, make him sleep in a bed with supports on the sides to prevent him from falling to the floor.

• If the attack is prolonged or the attacks occur almost without interruption, the doctor may consider it necessary to inject some antispasmodic substance (injectable barbiturates, magnesium sulphate solution, etc.), or to administer an enema to retain some other anticonvulsant substance, in addition to indicating treatment for the probable cause of the attack.