By Alice Emasu

My one-year-old son woke up with a high temperature. He suddenly lost consciousness. His body, legs and arms stiffened. He convulsed twice in a short time. He became weak, closed his eyes and gritted his teeth (locked his jaws) while stretching his legs. Whereas his body was hot, his feet were as cold as ice.

I struggled to open his teeth in vain. He bit my finger and stuck on it. I made an alarm, attracting a neighbour who then stuffed a piece of wet cloth into the boy’s mouth. He had passed stool and urine in the process.

This was the second time I was witnessing a child having convulsions. The first time was with my first born, now four years old. She had convulsions when she was one-year-old.

Convulsions are commonly known as Eyabwe in Luganda. They occur in young children after a rapid increase in their body temperature. A child becomes unconscious for a minute or two.
Convulsing is sometimes mistaken for epilepsy.

Dr. George Mayanja of Victoria Medical Centre in Kampala says convulsions are mainly caused by malaria and respiratory tract infections.

He, however, says the treatment for malaria does not necessarily control convulsions. “The Baganda treat Eyabwe with a herbal medicine known as Mulondo for malaria, but this does not help the convulsion,” he says.

Mayanja says one in 10 children will convulse before they are five. “Although the immediate cause is malaria, most children inherit the gene from their parents.”

He says if the gene is dominant in the child, they are likely to experience convulsions regularly.
Mayanja, however, adds that convulsions do not kill unless they are prolonged, say, for over five minutes.

He says frequent and long convulsions can affect the brain later in life but this is not common. Most children who convulse eventually outgrow the conditions once they are five years old.

First aid during an attack
Do not disturb the child by slapping or shaking him or her.
- Turn the child’s head to one side to prevent choking. Some people place a stick in the child’s mouth to prevent it from biting the tongue or lips. Do not attempt this, as it may result in lasting damage to the teeth. Mayanja insists that when not tampered with, a convulsing child will not bite the tongue.
- When the fit subsides, keep the child lying on one side, which is considered the recovery position, and ensure that it has access to fresh air.
- Mayanja says you also need to rub the baby with a wet cloth or sponge to bring down the temperature.

He, however, advises that if the baby convulses for more than five minutes, the parents need to rush it to a doctor because convulsing for long is a clear symptom of other serious health complications.

According to Dr. Stephine Greene, an American consultant paediatrician, once a child convulses, make sure they are not hot, by removing extra clothing or bedclothes. “If the room temperature seems high, open a window but ensure that the child does not get too cold either and give him or her plenty of cold drinks,” he says. Greene says if a child is rushed to hospital or a health centre due to prolonged convulsion, the child will be admitted especially if it is convulsing for the first time.

“It is always important to know whether the convulsions are only due to a harmless viral infection by consulting a doctor. If the baby has a history of convulsions, parents should have diazepam ready in case an attack occurs,” he says.
Diazepam can be administered into the rectum from a specific rectal tube.

Identifying an attack
The attack often begins with the child losing consciousness and shortly afterwards, the body, legs and arms go stiff.

The child throws the head backwards while the legs and arms begin to jerk.

The skin goes pale and may even turn blue briefly.

The attack ends after a few minutes and the shaking stops. The child goes limp, and regains its normal complexion and consciousness slowly.

Some children regain consciousness faster than others.

Is it possible to prevent convulsion?
It is difficult to avoid convulsions among children prone to it. But convulsions can be managed by giving temperature-lowering medicines like paracetamol. The doctor must advise you on that.
Try other means of lowering the temperature.

“If your child has suffered convulsions in the past, your doctor may advise you on the special enemas containing diazepam to keep on standby,” Greene says.

Facts about febrine convulsions
It is an attack brought about by an illness that causes a high temperature, usually a minor viral infection, malaria or bacterial infection. Children aged between six months and five years are more prone to attacks. A child with febrile convulsions can scare parents into fearing he or she is dying. But such convulsions are not as serious as they appear.
Thirty per cent of children who have a febrile convulsion will have another one especially after the age of three.

What is a convulsion?
It is an attack in children caused by unusual electrical activity of the brain. A child becomes unconscious and usually stiff, with jerking of the arms and legs.

What is epilepsy?
Epilepsy are fits without fever, usually in older children and adults. Rarely do convulsions in childhood lead to epilepsy.

Do febrile convulsions cause permanent brain damage?
It is rare

Does a child suffer discomfort or pain during a convulsion?
No. The child is unconscious and is unaware of what is happening.

What shall I do if my child has fever?
- You can take the child’s temperature by placing the bulb of the thermometer under his armpit for three minutes with his arm held by his side.

- Give the child plenty of fluids to drink.

- Give a child paracetamol (panadol) to reduce the temperature. Give the correct dose, by following the instructions on the medicine bottle.

- Repeat the dose every four hours until the temperature falls to normal, then every six hours for the next 24 hours.

- If the child seems ill or has ear ache or a sore throat, let your doctor see him in case any other treatment such as an antibiotic is needed.

Antibiotics or antimalarialso are not necessary for most fevers that may be due to viruses.


IAA Medical leaflet