178 Where There Is No Doctor 2011
seizures (FITS, CONVULSIONS)
We say a person has a seizure when he suddenly loses consciousness and makes
strange, jerking movements (convulsions). Seizures come from a problem in the brain. In
small children, common causes of seizures are high fever and severe dehydration. In
very ill persons, the cause may be meningitis, malaria of the brain (cerebral malaria),
or poisoning. In pregnant women, it may be eclampsia (see p. 249). A person who
often has seizures may have epilepsy.
♦ Try to figure out the cause of a seizure and treat it, if possible.
♦ If the child has a high fever, lower it with cool water (see p. 76).
♦ If the child is dehydrated, give an enema of Rehydration Drink slowly.
Send for medical help. Give nothing by mouth during a seizure.
♦ If there are signs of meningitis (p. 185), begin treatment at once. Seek medical help.
♦ If you suspect cerebral malaria, inject quinine or artesunate (see p. 366).
♦ If you suspect eclampsia, give medicine (see p. 390).
EPILEPSY
Epilepsy causes seizures (fits) in people who otherwise seem fairly healthy. Seizures
may come hours, days, weeks, or months apart. In some persons they cause loss
of consciousness and violent movements. The eyes often roll back. In mild types of
epilepsy the person may suddenly ‘blank out’ a moment, make strange movements, or
behave oddly. Epilepsy is more common in some families (inherited). Or it may come
from brain damage at birth, high fever in infancy, or tapeworm cysts in the brain
(p. 143). Epilepsy is not an infection and cannot be ‘caught’. It is often a life-long
problem. However, babies sometimes get over it.
Medicines to prevent epileptic seizures:
Note: These do not ‘cure’ epilepsy; they help prevent seizures. Often the medicine must
be taken for life.
♦ Phenobarbital often controls epilepsy. It costs little (see p. 389).
♦ Phenytoin may work when phenobarbital does not. Use the lowest
possible dose that prevents seizures (see p. 389).
When a person is having a seizure:
♦ Try to keep the person from hurting himself:
move away all hard or sharp objects.
♦ Put nothing in the person’s mouth while he is having
a seizure—no food, drink, medicine, nor
any object to prevent biting the tongue.
♦ After the seizure the person may be dull
and sleepy. Let him sleep.
♦ If a seizure lasts more than 15 minutes, put liquid diazepam in the anus using a
plastic syringe without a needle. For dosage see page 389. Do not inject phenytoin,
phenobarbitol, or diazepam into the muscles. These medicines can be injected in
the vein, but it is very dangerous if you have little experience. Only a person with
experience giving injections into a vein should give injections of these medicines.
For more information on seizures, see Disabled Village Children, Chapter 29.