2 6-10
Correspondence ABSTRACT
Dr. Olumide O. Jarrett Background: Febrile seizures are commonly encountered in
Department of Paediatrics, emergency paediatric practice. Initial pre-hospital intervention given
University College Hospital, by caregivers has been shown to impact outcome.
Ibadan, Nigeria. Objectives: To describe the spectrum of pre-hospital interventions
Tel : +2348037203717 given for the treatment of childhood febrile seizures in Ibadan,
E- mail: tokunbojarret@yahoo.com Nigeria.
Methods: All consecutive cases of febrile seizures seen at the
emergency room of University College Hospital, Ibadan over a period
of 13 months were the subjects of the study. Details of history of
illness including the interventions given before presentation were
recorded. All the children had lumbar puncture and examination of
their cerebrospinal fluid (CSF). All were followed up till discharge
and the outcome was recorded.
Results: A total of 147 children, 83 males and 64 females with febrile
seizures were studied. Harmful traditional practices were found to
be common in the cohort studied. Fifty-nine (40.1%) of the children
received at least one form of intervention believed to be capable of
aborting the seizure during the attack at home. Herbal preparation
was the most common form of pre-hospital treatment, given in 15
(10.2%) of the cases. Other forms of pre-hospital interventions given
were application of substances to the eyes (6.1%), incisions on the
body (2%) and burns inflicted on the feet and buttocks (1.4%). None
of the children received rectal diazepam or buccal midazolam as
home remedy for seizures. There was a statistically significant
relationship between harmful cultural practices and the socio-
economic class of the caregivers (P=0.008).
Conclusions: Pre-hospital treatment of childhood seizures in Ibadan
comprises mainly harmful traditional practices. There is a need for
appropriate health education to reduce the morbidity and mortality
associated with febrile seizures in the locality.
INTRODUCTION
A febrile seizure refers to a seizure occurring in infancy Seizures cause intense parental anxiety.10 This coupled
or childhood usually between three months and five with ignorance, is often responsible for the various
years of age as a result of elevated body temperature forms of inter vention offered by parents and
in the absence of pathology in the brain. 1 Febrile caretakers when a child has an episode of seizure. These
seizures are commonly encountered in emergency interventions include the administration of cows urine
paediatric practice and have been described as the concoction 2,3 and application of substances to the eyes
commonest cause of seizure in children under the age and mouth such as palm oil, kerosene, eucalyptus oil
of five years.2,3 Incidence has a wide variation amongst etc.2 Some make incisions on the body while others
different population groups being as low as 2-4% in inflict burns injury on the child in an effort to rouse
Caucasians and as high as 15.3% in Africa.2-7 Common the unconscious child. In an earlier study about three
causes of febrile seizure in the tropics include malaria, decades ago, Familusi and Sinnette reported a high
pneumonia, urinary tract infection, septicemia and viral number of parents (52%) administering native
infections.2-9 concoction as home treatment for febrile seizures. 2
2. Agents rubbed into eyes Table 3 shows that of the 59 parents/caregivers who
gave any form of treatment at all to their children at
onions 3 5.1 home, 9(15%) were in the upper class, 36(61%) were
in the middle class while 14 (23.7%) were in the lower
metholatum 1 1.7
class. Seventeen per cent of the upper class had pre-
carnel oil 1 1.7 hospital intervention, 47% of the middle class and 44%
of the lower class. There was a statistically significant
palm oil 1 1.7 difference between the types of pre-hospital
wine 1 1.7
intervention given in the different socioeconomic
classes. (p= 0.008). None of the children in the upper
salt 1 1.7 class had cow urine mixture.
3. Burns to parts of the body 2 3.4 There were two deaths giving a case fatality of 1.4%.
4. Skin lacerations 3 5.1 The two deaths however occurred in the group of
children who had not received pre-hospital
5. Water to the body 8 13.6 intervention.
6. Others 7 11.9
At the time of discharge persisting neurological deficits
Total 59 100.0 were seen in 6 of the 145 survivors. Four of them
had generalized hypertonia while 2 children had 6th
others = kerosene, lime, coconut oil, eucalyptus oil and pepper and 7th cranial nerve palsies. There was no statistically
significant relationship between the occurrences of
Table 2: Pre-hospital management of 59 children with febrile neurological deficits and the pre-hospital intervention
seizures given in these children.
Total 39 76 32 147(100)