Frequent seizures, developmental delay in young children may be heat sensitive epilepsy

Text / Liu Yixuan

4-year-old Rui Rui has been suffering from heat cramps due to fever since she was 8 months old. In addition, her mother also found that Rui Rui’s development gradually does not keep up with children of the same age. age, and she is usually reluctant to talk. But the family believe that Rui Rui was sick too often when he was a child, and that he will catch up slowly when he grows up.

After entering kindergarten, Rui Rui had heat cramps more often, and even when there was no fever, convulsions occurred. The kindergarten teacher also told her mother that Rui Rui did not interact much with her classmates at school, her personality was stubborn, and she was emotionally unstable. She suggested that her mother should take Rui Rui to the hospital to be evaluated by a doctor.

Please read on…

Is Rui Rui’s condition just a heat cramp? Heat cramps are most common between 6 months and 5 years of age, and most common between 1 and 2 years of age. The main symptoms are fever with convulsions, and CNS infection is excluded. It usually occurs on the first day of the fever, and most of it resolves on its own within 1 to 2 minutes. Heat cramps are generally benign, improve with age, and usually do not cause neurological impairment or intellectual or behavioral problems.

Rui Rui’s age is indeed in line with the age at which heat cramps are likely to occur, but Rui Rui had developmental delays and behavioral and emotional problems. Later, she had convulsions even without fever. , and she needs to go to the hospital for a professional assessment by a pediatric neurologist.

◎ What is heat sensitive epilepsy?

Heat-sensitive epilepsy, as the name suggests, is a type of epilepsy characterized by being very sensitive to temperature, and an increase in body temperature can trigger epilepsy (for example, taking a bath hot, and body temperature increases after exercise). Unlike heat cramps, convulsions do not only occur with fever, they can occur in any condition, and a high percentage can affect neurological development, requiring anti-epileptic drugs to control the disease.

Dravet syndrome is a heat sensitive epilepsy disease. It is a severe epileptic encephalopathy caused by a gene mutation. It is a rare disease. Most first seizures occur before the age of 1, often with fever , so I may be mistaken in thinking it was just heat cramps, but after the onset, developmental delays, language and cognitive impairments, abnormal gait, and behavior problems began to appear.

Epilepsy in Zhuofei syndrome is generally intractable and requires simultaneous treatment with several anti-epileptic drugs.

◎ My child has heat cramps, when should I suspect the possibility of epilepsy?

● Convulsion time is too long (more than 15 minutes).

● Asymmetric unilateral limb twitching or unilateral leg weakness after the stroke.

• Multiple convulsions in one febrile episode.

● age of onset is less than 6 months or older than 5 years.

● Presence of growth retardation or neurological abnormalities.

● have a family history of epilepsy.

(The author is the attending physician at the Department of Pediatric Neurology, Chang Gung Memorial Hospital, Linkou)

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