By ULY CLINIC

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CONVULSIONS

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A convulsion is a medical condition where body muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled shaking of the body. Convulsion is sometimes related to malaria. 

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Differential Diagnoses

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Special concerns include body twitching, body spasms, jerking limbs, head spasms, fits, bladder incontinence, bowel incontinence, loss of consciousness and sleeping after convulsion. 

 

Diagnostic Criteria 

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• Trauma 

• Epilepsy 

• Intracranial haemorrhage 

• Alcohol or medication withdrawal 

• Drug induced seizures etc.

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Investigations:

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• Some investigations must be ordered:

• Serum glucose level

• Serum electrolytes (where appropriate)

• Exclude pregnancy for women of child bearing age

• CT scan is indicated as outpatient/inpatient depending on progress of patient after episode of seizure (where appropriate)

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Pharmacological Treatment

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• Diazepam IV 10–20mg at a rate of 0.5ml (2.5mg) per 30 sec, repeated if necessary after 30–60min; may be followed by IV infusion to max. 3mg/kg over 24 hours or per rectum 500µg/kg up to max of 30mg. OR Phenobarbitone IV 10mg/kg at less than 100mg/min in adult 

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Note: Look for treatable causes and if present treat them.

 

 

Referral: Refer the patient to next facility with adequate expertise and facilities if:

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• Fits do not stop

• Eclampsia

• Other complications

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Updated on, 26.10.2020

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References

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1. STG page number 3-4