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Seizure disorders in burned children: a retrospective review
G J Mukhdomi1, M H Desai, D N Herndon
1Department of Surgery, Shriners Burns Institute, Galveston, Texas, USA.
Insights
Hyponatremia is the leading cause of burn seizures in children. Younger children with larger, more severe burns are at higher risk, necessitating close metabolic and hemodynamic monitoring.
Area of Science:
- Pediatrics
- Neurology
- Burn Management
Background:
- Pediatric burn injuries can lead to seizures, a serious complication.
- Identifying the specific causes and risk factors for burn seizures is crucial for effective management.
Purpose of the Study:
- To review the common causes and associated factors of seizures in pediatric burn patients.
- To provide recommendations for monitoring and management of burn-related seizures.
Main Methods:
- Literature review of studies on pediatric burn seizures.
- Analysis of reported etiological factors, patient demographics, and burn characteristics.
Main Results:
- Hyponatremia is the most frequent cause of burn seizures in children.
- Other causes include epilepsy history, hypoxia, sepsis, and drug toxicity/withdrawal.
- Burn seizures are more prevalent in younger children and correlate with burn size and severity.
Conclusions:
- Close monitoring of metabolic status, electrolytes, and vital signs is essential in pediatric burn patients.
- Prompt correction of identified abnormalities can prevent seizures.
- Invasive diagnostic procedures like lumbar puncture and EEG should be reserved for refractory cases.
Abstract:
This review shows that hyponatremia is the most common cause of burn seizures in children, followed by a history of epilepsy, hypoxia, sepsis with high fever, unknown aetiology and drug toxicity or sudden drug withdrawal. This study also shows that burn seizure is most common in younger children and is related to size and degree of burn. We recommend close monitoring of metabolism, haemodynamics, arterial blood gases, wound and blood cultures, and levels of abnormalities in serum, electrolytes, glucose, Ca, P and Mg. Prompt corrections of any problems in these areas can be vital. Invasive procedures for the diagnosis of seizures, including lumbar puncture and EEG, should be reserved for infrequent non-responding cases.