Parental management of children's seizures at home

Aim: Parents play an important role in the management of seizures at home. Their attitude has to be fast and efficient enough to avoid complications such as aspiration pneumonia or persistent seizures. The main goals of this study were to analyse the quality of parental management and the predictors of admission after a seizure. Method: A five-year retrospective study of children suffering from seizures at home was conducted. Data were retrieved by medical records and completed by a structured questionnaire. Results: A total of 114 children were included in the study. Thirty-six percent of the parents turned the child in a lateral security position. Sixty-one percent of the parents did not administer intra-rectal diazepam, when the drug was indicated following the current guidelines. The reasons why diazepam was not administered were the lack of awareness of the procedure, lack of diazepam at home and impossibility to keep calm during the episode. The national emergency numbers were called within a median of 18 min after the seizure started, with a significant correlation between this delay and the total duration of seizures. The predictors of in-hospital admission were drug administration by the mobile unit (SMUR) (OR: a = 25.2; p = 0.001), a diagnosis of status epilepticus (OR: a = 23.6; p < 0.0001) and a pre-existing neurological disease (OR: a=0.19; p = 0.02). Conclusions: Our study finds a significant rate of inappropriate management of paediatric seizures at home. Improving parental education and the use of newer formulations of antiepileptic drugs are necessary to reduce morbidity associated with seizures.