Parent and caregiver knowledge, beliefs and responses to seizures in Jamaican children

OBJECTIVE: To determine the knowledge and beliefs about seizures and actions during seizures of parents/ caregivers of children hospitalised for convulsive seizures. DESIGN AND METHODS: This was a cross-sectional study of parents and caregivers of children with acute convulsive seizures hospitalised at the Bustamante Hospital, Kingston, Jamaica between May 1 and October 31, 2013. Subjects were identified by admission records. Parents/caregivers were invited to participate. A questionnaire on the knowledge, beliefs and response of parents/ caregivers during the child’s current seizure episode was administered face to face. Data were analysed for frequencies; comparisons between groups using Chi Square analysis for categorical variables, and the Mann-Whitney U test for data not normally distributed. RESULTS: Fifty participants were enrolled; 39 (78%) mothers; mean age (SD) was 33.8 (10.1) years. All sought medical care first. Twenty-two (44%) had plausible beliefs about the cause of seizures. Twenty-seven (54%) knew of appropriate actions during a seizure, 10 (20%) knew of appropriate precautions and 11 (22%) responded appropriately during the seizure. Eleven (22%) reported receiving seizure education. Witnessing a previous seizure, education level and seizure education were positively associated with knowledge of seizures (p < 0.05). Socioeconomic status was higher in those with plausible beliefs about seizures and lower in those who took appropriate action during a seizure (p<0.05). CONCLUSION: Parents/caregivers of children with convulsive seizures have appropriate health-care seeking behaviour but inadequate knowledge. Seizure education should be prioritised to improve parental knowledge of and response to convulsive seizures.

Demonstration of anticonvulsant properties of an aqueous extract of Spirit Weed (Eryngium foetifdum L.)

Rats were used to investigate the anticonvulsant potential of two aqueous extracts of Spirit Weed. In this investigation, convulsions were induced by picrotoxin (4.5 mg/kg, i.p.) and these convulsions were consistently abolished by the intraperitioneal (i.p.) infections of aliquots (3ml each) of a steam distillate extract of Spirit Weed. However, those rats which served as controls as well as those which were injected with aliquots (3 ml each) of the boiled aqueous decoction of Spirit Weed, died after 2 hours of convulsions. Also, the steam distillate extract of Spirit Weed delayed (by 12 + 3 minutes) the onset of convulsions when it was given before picrotoxin (4.5 mg/kg, i.p.). Additionally, the steam distillate extract of Spirit Weed mimicked the anticonvulsant effect of phenobarbitone in the same group of rats. Moreover, the steam distillate extract of Spirit Weed did not produce generalized central nervous sustem depression in conscious rats. Therefore, it is concluded that an ingredient in the steam distillate extract of Spirit Weed has anticonvulsant properties which may be useful in the treatment of some forms of epilepsy. This requires further investigation (AU)

A pattern of convulsions in childhood

Convulsions were a common cause of admission to hospital in patients under 16 years of age. During the period 1958-1961 there was a total of 447 such patients admitted to Kingston Public Hospital, the peak age was 1 to 5 years and there was a male dominance. Febrile respiratory infections were a major factor indicating the need for early, effective, treatment. Fever of undetermined origin affected about 18 per cent of the cases. Non-respiratory infections, cerebral damage and helminthiasis were infrequent causes of convulsions. Noteworthy was the absence of tumours, syphilis, hypertensive encephalopathy and heredity as aetiological factors. Reasons are also adduced for the probable mis-diagnosis of petit mal and psycho-motor epilepsy (AU)