Length of Postical Period on Children with Febrile Seizures

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Rialaigh

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Had a call a couple days ago with a 19 month old, called out for unresponsive not breathing. Upon arrival child is breathing but unresponsive to painful stimuli, feels very warm to the touch, family describes seizure like activity prior to going unresponsive. Just curious about personal experiences with being able to wake kids and neonates up at all post seizure (no previous seizure disorder, likely febrile). This 19 month old stayed unresponsive to painful stimuli for the better part of 45 minutes with me, vitals were beautiful (slightly tachy for her age) IV access was established..etc..etc...

I just started getting more concerned the further into the transport we got with no response at all, after giving report at the hospital the child began coming around some,

Curious about personal experience, and if anyone can point to a study or two about general post seizure behavior, length, etc...I know it can vary greatly in adults based on prior history, length of seizure, etc...this was concerning to me because my previous experiences with pediatric seizures have had a much shorter period of total unresponsiveness.
 
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Handsome Robb

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I don't have any hard data but for whatever reason I am the pediatric black cloud and hook some bad/weird pedi calls. I've had kids be postictal for all of 2 minutes and I've had them do what yours did. Just from experience it seems like the longer the seizure the longer the postictal period but that's not a solid rule obviously. Also, i've noticed the sicker they are the longer they take to come around partially because they're lethargic to begin with. I had a kid with a 107* temp, confirmed by multiple sites including continuous rectal monitoring via the MRx, who seized for a solid 10 minutes per mom who was an RN, ended up transporting him code due to traffic and location, took about 35 minutes and he had only gained one point on the GCS. You could've argued two points but either way, there was very little change. Checked on him a couple hours later and he was perfectly fine. Well, had a rip pin' bug but other than that was alright.

I'd say the ones I've been on generally have a longer postictal period but I also wonder how much of it is "acting asleep" due to fear, not feeling good so on and so forth.

Not sure if this answers your question at all.
 
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DesertMedic66

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We have a special needs kid about 6 years old that we constantly run on. His postictal period is about 6 hours after the seizure stops.
 
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Rialaigh

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My concern was the kid came around while we started the IV, but 10 minutes later I could pinch the backside of the thigh, tickle, rub, ..while holding one eye lid open and there was zero response, no pupil response, no twitching, nothing at all...it struck me as very strange...I was getting pretty concerned that either the kid was having a silent seizure or something much worse was happening/about to happen
 
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johnrsemt

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I have had post ictal periods run from less than 3 seconds (that was a fun patient that we transported 88 miles each way, 3 times a week for 8 years) to a couple of hours
 
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