~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ At 1:47 AM -0000 98.1.23, B.J. Pollock wrote: >I question the need for anti-convulsants for febrile seizures, unless >of course the child is in status. Most febrile seizures are "simple" >and are not followed by a repeat seizure during the febrile illness. >Even if these are complex febrile seizures with more than 1 sz. during >the febrile event, we regard non-febrile non-status seizures as benign >and do not require anti-convulsants. In Japan,the patient with 2~3 seizures within 24hr. from onset and without other risk factors are recognized as a simple seizure. Of course we all know that a simple seizure at first time is harmless and dosen't need medication, but when he/she falls into seizure in clinic I try to stop seizure immediately. I have saw many patients with 2 episodes of seizure during 24hr. when they haven't get medication.It must be horrible for parents to observe the kids under seizure. And almost all Japanese can receive medical service under a official insurrence, so their financial load is minimal. >For status one can take 2 approaches. Standard therapy is iv lorazepam >.05-.15 mg/kg (repeat x 2 10 minutes apart) and if repeated, would >give iv dilantin at no more than 1 mg/kg/min or over 20 minutes. In Japan , lorazepam is available only as a tab. I heard from the doctors who finished residency or fellowship in USA that lorazepam is good drag for pediatric convulsion, and I also have an experience that lorazepam rarely depress the respiration in old patients when I was a intern.But I can't use. #addition. A few years ago, a famous actor(I don't remember his name.) died of diazepam overuse.In Japan, the news told " he died of dilantin OVERTAKE." And many Japanese mistook it "he died of GELATINE overtake"(For Japanese ear it is hard to distinguish.) I'ts because Japanese brand name of diazepam is different. So many Japanese thought he died because he ate too much jelly desserts. This episode indicate that it is very difficult to share problems between different language and society. Nakashima,Taiji MD >> e-mail > The department of Pediatrics of Kushiro-Rousai hospital Nakazono-chou 13-23,Kushiro-shi,Hokkaido Japan tel 0154-22-7191 fax 0154-25-7308 ;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;;:;:;:;:;:;:;:;:;:;:;;:;:;:;:;:;:;:;:;;: ;:;:;:;:;:;:;:KUSHIRO-the city of the fog;:;:;:;:;:;:;:;:;:;:; :;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;:;: