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What Causes Vomiting And Loss Of Conciousness In A Child?

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Posted on Mon, 3 Aug 2015
Question: My son is 5 years old, underweight and has started vomiting in his sleep. He doesn't wake up as this is happening in between 10 pm and 1 am, I wake up to the sound of him choking on his own vomit. After he comes to, he immediately asks for food. By the next day he seems normal, no fever, no complaints or lethargy. It's like he doesn't remember the incident, and he was on the toilet last night, with a bucket between his legs. I screamed and shook him multiple times, tried to listen for a heart beat, and slowly he opened his eyes and his head rolled back. I asked him if he fell asleep, and he said "I almost died". Maybe I'm over reacting but that incident scared me, probably should have taken him to the hospital then. A couple hours later I went to bed with him, and by 10 pm again projectile vomited and choking, but he didn't wake up. I lifted him up and screamed for my husband. He saw his pediatric doctor today, and it was all maybe it's just something running it's course. How does a child only vomit at night, present no symptoms for almost 24 hours , and it continues again. The scary part is that I would think he would wake up with these bouts, instead he chokes on his on vomit and coughs a little. What could cause something like this? Where do I need to go for an answer or how can I politely demand tests, and which ones for his doctor to perform. I know every parent with a child that vomits fells this way, but my intuition says this is not normal or a bug.
He is on methylphenidate 18 mg, and has taken it for 2 years. He also takes clonidine at night to help him sleep, without it he would sleep for a couple of hours, then be up from midnight on. Picky eater refuses food and drinks minimally for the 8 hours on the Concerta. Has a limited diet mainly bratwurst, bacon, sausage, fried chicken and fish sticks. Broccoli, apples, and yogurt are hit or miss, and that is the extant of his palate. Cereal and milk are his main breakfast foods, refuses everything else. Main diet consists of meats and diary products. He has been diagnosed with adhd and autism. He weighs 32 pounds and is 42 inches tall. Highly active, very seldom rests. Thought more medical history may be useful.
doctor
Answered by Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
To me it appears to be seizure disorder

Detailed Answer:
Hello


Thanks for the query


I can understand your concern.
The weight and height both are normal for his age.
Most of the child in this age are fussy and choosy regarding their feeds.
Side effects of none of the medication mentioned above matches with his symptoms.
Vomiting and loss of conciousness (indifferent to the surrounding)is very common in seizure.
There can be variety of seizures like tonic clonic,a tonic, myoclonic or absence seizure.Sometimes it is very difficult to fit into a particular type of seizure.
I would request you to get him to a pediatrician for investigations like metabolic profile (blood sugar,calcium and electrolytes) and electroencephalogram.He may need to get admitted to the hospital as there is high chance of recurrence of seizure within next 24- 48 hours and each seizure episode is life threatening.
The other possibility is transient loss of conciousness.I would also like to measure his blood pressure and get a brain imaging like MRI done if clinical examination is suggestive.
Clonodine overdose may cause hypotension and methylphenidate should be avoided in case of seizure.

I hope this helps.

Wish your child good health.
Please do ask if you have any further query.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pradeep Kumar Jain (15 minutes later)
Thank you for a clearer direction to proceed. He went to his pediatrician today, and it was clear she thinking viral or something that would run its course. My last question is should we take him to the hospital now, or wait for another episode?
doctor
Answered by Dr. Pradeep Kumar Jain (7 minutes later)
Brief Answer:
I would like to get him to the hospital now only

Detailed Answer:
Thanks for writing back.

Considering it a seizure episode I would like to get him to the hospital now only and before appearance of the next episode as each episode can cause chocking and it may be life threatening.
Another advantage of getting him to the hospital now is that if next episode occurs in hospital physicians would be better able to assess, it will be easier to make a diagnosis and life threatening event can be terminated.

All the best.
Take care.
Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2074 Questions

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What Causes Vomiting And Loss Of Conciousness In A Child?

Brief Answer: To me it appears to be seizure disorder Detailed Answer: Hello Thanks for the query I can understand your concern. The weight and height both are normal for his age. Most of the child in this age are fussy and choosy regarding their feeds. Side effects of none of the medication mentioned above matches with his symptoms. Vomiting and loss of conciousness (indifferent to the surrounding)is very common in seizure. There can be variety of seizures like tonic clonic,a tonic, myoclonic or absence seizure.Sometimes it is very difficult to fit into a particular type of seizure. I would request you to get him to a pediatrician for investigations like metabolic profile (blood sugar,calcium and electrolytes) and electroencephalogram.He may need to get admitted to the hospital as there is high chance of recurrence of seizure within next 24- 48 hours and each seizure episode is life threatening. The other possibility is transient loss of conciousness.I would also like to measure his blood pressure and get a brain imaging like MRI done if clinical examination is suggestive. Clonodine overdose may cause hypotension and methylphenidate should be avoided in case of seizure. I hope this helps. Wish your child good health. Please do ask if you have any further query. Regards