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Small child fell off chair, head injury, shivering, vomiting symptoms. Did head injury cause seizures?

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Practicing since : 2001
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12 days ago my 12 month old fell from her high chair and landed head first on a wodden floor, it happened so fast i had not yet strapped her in, she just launched to one side i tried to catch her but missed. She cried straight away and then was quiet for about half an hour after which she was completely normal. I rang A and E who had a 4 hour wait so decided to observe her at home. 2 days ago i noticed she had slept for a long time so i woke her as she had had nothing to eat. She was only wearing a nappy and i gave her a cold yogart from the fridge a few miniutes later while eating some fruit she began to shiver about 5 seconds i touched her and she stopped she did not feel cold so i checked her temperature in case she was hot, her temp was 36.6. She was quite grizzly for the next 20 miniutes so i gave her her milk which she then vomitted. I did not think much about all this until yesterday when i suddenly linked the bang on the head the shiver and vomit. My question is could this episode have been a siezure, we have not been anywhere for days due to christmas so i know its not viral. if she had not been sick i definately would have said it was a shiver she was fully consious and looked normal. Im really worried the fall has damaged her brain, would you vomit after such a small episode or is this all a coinsidence and unrelated, and is 10 days post head injury within a time frame for symptoms also would a head injury fit be more classic fit, it looks like none of what i saw on you tube or what ive seen in my job(nurse) She did not appear over sleepy after but did go to bed as it was bed time. I know she should she a doctor but im not sure a GP would really know and i need some reasureance. thankyou.
Posted Thu, 19 Apr 2012 in Child Health
 
 
Answered by Dr. Shiva Kumar R 1 hour later
Hello

Thanks for the query.

Your question is a very good one and I will work on providing some good information and recommendations regarding what is going on.

Regarding the occurence of shivering without any evidence for febrile illness after a fall, I would like to conisder this as a brief seizure. However it needs a detailed explanation. So I personally want to know from you if there was other features of seizures like stiffening of the body or limbs, uprolling of eyeballs, blinking, brief unresposiveness or staring during the 5 seconds period. I know it is difficult to observe these during the first episode. The presence of any one of the above would help in the diagnosis.

If you observe any of these the child would require investigations like EEG and scan of the brain to get further clues about the diagnosis. If not, observation of the child for further episodes and if possible video recording of the events with mobile phone would help in arriving at the diagnosis.

In the mean time please schedule visit with your child specialist for a good physical exam and consultation.

Thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
 
Follow-up: Small child fell off chair, head injury, shivering, vomiting symptoms. Did head injury cause seizures? 2 hours later
I was sat with her as was my partner at the time, he describes it as a bit like trying to have a bowel movement to me more like someone stepped over your grave episode. There was no limb stiffening, eye rolling or loss of conciousness in fact mentally she was completely normal, before during and after. She was sat on the floor at the time and did not fall over and the vomit was half an hour later and was not huge which i thought at the time was vomit with wind. The bump on her head was on the right forehead and left a small bump and bruise which was gone in a few days. If this was a seizure is it likely to happen again or could it be a one off event. I am confident i didnt miss anything strange as i was looking right at her and it did not alarm me at the time much, i even think i have seen her do something similar after she has woken up before the head injury however i know seizures can be subtle and dont want to ignore it i am very concerned. thankyou very much for your reply.
 
 
Answered by Dr. Shiva Kumar R 11 hours later
Hello and Thanks again,

From the description provided to me "it DOES NOT seem to look like a seizure". So I personally feel the child has to be observed closely for couple of weeks.

As pediatric epilepsy is difficult to diagnose, if unusual events, vomiting or jerkings occur again she needs to be investigated in detail.

For time being investigations are optional. I personally feel we can wait and if similar episodes recur to proceed for the investigations like scan and EEG.

Thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
 
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