Friday 19 January 2018

Spleen facts and how to cope with febrile seizures

Dr Nina Byrnes
Dr Nina Byrnes

Nina Byrnes

Our GP advises on the consequences of spleen removal and what to do if your child has a febrile seizure.

Question: My dad has had problems with his spleen and needs to have it removed. Is it an important organ and what will this mean for him?

Dr Nina replies: The spleen is found in the upper left part of our abdomen under the lower ribs. It is about the size of a fist. It does play an important role in our immune systems but we can survive without it.

The spleen helps fight germs that invade the body. It also helps regulate the numbers of blood cells circulating in the blood and removes old or damaged red cells from circulation. If the spleen isn't working properly you are at risk of anaemia, increased infection and bruising or bleeding. If the spleen is removed the liver and bone marrow can take over many of its functions.

The spleen may need to be removed if it has been subjected to damage or trauma. This sometimes occurs due to abdominal injury in a fall or road traffic accident. It may become enlarged due to infection or illness or it may not function correctly in certain conditions, such as sickle cell disease and thalassemia.

If you have an enlarged or malfunctioning spleen you may notice pain in your upper left abdomen, fatigue or frequent infections. Problems are also sometimes picked up with blood tests or abdominal scans or ultrasound.

If the spleen is not too large and partially functioning it may not be removed. Your doctors will keep a close eye on you and prescribe antibiotics to help fight infections that occur. If the spleen is causing problems with the blood or is very enlarged it may be advised to have it removed.

Those who have had their spleen removed carry a small risk that infections may become serious more quickly. There are a number of precautions that can help reduce this risk.

It is essential that all immunisations are up to date. This includes vaccination against pneumococcal disease every five years, receiving an annual flu vaccination, and ensuring vaccination against Haemophilus influenza B and meningitis C. Those without a spleen may be advised to take a daily antibiotic to reduce the risk of serious bacterial infection.

They are also advised to seek medical review early with any symptoms of infection or illness such as fever, cough, malaise or urinary problems. A full course of antibiotics will likely be prescribed as the risk of serious infection can be high.

Question: My niece had a seizure last week. She ended up in hospital. The doctors told her parents it was a febrile seizure, that she should be okay and that she doesn't have epilepsy. What are these and will it happen again?

Dr Nina replies: Febrile seizures are a form of convulsion or seizure that occurs in young children and is usually triggered by fever. They most commonly occur in conjunction with common childhood illness such as viruses, ear infections, cold and throat infections. Those aged six months to five years are most commonly affected. About one in two children will experience a febrile convulsion at some stage. They can run in families.

Most seizures occur as general convulsions. More rarely they may just involve the tremor or movement of one part of the body, eyelid rolling or stiffness of the body. Seizures are generally accompanied by a fever of over 38 degrees centigrade.

The vast majority of seizures are short lived and harmless. There is lots of evidence to show that most children who have short febrile seizure suffer no brain damage and go on to normal school achievement.

If your child has a febrile seizure lie them on their side in the recovery position. This will prevent them swallowing any vomit and will keep their airway open. Stay with them and try to time how long the seizure lasts.

Seizures can be frightening to observe. If it is their first one or it lasts longer than five minutes do go to hospital or call an ambulance. It is likely all will be okay but a thorough check is very important. If they have happened before, are diagnosed as simple febrile seizures and last longer than five minutes it is okay to follow up with your GP.

Doctors don't normally prescribe epilepsy medication for febrile seizures. They do sometimes prescribe medication such as diazepam which can be used if future seizures occur and are prolonged.

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