Well, in the spirit of Epilepsy Awareness Month, Jenelle decided to give us her own personal demonstration on the dangers that viral illness can threaten the seizure threshold. Long story short, she had an over night stay on Monday at Children's Hospital Orange County for observation of uncontrolled seizures.
Last Friday, Jenelle was sent home from school with a low grade fever of 101. As a precaution we took her to the doctor so they could check the usual culprits; ears, throat, etc. She was fine and in fact giggled her way through the exam. Over the weekend her temperature was normal, and she was acting fine except on Sunday, when she started to get unusually cranky. She had no fever so we sent her to school on Monday.
In the early afternoon on Monday, Jenelle's teacher called to tell me Jenelle was having some increased seizures. We talked about timing them, and she wanted to watch her a little longer before using her Diastat. About a half an hour later, she called back to tell me her seizures were clustering too long, so they were going to give her Diastat. I told her I was on the way, and made it to her school pretty quickly. When I got there, Jenelle was sleeping (post ictal) on her side, and her skin was very mottled and blue looking. Shortly before I arrived, they took her temperature and it was 104. The teacher had Tylenol ready for me to give her (it's rather funny now to think the school could giver her Diastat, but not Tylenol) so I did. While looking at Jenelle, we noticed she had some shallow breathing, so I made the decision to call an ambulance. I had been planning to take her straight to the ER, but was not comfortable transporting her like that in my car, especially with it being the same time that school was letting out.
The Paramedics and Ambulance arrived very quickly and put Jenelle on blow by oxygen. After a couple of minutes on oxygen, she started to open her eyes and come around. At this point, her temperature was 103. In all, we believe that Jenelle was having cluster seizures and probably seized a total of 45 minutes out of an hour (in clusters, not one long seizure but rather a lot of little ones.) As some of you know, Jenelle's cousin is at CHOC in the PICU recovering from a stroke due to complications with her shunt. Ironically, one of the paramedics recognized our last name and asked if we were related. Not a good month for the Curran family to say the least.
As it turns out, the ambulance was a good idea because Monday night was the busiest night of the year at CHOC/St. Joseph ER. Even with arriving by Ambulance, it took over 6 hours to assess Jenelle's condition. They took blood and urine samples to rule out infection, and both came back normal. The doctor believes she has some sort of viral illness. We arrived at 3:30, and around 7:30 Jenelle started seizing again, this time she seized for 13 out of 15 minutes. The ER quickly gave her some Ativan and it seemed to do the trick. Around 10:00 p.m., we made the decision to admit Jenelle for observation. Immediately when we arrived, the ER asked for the number to Dr. Shields at UCLA and put in a call to him for instructions on the seizures. UCLA was in charge of everything involving neurology via phone and gave CHOC a good plan on how to treat her seizures.
We finally got to a room around midnight, and Jenelle was still awake but out of it until 2:00 a.m. Jenelle woke with a fever of 102 on Tuesday morning, and stayed asleep most of the day. I went home to shower and get Jack from school around 3:30, and by the time we got back to the hospital, Jenelle was awake, cranky and crying. Even though the crying wasn't fun, it was nice to see her be somewhat herself. While she was sleeping all the time, we still weren't comfortable that she wasn't having seizures. Once she was awake and cranky and more of herself, we felt it best to take her home.
This morning Jenelle has been awake and bouncing around as normal. She still has a low grade fever of 99, but is more hungry and much more alert. Unfortunately now our "three years since her last hospitalization" streak is over, but at least it was something very minor. As always, when kids who have seizures get sick, their seizure threshold is lowered and seizures can get out of hand very quickly. We were so impressed with the communications between CHOC and UCLA and we're glad she is home and back to some seizure stability.
Thanks for the thoughts and prayers. I'll keep you posted.