To take laughing toddler to A&E?

[Hogi]

I actually don't know if I'm being unreasonable here. I guess i'm just worried.

I can't remember when it started but my toddler would have random burst of uncontrollable laughter a few times a day for seemly no reason. Nothing was funny and it usually gets a bit worse when he's going to sleep or waking up but we just thought it was a quirk of his because he does have a genetic condition and probably is on the spectrum so we just kind of ignored it because laughing can't be bad?

Over the last 24 hours it's been relentless, it's happening more than it ever has and it kept him awake - it was short bursts of laughter for over an hour and he was getting really agitated.

I googled it and it's saying it maybe something called gelastic seizures - it's rare (but so is he's genetic condition) and the history and his symptoms seem to fit what's happening.

He's again having a few attacks this morning and obviously the doctors aren't open but I'm thinking if a 2 year old is potentially having seizures then maybe we should get him checked out?

I don't know really I don't think he can wait a few days with this going on as it's really affecting him (more than it usually does).

Don't worry I'm very aware we just get the absolute very superficial knowledge in regards to neurology, couldn't hope to compare with a regular dr let alone a neurologist! It's very much a learn as you go profession, often googling for more information about a atypical medical condition on route then try to get through trying to manage said life threatening exacerbation of it whilst appearing confident and knowledgeable to manage the scene. It;s one of the main reasons why we get constantly annoyed with 111 - "oh don't worry we'll send the ambulance crew to check out your toddler with a possible neurological condition that they may well not even be aware exists and give you the expectation that they're going to do anything other than provide a taxi service to A&E, even though you've got a car on the driveway and could well arrive at A&E 2-3 hours sooner if you just get going now"

We get teaching on first line management for tonic clonic and that's about it. Often scratching our heads with absence seizures and similar "should we give them any diazepam, probably not it's not specifically in the pgd... but they;re having a seizure.... Lets just hope they come out of it before we arrive at A&E and no one says "so when did they last get any benzos....."

I hope it gets sorted for you xx

I hope you get seen by someone who knows about these things!

I hope the wait isn't too long. Do you have people close by who could sort out anything you need?

I’m glad there have been some replies saying this is a justifiable reason to go to A&E.

It always disturbs me when you get the inevitable responses saying “This doesn’t sound like an emergency?” and that the OP should make a GP appointment, because, apparently, only being half dead or having a leg hanging off is a good time for A&E.

It scares me people who don't have any medical knowledge advising on seizures. Prolonged to that level definitely needed medical advice so well done you for phoning.

Definitely not something I'm saying to not to be concerned about, and as I said this really isn't my expertise and I have certainly wouldn't dismiss odd neurological behaviour in my role as a paramedic. What I was meaning was I would have a suspicion that like you say this is part of some rare genetic condition, and that there wasn't going to be a solution/treatment available though A&E on the day and that would be a specialist neuro referral which in my area if the patient is otherwise physically well they would be waiting a few weeks for, or more, These referrals can also be made via their GP without the wait in A&E.

But this is just from anecdotal observation that ultimately a lot of people with odd neurological presentations spend hours and hours in A&E and then discharged. It's fairly common with the rarer neurological presentations that the patients history develops into "i went to A&E yesterday/last week with this, was there all day and I'm not aware if they've done anything, they just told me to see my GP, but it's still happening and my GP hasn't got any appointments till next week, so they told me to call 111, they sent you, what do you think I should do...." and the circle continues.

That’s really unpleasant to read.

sometimes people need medical help. I’m always fearful of going to hospital/ a&e even the doctor for fear of not being worthy of being seen. I’d never waste anyone’s time. Never have I called an ambulance for myself or my children or family. I have taken buses with broken bones, and been dangerously unwell and walked to hospital.

the op’s child might be experiencing neurological seizures. If you did turn up to such a case maybe realise that mum wouldn’t call an ambulance for a child laughing but maybe think more deeply about what could be happening.

Agree sleepy

My ds has a rare genetic disorder that was initially suspected as myoclonic and focal epilepsy.

1 in a million people have the same genetic fault as him.

1 in 77,000 people are estimated to have the condition.

I'm still learning. His neurologist is still learning.

I wouldn't expect a paramedic to be able to know scarily what was causing the issue. What I'd expect is you to be able to determine how medically unwell he was at the time.

You get use to accepting you have to wait until next appointment to raise new symptoms. You get to learn when it's medically concerning or not.

So much so when we turn up in Aug to ds next appointment we will announce that he hasn't been able to properly feel or wiggle the toes on one foot since February

Not all are medically unqualified.

I'm glad you're getting medical advice. Seizures should not be taken lightly.

Just an update - we've been admitted. They have said it's quite a complex issue but they're gonna see what we can do.

Waiting to see the ped doctor now.

We're normally professional don't worry. But yes it's pretty typical to spend the drive to the job ridiculing it and putting the world to rights, before we turn up and get on and deal. The picture of the job detail from 111 would absolutely have been photographed and shared on one of the groups "111 Cat2 emergency for a toddler whom keeps laughing". You've got to have a coping mechanism otherwise you'd go mad in this job!!

The majority of the calls we get are absolute non-emergencies barely requiring anything more than first aid, genuinely last night I was sent to a patient who called 111 as they'd had a nightmare and couldn't get back to sleep and wanted a sedative. I had to drive 12 miles to just tell them that we didn't provide that service. You have to have a coping mechanism because otherwise you'd go mad because all of these jobs get prioritised above the elderly fallers laid on the ground in agony for hours at are left at the bottom of the list because their complaint is just 'hip pain'.

It's like in this case 111 encouraging to wait for an ambulance, which typically will be there in under 4 hours (can be upto 12), when they're not neurologists, they're not going to do any treatment at all just drive you to hospital, when they probably have their own car outside the house. If the poster/mother is really concerned just wanting some answers/reassurance from a specialist/a treatment plan essential why delay things by involving an additional service that's not tied into the rest of the NHS!?!?!

That must be exhausting, poor little mite. Glad you’re getting help. All the best 💐

Hope it goes ok ❤️

Sounds like seizures. Id take him to the hospital in a heart beat

I'm glad they have admitted you, I went out with someone a few years ago who had seizures that sound very similar. It happened a lot at night with him.

Well done, hope they can figure out what’s going on.

I hope they get to the bottom of it quickly.

That's interesting that it happens at night.

My toddler does it as he's falling asleep, few times during the night and then when he wakes up - that's when it's at its worse.

This was on an episode of Greys Anatomy :- really glad you went to A&E, good luck!

@Hogi seizures are often more common around sleep- either on falling asleep/waking or during sleep.

We've seen the doctor and they've advised they are going to take bloods but cannot diagnosed epilepsy so will email our consultant to see if we can be referred for a EEG which may be 6-8 weeks.

I'm just glad they're making sure he's okay but I really hope they calm down for him. 6-8 weeks without proper sleep sounds hellish but we'll see.

Thank you so much for the advice and kind words everyone

Stop being so ridiculous. There are obviously time wasters out there, many of them. Not everything is a dig at specifically you ffs.

A and E for sure.

Anything where there's an answering service has a potential for Chinese whispers. DH is a very, gets a 1am call for a "dog with a sore eye", turns out it's a flat faced breed and the eyeball is not where it belongs ...

Yep he cursed when the call came, yes it gets bandied around as an "answering service are shite" example along with the "can I put fake tan on my guinea pig" call (it was hot, owner was checking if they could put sun tan lotion on GP's pink nose as horse owners generally do ...) but the private survival mechanisms are necessary.

There's also the cautionary tale to be careful what you wish for and the "odd" emergency calls are often the most difficult!

Hope the doctors can help.