Pediatric Heart Expert Forum
Toddler with Neuro and Cardio Symptoms
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Toddler with Neuro and Cardio Symptoms

I have a two year old boy who has been very healthy other than allergies and having tubes placed in his ears.  5-3-12 I picked him up from daycare and we went out to eat. He was flushed, but the air conditioner had gone out in the restaurant, and we were all pretty warm. At the end of the meal collapsed in his highchair falling/slumping backwards. We were afraid he was choking. He was unconscious for a few seconds and came out of it while we were taking steps to address choking. He was disoriented and could not keep his eyes open or stay on his feet.  We took him to the ER and he had 103 temperature and had a serious seizure while being examined. We were admitted and dismissed the next day with a diagnosis of Febrile Seizures with the explanation that his fever must have risen so fast that it sent him into one. They classified the event during dinner a smaller seizure. We were giving educational material and a medicine to use if he had another one lasting more than 2 minutes. We were alarmed but prepared that this could happen with future fevers.

5-8-12 after regaining some normalcy in our routines the daycare called to tell me that he was very disoriented, was staggering, his mouth had turned blue, he was very cold and he was not focusing or responding. He had not had a noticeable seizure nor had he lost consciousness. He was taken to the ER by the time I got to him he was back to his normal self, except that the tip of his nose was blue. That had just happened before I arrived, it was not residual from the episode. The ER doctor and our pediatrician decided to send us to facility with a children's hospital.

Blood tests, urine tests, x-rays, EEG, and CT scan were all normal. ECHO and EKG are waiting for a more in-depth review, but look fine on the surface. The event at the daycare was not accompanied by fever which damages the theory of febrile seizures if the first and third events were actually seizures.  If they weren't we have no theory at all. Need new Ideas
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It sounds like you did the correct thing to take him to a facility where he could have a thorough pediatric evaluation including an ECG and echocardiogram.  In young children, there can be a fine line between neurally based seizures and some cardiac symptoms.  If the echocardiogram is normal, then a cardiologist should consider placing an event monitor on your child.  This would document the heart rate if there are further episodes.  It would be important to rule out an arrhythmic cause.  If the ECG, event monitor and echocardiogram are all normal, then it makes a primary cardiac problem very unlikely. One would still need to consider a seizure disorder;  perhaps not the typical febrile seizures of childhood, but rather true epilepsy.  So follow up with a neurologist would be important.  Lastly, if your child has an underlying endocrine problem such as hypoglycemia (low blood sugar) that can alter the mental status as well.  Good luck.
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