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Dr. Gupta
Dr. Gupta, Pediatrician
Category: Pediatrics
Satisfied Customers: 7913
Experience:  MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
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Hi, 2 nights ago, my 5 year old grandson went to bed feeling

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Hi, 2 nights ago, my 5 year old grandson went to bed feeling fine, but woke a few hours later, screaming, appeared to be in a trance, eyes open but looking straight through you, then had bowels opened in his bed. Eventually went back to sleep, did not remember anything in the morning, oh, my daughter said he felt quite warm at the time, but not unduly so. He has never so much as wet the bed so this is totally out of character for him. Obviously concerned, he is fine now, apart from waking up today unable to speak properly, throat very sore and swollen, feels hot and generally unwell. He also has awful excema, all over his arms, legs and trunk, he has steroid cream but lately it has been getting worse, continually scratching at night causing his lesions to bleed through pyjamas, onto his bed, GP won't refer to a dermatologist, insisting they just use a higher concentration of steroid cream. My daughter has not taken him to the doctor concerning the night time episode, I think she should! Could you please give me your opinion and advice, thank you.

PediatricMD :

Hello & welcome to Just Answer!

If you have any questions after reading my answer, be sure to let me know.

PediatricMD :

I can understand your concern regarding your grandson,

PediatricMD :

It would appear that he may have had a problem related to his sleep

PediatricMD :

this could be a night terror

PediatricMD :

which is well known at this age,

PediatricMD :

and can present with the symptoms that you have mentioned

PediatricMD :

These are more common when a child is unwell

PediatricMD :

and thus when your grandson was unwell he probably had a night terror

PediatricMD :

While he should be seen by the pediatrician, it is unlikely to be an emergency at the present point of time

PediatricMD :

I agree that you should get the child evaluated by a dermatologist if possible, but at the very least the pediatrician should help to intervene in this situation ....

PediatricMD :

You can read about night terrors here

PediatricMD :

http://kidshealth.org/parent/general/sleep/terrors.html

PediatricMD :

Is there anything else that I can help you with ?

PediatricMD :

You have already rated the interaction as poor service, I would appreciate it if you could ask further questions and rate the session at the end of the interaction

PediatricMD :

Are you there?

Customer: Hi, you haven't told me anything other than what I told you, a night terror. I wanted to know why he was vague and didn't respond to verbal stimuli and why he would have a full bowel movement in his pyjamas in bed, totally out of character.mi wanted to know the cause of night terrors, eg, sleep deprivation, pyrexia of unknown origin, which he didn't have when he went to bed, and also he was perfectly in good health that day and on going to sleep. I also wondered if the steroid cream, which his mother has to use frequently on him c
PediatricMD :

I will reply to your question, though your answer is incomplete.... regarding the steroid cream ...

PediatricMD :

The night terror was probably related to the fever ... .any acute illness can definitely lead to increased risk of night terror

Customer: Yes I am here, the rest of question was could cream be being absorbed and causing problems, forgive me for spelling eczema incorrectly.
PediatricMD :

The bowel incontinence can be a part of the night terror (though uncommon), rarely it may suggest a seizure disorder (& this can be confirmed by a sleep monitoring using video EEG),

PediatricMD :

The lack of response to verbal stimuli is classical of night terror

PediatricMD :

The steroid cream - I really cannot comment on that without knowing the exact formulation, and your question regarding the steroid cream use...

PediatricMD :

Ok, Again steroid creams can have various potency, and the ones with higher potency, if used over a long period of time can get lead to certain local problems (like skin thinning), and rarely systemic effects also...

PediatricMD :

however if you use a low potency cream (like hydrocortisone 1 %) then this is quite unlikely, even with use of a few weeks to months

PediatricMD :

There are other non steroidal options for treating eczema, that only a dermatologist would be able to prescribe,

PediatricMD :

creams like TACROLIMUS (0.03 %) are quite effective in reducing eczema itching, and have a steroid sparing effect in treating this condition

PediatricMD :

However, your GP may not be aware of this, and may be reluctant in prescribing the same (or a similar formulation)

PediatricMD :

...

PediatricMD :

Please let me know what else you would like to know ...

PediatricMD :

Are you there?

Customer: Hi, thanks, XXXXX XXXXX really worried concerning his sleep, or lack of it. He is a very active little boy, and like all of them, his feet only stop running when he goes to bed. He very rarely gets to sleep quickly, he is usually awake 1-2 hours later, talking to himself. Once asleep, he is continually scratching and wakes up every night because it is sore and bleeding, also, and this may sound silly, but my daughter has moved to a beautiful but very old, big house, which they are slowly tr
PediatricMD :

Again the text is incomplete

Customer: Sorry went to soon, house still needs a lot if work, but what worries me, is house freezing, George goes to bed with vest, t-shirt, pyjamas, socks, hot water bottle and three duvets, but still wakes up, every night around 2am, saying he is cold and asks to get in bed with them. He is at school now, so still has to be awake early as both mum and dad work, so he is dropped off with someone and then they take him to school, could this be a major factor as to what is happening.
PediatricMD :

This could be a major factor for what (in your opinion?) eczema? night terrors? falling ill ?

PediatricMD :

From my perspective, while I cannot be sure, I believe that some times allergies (like the eczema) may be exacerbated by the sudden change in temperature.

PediatricMD :

As far as the rest of it is concerned, it is nowadays (unfortunately) quite common for kids to have limited time with the parents due to both of them being working,

PediatricMD :

These stresses are unlikely to have a significant impact in most cases though,

PediatricMD :

Is there anything else that I can help you with?

PediatricMD :

Are you there?

PediatricMD :

Please feel free to get back for any clarifications,

PediatricMD :

Do leave a positive feedback if the discussion was useful,

PediatricMD :

Warm regards

PediatricMD :

Dr Gupta

Dr. Gupta and 3 other Pediatrics Specialists are ready to help you
Customer: replied 3 years ago.
Hi, last thing, my grandsons skin, having eczema, is extremely dry, how important is it to keep skin moisturised, and n your opinion, which is the best moisturiser, thanks.
The need for keeping the skin moisturized is CRITICAL,
I always suggest the following things to kids with Eczema
"Minimum use of soap especially on the face; Use Dove/ Pears soap; May TRY OILATUM or CETAPHIL Emollient (Liquid soap); Pad dry;
Apply Nivea/ Ponds Moisturizer/ ELOVERA/ EMOLENE cream, Baby oil (Olive oil) within 5 minutes of bath to retain moisture;
COTTON clothes only; If above 6 months use SUNSCREEN for kids too"

Also ensure that you pad dry the child with a soft cloth / towel immediately after the bath, and apply the moisturizer on the slightly wet skin.
Hope this helps.
Warm regards