Dr Tom Smith 

Doctor, doctor

Dr Tom Smith answers your questions
  
  


A friend from India says he heard that sniffing smelly feet could help prevent convulsions in epilepsy. Is this true?

Amazingly it may be, but it's not the feet that you must sniff - it's the shoes. Asking someone who feels a fit coming on to sniff smelly shoes has been a traditional way to nip the convulsion in the bud. It is proposed that the odour activates nerves that damp down the stimulus to convulsion. An article on just this subject appeared recently in Clinical Neurology and Neurosurgery - there is no more respectable journal.

You wrote recently about children with fevers and paracetamol. Ibuprofen is also recommended. Are there times when we should use one, not the other?

On the whole, we would use these only if children were distressed and uncomfortable - if they just have a 'temperature' but are not obviously ill or unhappy, then all that is needed is tender, loving care. The drugs are useful in easing the headaches and muscle pains that come with the fever. As for which is more effective, so many studies show that they hardly differ that I don't prefer one to the other. We don't use ibuprofen in children who have kidney problems or who are dehydrated, since it can put them into kidney failure. For children who are susceptible to stomach inflammation, we recommend paracetamol. For years we avoided ibuprofen in children with asthma, but a comparison of it with paracetamol in 1,879 asthmatic children found no difference in the number of asthma attacks afterwards.

 

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