- A seizure is the physical and behavioural changes that occur after an episode of abnormal activity in the brain or part of the brain
- It is a symptom not a diagnosis
- By the age of 16 years approximately 1% of the population will have suffered a seizure without a fever
- Recurrence risk :
- 50% will have a second afebrile seizure
- 75% of those will have a third afebrile seizure
- 88% of these are within two years
General history, plus consideration of:
- Neurological state and behaviour prior to seizure
- Duration of seizure, focal features
- Recent trauma
- Poisons / drug ingestion
- Co-morbidities e.g. ventriculoperitoneal (VP) shunt
- Developmental history
- Determine if the child has had a vacination in the past 14 days. If so, a WAVSS WA Vaccine Safety Surveillance: Adverse Reaction Reporting Form needs to be completed.
- Full systems examination including neurological
- Assess for meningism
- U&E, Calcium, Magnesium, Phosphate
- CT if clinically indicated (seek Emergency Department Senior Doctor advice)
- EEG (as outpatient)
- Metabolic screen if clinically indicated
- Breath holding
- Gastro-oesophageal reflux (GOR)
- Panic attack
- Most seizures will terminate within 5 minutes. Those that last longer are likely to continue.
- If a seizure is still in progress on arrival to the Emergency Department, treatment should commence as per ED Guideline: Status Epilepticus.
- Prolonged seizure > 15 minutes
- GCS < 15 (1 hour post seizure)
- Age < 1 year
- > 1 seizure
- Focal seizures
- Signs of raised intracranial pressure (ICP)
- Signs of aspiration
- High parental/carer anxiety
- Parents should be warned that all children or adolescents who have had seizures should be supervised when bathing, swimming, riding a bicycle on the road, and should avoid tree climbing.
- Parents should be advised of first aid measures and given parent information sheet – First Aid for Seizures.
- Arrange referral to General Paediatric Clinic and EEG request (PMH – complete green form).
We want your feedback!
Help us provide guidelines that are useful to you, the clinician.
Give feedback here