Seizures
Seizure guideline
Abnormal electrical activity in the brain - motor, sensory...
50% isolated secondary to fever or head injury
Most are brief, self terminating
>5min may not self terminate
DDX
PREVOKED
?fever, infective symptoms
Febrile convulsion
Meningitis
?Afebrile
Hypoxia
Electrolyte disturbance
- HypER/hypOnatremia
- hypOmagnesemia
- hypOcalcemia
- hypOglycaemia
- nonketotic hypERglycaemia
HypERthyroidism
Toxin/intoxication
Withdrawal
- OH, drug
Dialysis disequilibrium syndrome
Porphyria
UNPREVOKED
Epilepsy
- ILAE
Hx
Neuro Hx
tonic
clonic
floppy
unresponsive
apneic/cynosis
post-ictal
Inf Hx
Ix
Sats
BSL
EUC
Hyper/hypoNa
hypoCa (Vit D, PTH)
hypoMg
uraemia
TFT
Urine drug screen
Rx
Stay with them
Check time
Move from danger
Left recovery
Pillow under head
OOO if first seizure, >5mins, in water, head injury, cyanosis persists post cessation
Abnormal electrical activity in the brain - motor, sensory...
50% isolated secondary to fever or head injury
Most are brief, self terminating
>5min may not self terminate
DDX
PREVOKED
?fever, infective symptoms
Febrile convulsion
Meningitis
?Afebrile
Hypoxia
Electrolyte disturbance
- HypER/hypOnatremia
- hypOmagnesemia
- hypOcalcemia
- hypOglycaemia
- nonketotic hypERglycaemia
HypERthyroidism
Toxin/intoxication
Withdrawal
- OH, drug
Dialysis disequilibrium syndrome
Porphyria
UNPREVOKED
Epilepsy
- ILAE
Hx
Neuro Hx
tonic
clonic
floppy
unresponsive
apneic/cynosis
post-ictal
Inf Hx
Ix
Sats
BSL
EUC
Hyper/hypoNa
hypoCa (Vit D, PTH)
hypoMg
uraemia
TFT
Urine drug screen
Rx
Stay with them
Check time
Move from danger
Left recovery
Pillow under head
OOO if first seizure, >5mins, in water, head injury, cyanosis persists post cessation