Children with seizures presenting to accident and emergency.

Abstract

Abstractwith seizures. Children presenting with Objective-To analyse the diagnoses made seizures have a potentially broad range of in children presenting to an accident associated problems that require appropriate and emergency (A&E) department with management. Such an analysis would be useful seizures.for planning district A&E and paediatric Methods-All children who presented to a services. district general hospital A&E department with seizures over a 1 year period were Methods identified. A retrospective review of A&E We studied all children presenting as an and hospital records was performed one emergency within one year to a district general year after they were first seen. The types hospital A&E Department serving a population of seizure, investigations performed, treat-of 70 000 children. Children presenting as an ment given, and the range of associated emergency, whether self referred or referred by diagnoses were ascertained. their general practitioner (GP), are admitted Results-199 children (of 21 795 attending through the children's A&E department at A&E in the year) had 254 visits with Sunderland District General Hospital (SDGH). seizures, which represented 1 2% of the We obtained the names of all patients recorded child attendances at A&E. Self referral as having a seizure, collapse, blackout, or occurred in 87%, and 52 patients had "funny turn" from the A&E register. One or established epilepsy. Febrile seizures more criteria were required: a description by an were far the commonest type of first independent witness, an appropriate clinical seizure (n = 75), but there were also 13 history with postictal signs, a further seizure cases of symptomatic seizures resulting witnessed in the A&E department, or loss of from various metabolic and neurological consciousness in a patient known to have causes.

Characteristics of Children Admitted to the Emergency Department with Convulsive Epileptic Seizures: A Single-Center Study

“…Previous studies reported that seizures accounted for approximately 1-2% of all pediatric emergency department visits. [7][8][9][10][11] In our study, only 0.28% of all emergency department visits were due to a convulsive epileptic seizure. The very low incidence of seizures among all pediatric emergency department visits may be due to the fact that emergency departments in Turkey have become a common place for both urgent and non-urgent child healthcare provision.…”

“…10 In another study, 5% of all children who presented with a seizure were diagnosed with status epilepticus. 9 Although the majority of the seizures stopped before arrival to the emergency department, it was imperative to administer the appropriate anti-convulsant medication and arrange intensive care referral in case of status epilepticus.…”

Practice parameter: Evaluating a first nonfebrile seizure in children

“…In many children, the history and physical examination alone will provide adequate information regarding probable cause of the seizure 12 or the need for other tests including neuroimaging. 13 The etiology of the seizure may necessitate prompt treatment or provide important prognostic information.…”

Prevalence, Aetiology and Outcome of Status Epilepticus in Children with Convulsions at the Wesley Guild Hospital, Ilesa

“…Although, it is commonly agreed that outcome is primarily a function of underlying aetiology, there is still much controversy as to which other factors such as age, duration, treatment or CSE itself, modify the outcome [12,21,23,24]. Where there has been no acute or progressive central nervous system insult, morbidity and mortality are low [4,5,17,20,[25][26][27]. Failure to diagnose and treat status epilepticus in a prompt and accurate manner has been shown to result in significant overall mortality and neurological morbidity [17,23,28].…”

“…Status epilepticus in childhood is a life threatening condition with serious risk of neurological sequelae and constitutes a medical emergency [2,4,5]. According to the Canadian Paediatric society the commonest cause of status epilepticus is prolonged febrile convulsion [6].…”