Seizure (peds)

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General

It is important to consider performing imaging in young patients with new-onset focal seizures to look for a brain mass or trauma

immed after trauma = impact sz (no antieleptics)

>20min after = TBI (antieleptic)

INH --> pyridoxine

Status epilepticus is a "prolonged" seizure or recurrent seizures lasting >5 minutes without the patient's regaining consciousness. Rapid cessation of status epilepticus is important to prevent irreversible neuronal damage

In children with a prolonged postictal state, especially in those who are not known to have had a prolonged postictal state with past epileptic episodes, consider the diagnosis of nonconvulsive status epilepticus.8 Consider an emergency EEG to identify seizure activity. If EEG testing is not available, a trial of anticonvulsants can be initiated and might result in improved mental status. Morbidity and mortality are increased when nonconvulsive status epilepticus is untreated, but less so than with untreated convulsive status epilepticus.8


Table 129-1 Events Masquerading as Seizures