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Seizures
Pre-reading
Don't Forget the Bubbles : Febrile Convulsions

Seizure Guideline
File Size: 534 kb
File Type: pdf
Download File

Workbook Questions

Case 1
A 4-year-old boy presents to ED with his grandma after having a shaking episode at home. He has had a runny nose last night and been kept away from daycare today for the same. The episode occurred shortly after he woke from sleep and his grandma describes he felt hot prior to it starting. He shook for around 90 seconds but stopped before QAS arrived. His temperature with QAS was 38.1.

  1. What questions in the history would help you to determine whether this was a seizure?
  2. What type of seizure is this likely to be and what age group do they occur in?
He is febrile in ED but this resolves after ibuprofen. He otherwise has an unremarkable examination with no focal signs of illness. He now appears well and is sat up in bed playing 2 hours after the initial presentation.
  1. Would you perform any further investigations?
  2. What is your likely disposition?
  3. What advice will you give to his parents on discharge?  They are keen to know how to manage a similar event and whether this means he has epilepsy.

Case 2
A 7-year-old girl with known epilepsy presents via QAS after having a seizure at school. It was described as a tonic-clonic seizure, which is in keeping with her normal seizure pattern. The school administered intranasal midazolam, which resolved the seizure.

  1. What factors or precipitants could increase the chance of her having a seizure?
  2. She returns to normal within 30mins and mum arrives and states she missed her morning medications, would you do any further investigations?  And what is her likely disposition?
Minutes prior to them leaving the department she begins to seize, it is again consistent with a tonic-clonic seizure
  1. What are your immediate management priorities and what would be your first choice drug?
  2. She continues to seize despite your initial management, what would you consider next?

Her seizure resolves after administration of your choice drug and she returns to her normal self after around 30 minutes, mum is keen to take her home. What is the best disposition for her at this point?

Copyright © 2015
  • Home
  • Guidelines
    • Abdominal pain in adults
    • AAA Rupture
    • Acute Coronary Syndrome
    • Anaphylaxis
    • Aortic Dissection
    • Appendicitis
    • Asthma
    • Backpain
    • Bowel Obstruction
    • Bronchiectasis
    • Burns
    • Chest Pain >
      • ADP Chest Pain Pathway
    • Cholecystitis
    • Confusion
    • COPD
    • Diverticulitis
    • DKA
    • DVT
    • Eating Disorders
    • Febrile Neutropaenia
    • Fractures >
      • Bier's block procedure form
      • Fractured neck of Femur
    • Funnel Web Spider Bite
    • Headache
    • Influenza Like illness
    • Meningitis
    • Obstetrics >
      • QLD Clinical Guidelines
    • Pancreatitis
    • Paracetamol OD
    • Pathology Ordering
    • Peri-anal abscess
    • Pertussis
    • Pneumonia
    • Pneumothorax
    • Podiatry
    • Procedural Sedation >
      • Procedural Sedation
    • Pulmonary Embolus
    • PV Bleeding in Early pregnancy >
      • EPAU - Early Pregnancy Assessment Unit
    • Redback Spider Bite
    • Ring cutter use
    • Seizure
    • Septic Arthritis
    • Use of Restraints
    • Stroke / TIA
    • Sepsis
    • Smoking cessation
    • Snake Bite
    • Syncope >
      • Telemetry guideline
    • TIA
    • Tonometer use
    • Antidotes
    • Dagibatran reversal guidelines
    • Funnel Web Spider Bite
    • Redback Spider Bite
    • Paracetamol OD
    • Snake Bite
    • Warfarin Reversal Guidelines
    • Trauma >
      • C-spine injury
      • Head Injury
      • Imaging Guidelines
      • Trauma in pregnancy
      • Sutures
    • Abdominal Pain
    • Allergy / Anaphylaxis
    • Antimicrobial Guidelines
    • Asthma & Wheeze
    • Behavioural Disturbance
    • Boils - Staph decolonisation treatment
    • Bronchiolitis
    • Buckle fractures
    • Burns
    • Cervical Spine Guideline
    • Chest Pain (Paediatric)
    • Child Protection
    • Constipation
    • Croup
    • DKA
    • Drowning
    • Eating Disorders
    • Fever
    • Fluids in Kids
    • Foreign Bodies
    • Gastroenteritis
    • Headache
    • Head Injury
    • High Flow Nasal Cannula Oxygen
    • Hypoglycaemia
    • Jaundiced Neonate
    • Limping in children
    • Malaria
    • Meningitis
    • Oncology Emergencies
    • Otitis Externa
    • Otitis Media
    • Paediatric Fracture Clinic Referral
    • Paracetamol Poisoning
    • Petechial Rash
    • Pneumonia (CAP)
    • Seizures / Status Epilepticus
    • Sepsis Guideline
    • Tetanus Prophylaxis
    • Torticollis
    • UTI NICE Guideline
    • Trauma in children >
      • LCCH Paeds Trauma Guidelines
      • C Spine Injury LCCH Guideline
      • LCCH Massive Transfusion
    • RCH Melbourne Guidelines
  • Parent Handouts
    • Accidental Poisoning
    • Abdominal Pain
    • Ankle Sprain
    • Arrhythmia
    • Asthma
    • Bronchiolitis
    • Chest Infections
    • Cast Care
    • Cellulitis
    • Constipation
    • Croup
    • DKA
    • Epistaxis
    • Eye Foreign Body
    • Febrile Convulsion
    • Fever
    • Fracture- Buckle
    • Fracture- Clavicle
    • Fracture- Elbow
    • Fracture- Finger/Toe
    • Fracture- Foot
    • Gatroenteritis
    • Glue- Lacerations
    • Head Injury
    • Jaundice
    • Otitis Externa
    • Parechovirus
    • Periorbital and Orbital cellulitis
    • Pulled Elbow
    • Seizures
    • Tonsillitis
    • Urticaria
    • Viral Illness
    • Wound Care
  • ACE the ACEM
  • Blog