Seizures
Pre-reading
Don't Forget the Bubbles : Febrile Convulsions
| Seizure Guideline |
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.
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.
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?
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.
- What questions in the history would help you to determine whether this was a seizure?
- What type of seizure is this likely to be and what age group do they occur in?
- Would you perform any further investigations?
- What is your likely disposition?
- 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.
- What factors or precipitants could increase the chance of her having a seizure?
- 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?
- What are your immediate management priorities and what would be your first choice drug?
- 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?