Emergency department management of epileptic seizures in children

Protocols for the emergency medical management of epileptic seizures are available. However, for children with a diagnosis of epilepsy who recover their baseline neurological status after one or more seizures, there is a lack of consensus on follow-up care (eg, the need to order complementary tests or not, or where to refer the patient). We reviewed the cases of 164 patients with epilepsy who came to the emergency department with one or more seizures. The aim was to assess patient profile, the ordering of additional tests and whether the tests proved useful for managing the case. Sixty percent of the patients sought emergency care after a single seizure that resolved before arrival at the hospital. Blood tests were done in 29.9% (all were normal) and antiepileptic drug levels were measured in 22% (36.1% were too low). Although testing for antiepileptic drug concentrations offers the highest diagnostic yield, this test is subject to certain limitations that lead to reduced use. [Emergencias 2013;25:116-118]