Seizure (peds)
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
| Syncope |
| Breath-holding spells |
| Cataplexy |
| Narcolepsy |
| Vasovagal event |
| Standing for long periods of time |
| Standing quickly from laying or sitting |
| Hair-grooming syncope |
| Earring-changing syncope |
| Micturition syncope |
| Emotional distress or pain |
| Hypoglycemia |
| Hypovolemia |
| Sandifer syndrome (gastroesophageal reflux) |
| Acute life-threatening event |
| Acute dystonic reactions/drug reactions [i.e., promethazine (Phenergan)] |
| Movement disorders |
| Tics |
| Myoclonic jerks |
| Chills or rigors |
| Shudder attacks |
| Mannerisms |
| Self-stimulation |
| Choreoathetosis |
| Night terrors, sleep walking |
| Migraine variants |
| Benign paroxysmal vertigo |
| Nonepileptic paroxysmal event (pseudoseizure) |