Emergent diagnostic testing for pediatric nonfebrile seizures

Area of Science:

• Pediatric Neurology
• Emergency Medicine
• Diagnostic Imaging

Background:

• American Academy of Neurology guidelines suggest laboratory studies or CT scans for children with nonfebrile seizures if clinical history indicates abnormality.
• Evaluating predictors for clinically significant results from these diagnostic tests is crucial.

Purpose of the Study:

• To determine if patient or seizure characteristics predict a higher likelihood of clinically significant findings from laboratory studies or CT scans in children with nonfebrile seizures.

Main Methods:

• Retrospective case series of 93 children with nonfebrile seizures.
• Evaluation conducted in an urban pediatric emergency department (ED) from July 2007 to June 2011.

Main Results:

• Laboratory studies were performed in 87% of patients, with 7% yielding clinically significant results.
• CT scans were obtained in 35% of patients, with 9% showing clinically significant findings.
• Younger age (<2 years), active seizure in ED, and first-time seizure showed a trend toward increased laboratory test yield, but results were not statistically significant.

Conclusions:

• No statistically significant predictors for laboratory or CT abnormalities were identified in children with nonfebrile seizures presenting to the ED.
• Clinical history of the present illness, rather than seizure characteristics, should guide decisions for further testing, aligning with existing guidelines.