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Children with seizures presenting to accident and emergency
R A Smith1, T Martland, M F Lowry
1Department of Child Health, University of Newcastle upon Tyne.
Insights
Accident and emergency (A&E) departments see many children with seizures, most commonly febrile seizures. Paediatric specialists are crucial for managing diverse pediatric seizure diagnoses in A&E settings.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Clinical Pediatrics
Background:
- Seizures are a common reason for pediatric visits to accident and emergency (A&E) departments.
- Understanding the spectrum of seizure diagnoses in children is vital for appropriate A&E care.
Purpose of the Study:
- To analyze the diagnostic patterns of pediatric seizures presenting to an A&E department.
- To characterize the types of seizures and associated conditions in children attending A&E.
Main Methods:
- Retrospective review of A&E and hospital records for children presenting with seizures over a one-year period.
- Data collection included seizure types, investigations, treatments, and diagnoses.
Main Results:
- 199 children accounted for 254 A&E visits due to seizures (1.2% of pediatric attendances).
- Febrile seizures were the most frequent first seizure type (n=75).
- Symptomatic seizures, including metabolic and neurological causes, were also observed (n=13).
Conclusions:
- Pediatric seizure presentations in A&E differ significantly from adult presentations.
- A&E staff require awareness of the broad range of pediatric seizure issues.
- Availability of experienced pediatric staff is recommended for A&E departments.
Objective:
To analyse the diagnoses made in children presenting to an accident and emergency (A&E) department with seizures.
Methods:
All children who presented to a district general hospital A&E department with seizures over a 1 year period were identified. A retrospective review of A&E and hospital records was performed one year after they were first seen. The types of seizure, investigations performed, treatment given, and the range of associated diagnoses were ascertained.
Results:
199 children (of 21,795 attending A&E in the year) had 254 visits with seizures, which represented 1.2% of the child attendances at A&E. Self referral occurred in 87%, and 52 patients had established epilepsy. Febrile seizures were far the commonest type of first seizure (n = 75), but there were also 13 cases of symptomatic seizures resulting from various metabolic and neurological causes.
Conclusions:
The children studied had a very different spectrum of problems from adults. A&E staff should be aware of the range of problems in children who present with seizures. Experienced paediatric staff should be available to assist all A&E departments where children are seen.