title: Infant seizures not so infantile: first-time seizures in children under six months of age presenting to the ED.
abstract: Data regarding first-time seizures in children <or=6 months of age is limited. This retrospective study, therefore, reviews the presentation, management, and outcome of children <or=6 months of age presenting to a pediatric tertiary care facility with a first-time seizure. Charts for 31 patients were identified and reviewed. Nineteen patients (61%) received sepsis work-ups. Two of the 31 (7%) had infectious etiologies. One of these infants, a 3-month-old who presented with only a history of fever and eyes rolling back but otherwise appeared well on initial presentation, had pneumococcal meningitis. Neuroimaging studies were performed in 22 (71%) patients with 12 of 22 (54%) having abnormal findings. Electroencephalogram (EEGs) were performed on 22 patients (71%) with 11 (50%) showing seizure activity. Electrolytes were checked on 19 patients (61%) with 5 being clinically significant. Etiologies included idiopathic (32%), congenital anomalies (26%), inborn errors of metabolism (16%), electrolyte abnormalities (16%), infection (7%), and trauma (3%). In conclusion, unlike children >6 months of age in whom febrile seizures and idiopathic seizure disorders are most common, a large percentage of children <or=6 months of age presenting with first-time seizures have significant underlying pathology. This pathology often includes immediately life-threatening conditions in these children who may look deceptively well on initial evaluation.
mesh_terms: D001772:Blood Cell Count; D004569:Electroencephalography; D004573:Electrolytes / Q000097:blood; D004636:Emergency Service, Hospital; D006257:Head / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D011859:Radiography; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood / Q000209:etiology / Q000628:therapy; D013577:Syndrome; D013997:Time Factors
chemical_list: D004573:Electrolytes