title: Shake, rattle, and roll: an update on pediatric seizures.
abstract: Seizure is a common presenting complaint for patients in the pediatric emergency department (PED) setting. In some cases, protocols are in place on how to manage this group of patients, for example, a patient with a simple febrile seizure already back to baseline or a patient with known epilepsy already back to baseline. However, many scenarios present dilemmas for physicians in the PED, specifically patients with status epilepticus (SE). Unfortunately, there is not a national SE protocol, and hospital-specific guidelines may or may not exist. Current practices are constantly changing because new medications arise, and more information is gathered regarding existing medications and guidelines. Here we will review the basics about first-time afebrile seizures presenting to the PED and common treatments specific to seizure types. We will then review SE management basics and medical therapy, including both older and newer agents and their routes of administration for both the prehospital and the hospital setting.
authors.affiliation: Pediatric Emergency Medicine Fellow (Szlam), *Division of Pediatric Emergency Medicine, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville; and Associate Professor of Pediatrics (Meredith), †University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis. TN.
authors.forename: Sarah
authors.initials: S
authors.lastname: Szlam
authors.forename: Mark
authors.initials: M
authors.lastname: Meredith
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D004635:Emergency Medicine / Q000379:methods*; D004636:Emergency Service, Hospital; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059906:Neuroimaging; D009460:Neurologic Examination; D010808:Physical Examination; D011041:Poisoning / Q000175:diagnosis; D012640:Seizures / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D000927:Anticonvulsants