Pediatric Seizures: Subtle and Often Difficult to Diagnose

Status epilepticus is the most common neurologic emergency in pediatrics with a rate of 18/100,000 cases per year and a mortality of 0–3%.1,2 In a multistate analysis of pediatric EMS transports, seizures were among the 3 most common medical complaints identified.3 Identifying status epilepticus early in the clinical course is important. The longer the seizure persists, the more refractory the seizure becomes which leads to increased morbidity and mortality.4 Given the risk associated with delayed treatment, early identification and treatment is paramount. Pediatric patients present unique challenges in prehospital seizure management. Ongoing seizure activity in the young child is often overlooked or misinterpreted by EMS providers. This can delay treatment for seizure termination. The frequency of pediatric seizure complaints in the prehospital setting exemplifies the need for EMS providers to be keenly aware of the subtle characteristics of pediatric seizures. Clinical Presentation & Assessment Seizures either present in a convulsive or non-convulsive manner. Convulsive seizures commonly present in a generalized tonic-clonic way that’s typically recognized and treated quickly by EMS personnel. Convulsive seizures may also present with unilateral stiffness or shaking. In contrast, non-convulsive seizures may be tricky to identify, especially in the pediatric population. Subtle, non-convulsive seizures may be present more commonly in children. Moreover, the younger th...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Exclusive Articles Patient Care Source Type: news