Pediatric Hospital Medicine

12

Part I • Neurology

TABLE 2.3 DIAGNOSTIC STUDIES ( continued )

PROCEDURE

TYPE OF TESTING PURPOSE OF TEST

CONSIDERATIONS

LP

• Consider in all children with new-onset seizures in the

• Neuroimaging to exclude a space occupying lesion should be performed prior to LP in children with seizure and new neurologic deficits.

setting of fever, especially before 6 mo of age. children with prolonged febrile seizure, new neurologic deficits.

• Perform in

CT, computed tomography; EEG, electroencephalogram; ER, emergency room; LP, lumbar puncture; MRI, magnetic resonance imaging.

TABLE 2.4 DO’S AND DON’TS FOR EVALUATION OF AN UNPROVOKED SEIZURE DIAGNOSTIC STUDIES TREATMENT DO DON’T DO DON’T • EEG for any child with a first-time un provoked seizure • Consider LP for a child with new-onset seizures in the set • Head CT • Brain MRI • Laboratory testing • LP in sim ple febrile seizure • Counseling for seizure safety to parents and families • Refer to Pedi atric Neurology for ongoing management.

• Empirically start anti epileptic

medications.

ting of a fever, espe cially those < 6 mo of age or a prolonged seizure.

CT, computed tomography; EEG, electroencephalogram; LP, lumbar puncture; MRI, magnetic resonance imaging.

■ REFERENCES 1. Kiriakopoulos E. Understanding seizures. Epilepsy Foundation. Published October 1, 2019. Accessed January 10, 2023. https://www.epilepsy.com/what-is-epilepsy/under standing-seizures#Is-this-epilepsy? 2. Asadi-Pooya AA, Farazdaghi M. Aura: epilepsy vs. functional (psychogenic) seizures. Seizure . 2021;88:53-55. 3. Wirrel E. A brief guide to diagnosis and management of new-onset, unprovoked seizures in children. Epilepsy Foundation. Reviewed March 19, 2014. Accessed January10,2023.https://www.epilepsy.com/stories/brief-g​ uide-d​ iagnosis-a​ nd-management- new-onset-unprovoked-seizures-children

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