International Journal of Medical Advances and Discoveries

Full Length Research Paper

Are laboratory workup really needed on management of pediatric seizures at emergency rooms?

¹E Ulas SAZ, ²Tugcin Bora Polat and ³Sarenur Gokben

¹Pediatric Emergency Department, Ege University School of Medicine, 35100 Bornova,Izmir, TR

²Pediatric Cardiology Department, Yuksek Ihtisas Training and Research Hospital, Ankara,TR

³Pediatric Neurology Department, Ege University School of Medicine, 35100 Bornova, Izmir, TR

Accepted 03 April, 2012

Abstract

This study was carried out to determine the value of workup done at emergency departments (EDs) on the management of pediatric seizures. We retrospectively reviewed all patients with seizures admitted to Ege University's Childrens Hospital's ED between March and December 2008. All demographic findings, seizure characteristics and laboratory workup were recorded. Eighty-three children were eligible. The mean age was 5.5±4.6 years; majority seizures (83%) lasted less than 10 minutes of which 66% were afebrile. Although, most patients had blood workup (92%), cranial computerized tomography scan or electroencephalogram was carried out in only five patients. Metabolic abnormalities were detected in 25 patients. The frequency of metabolic abnormalities was significantly higher in patients under two years of age (53.4% vs 24.4%) (p=0.02). No seizures occurred due to metabolic abnormalities. CT scans and EEG were abnormal in a patient with tuberosclerosis. Six patients were hospitalized. Altghough, blood workup, CT scans and EEGs are frequently obtained in patients with seizures at EDs, they have a limited value on management. Our results showed that extensive workup may be helpful in selected patients, i.e those younger than two years of age, that have either focal seizures or seizures lasting longer than 10 minutes.

Keywords: Seizure, children, workup, emergency department.