Demographic patterns, acute management, and outcomes of paediatric seizures presenting to the emergency department: a retrospective study

Abstract

Background: Seizures are among the most common neurological emergencies in paediatric emergency departments (EDs). Presentations range from benign febrile seizures to life-threatening status epilepticus, requiring rapid assessment and evidence-based management.

Methods: It was a retrospective case series that used a group of 40 pediatric patients who came to the ED with seizures. The information gathered was the age, sex, the type of seizure, its duration, related fever, laboratory and neuroimaging results, management, disposal and short-term outcome. In known epilepsy, seizures were categorized as simple febrile, complex febrile, focal epilepsy, generalized afebrile seizures, status epilepticus or breakthrough seizures.

Results: 50% of the patients were non adults (less than five years old) and the percentage of males was higher (57.5%). The percentage of febrile seizures (simple 32.5, complex 15%) was 47.5. The proportion of focal epilepsy was 22.5, generalized afebrile seizures 17.5, status epilepticus 7.5 and single unprovoked seizures 5. Structural abnormalities were detected in the neuroimaging of select cases of focal epilepsy. 27.5% percent of the patients needed to be admitted to the hospital, and 7.5 percent needed Paediatric Intensive Care Unit (PICU) services. Patients showed positive neurological outcomes at all-time discharge.

Conclusions: The range of clinical manifestations of pediatric seizures in the ED is wide, and febrile seizures prevail among younger children. Evidence-based diagnostic and management practices can be achieved on adherence and appropriate resource utilization and positive short-term results. Further focus on the standardized care pathways and parental education is necessary to achieve maximum optimization of pediatric seizure management in the emergency care setting.