Background
Children 2-16 years of age presenting to the Children's ED with their first afebrile generalised tonic-clonic seizure may be eligible for discharge from ED to the first seizure clinic if they meet certain criteria.
Inclusion criteria:
- 2yrs -16yrs only
- 1st afebrile generalised tonic clonic seizure
Exclusion criteria:
- If abnormal development / ASD
- If neurological deficits or concerns (e.g. increasing headaches) are identified
- If unable to tolerate MRI brain without sedation or GA
Please refer children meeting exclusion criteria to the on-call paediatric registrar.
Prior to discharge please ensure:
- Baseline bloods including U&E and glucose
- Thorough neurological examination
- ECG
- Provide first seizure leaflet
- If first seizure required midazolam to abate – please prescribe appropriate dose buccal midazolam and provide basic seizure safety and buccal midazolam administration education
- Referral form to Paediatric First Seizure Clinic completed, sent by internal mail to the Paediatric Epilepsy CNS office (who will notify Paediatric Consultant of referral via email).