A 6yo girl who has previously been well presented with a hx of tonic-clonic seizures lasting
4mins. Her mother brought her to the hospital and she appeared well. She is afebrile and didn’t
lose consciousness during the episode of seizure. She has no neurologic deficit. What is the most
appropriate inv for her?
a. ABG
b. Serum electrolytes
c. ECG
d. Blood glucose
answer:B
both glucose and electrolytes should be checked but since we can only choose one, well hypoglycemia is more associated with losing consciousness so electrolytes seems more appropriate
Differential Diagnosis of Seizures in Children
• benign febrile seizure
• CNS: infection, tumor, HIE, trauma, hemorrhage
• metabolic: hypoglycemia, hypocalcemia, hyponatremia
• idiopathic epilepsy and epileptic syndromes
• others: neurocutaneous syndromes, AVM, drug ingestions/withdrawal
• seizure mimics
Investigations
• lab tests: CBC, electrolytes, calcium, magnesium, glucose
• toxicology screen if indicated
• EEG
• CT/MRI, if indicated (focal neurological deficit or has not returned to baseline several hours after seizure)
• consider LP if first-time non-febrile seizure
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