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Basic Approach

  • Step 1: Describe the seizure
    • Did patient have an aura?
    • Was there loss of consciousness?
    • What did the movements look like?
    • Did they have postictal phase?
    • Did they have a trauma as well?
  • Step 2: Ask about TIME (mnemonic)
    • Tongue biting
      • Usually occurs on the lateral sides of tongue
    • Incontinence
    • Medication changes/adjustments
    • Ethanol use
  • Step 3: Do a FULL neurologic examination
    • Mental Status
    • Cranial nerves
    • Visual fields
    • Speech
    • Cerebellar (finger-nose)
    • Motor
    • Sensation
    • Reflexes
    • Gait
  • Step 4: Testing plan
    • Glucose
    • Pregnancy Test
    • CBC
    • Electrolyte panel
    • Urine drug screen
    • Drug levels of anti-epileptic agents
  • Step 5: Simple seizures (<5 minutes) do not require immediate treatment
    • Roll them on side
    • Suction

Additional Reading