Seizures (paediatric)

SJH Emergency Medicine
NHS Lothian

Convulsions are common in childhood. Many are brief and self-limiting but prolonged convulsions are potentially dangerous.

Many children with a simple seizure can be discharged. – but discuss with senior ED staff or paediatric registrar. Remember that febrile convulsions are often benign but the cause (i.e. the source of the temperature) may not be. For those that are not associated with a fever, follow up should be arranged with the paediatric team.

Status epilepticus

Follow the paediatric protocol for prolonged seizures.

General comments

  • The paediatric staff should be involved as soon as possible in the management of ALL fitting children or any child who has had a fit.
  • Beware of hypoglycaemia as a cause of convulsions.
  • Beware of respiratory depression especially when multiple agents have been used. Many children become apnoeic either as a result of their seizure or its treatment. Always ensure you know whether the parents, GP or ambulance crew have given treatment before arrival in ED to avoid overdosing with benzodiazepine.
  • Sometimes it is difficult to decide if a child is asleep after the treatment has taken effect, or still fitting. If tone is increased or eyes are deviated and rolled up, the child may still be fitting. Get senior advice.
  • Prolonged convulsions may cause cerebral oedema

Editorial Information

Last reviewed: 23/08/2024

Next review date: 23/08/2026

Author(s): Alexis Leal.

Reviewer name(s): Alexis Leal, Deepankar Datta.