Evaluation and Management of New Onset and Breakthrough Seizures in Adults in the Emergency Department

AbstractPurpose of ReviewThis review seeks to inform ED providers about best practices in the evaluation and treatment of new onset seizures in adults as well as those with established seizure diagnosis and breakthrough seizures.Recent FindingsCurrent evidence suggests that early EEG has a higher rate of detecting epileptiform activity which is important as it can determine which patients need initiation of AED therapy. Early initiation of AEDs is important because although it does not have a mortality benefit or improve long-term remission it does improve quality of life and number of seizures.SummaryAppropriate assessment and treatment of new onset and breakthrough seizures are crucial for this common presentation. Successfully ruling out other etiologies and ensuring timely follow-up and EEG/neuroimaging are key decisions ED providers must make in the care of these patients. Given the variability of neurology consultation and follow-up based on location, ED providers must understand and well utilize their available resources to advocate for best care for patients with seizures in their EDs.
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research