Abstract

PINOL-RIPOLL, G. et al. Characteristics and management of epileptic seizures in emergency department snd diagnostic correlation at discharge. An. Med. Interna (Madrid) [online]. 2008, vol.25, n.4, pp.168-172. ISSN 0212-7199.

Background: Patients with seizures are common in the emergency department (ED), yet little is known regarding the management of these patients. This study was performed to define the demographic characteristics of patients with seizure disorders in the ED patient population and to determine final disposition, diagnostic and therapeutic activities, and to evaluate the concordance between provisional and definitive diagnosis. Material and methods: We recorded prospectively all patients which were diagnosed of seizure in ED of Hospital Clínico of Zaragoza between November 1^th and April 30^th. Chart review was used to gather definitive diagnosis regarding these patients. Results: Of the 54,022 patients who presented to the ED during the study period, 137 (0.36%) had complains related to seizures. Sixty one (44%) of these patients were admitted to the hospital. New-onset seizures were thought to be present in 60% of patients. Blood work was abnormal in 12% of patients and 48% of patients had pathological findings in neuroimaging study. False positive diagnosis was present in 33% of patients. The most important trigger of seizures in epileptic patients was tapped suddenly the antiepileptic drug treatment. Conclusions: We found a false positive diagnosis in 33% of patients, and the most important confounding pathology was sincope and stroke. High percentaje of pathological findings in neuroimaging studies were found. Electroencefalographic and toxicological studies were performed less than is recommended.

Keywords : Diagnosis; Epilepsy; Emergency room care; Neurological examination.

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