Are laboratory workup really needed on management of pediatric seizures at emergency rooms?

Abstract

This study was carried out to determine the value of workup done at emergency departments (EDs) on the management 
of pediatric seizures. We retrospectively reviewed all patients with seizures admitted to Ege University's Childrens 
Hospital's ED between March and December 2008. All demographic findings, seizure characteristics and laboratory 
workup were recorded. Eighty-three children were eligible. The mean age was 5.5±4.6 years; majority seizures (83%) 
lasted less than 10 minutes of which 66% were afebrile. Although, most patients had blood workup (92%), cranial 
computerized tomography scan or electroencephalogram was carried out in only five patients. Metabolic abnormalities 
were detected in 25 patients. The frequency of metabolic abnormalities was significantly higher in patients under two 
years of age (53.4% vs 24.4%) (p=0.02). No seizures occurred due to metabolic abnormalities. CT scans and EEG were 
abnormal in a patient with tuberosclerosis. Six patients were hospitalized. Altghough, blood workup, CT scans and 
EEGs are frequently obtained in patients with seizures at EDs, they have a limited value on management. Our results 
showed that extensive workup may be helpful in selected patients, i.e those younger than two years of age, that have 
either focal seizures or seizures lasting longer than 10 minutes.