Further Work-Up in the Acute Care Setting is Not Indicated: Resources

Brugman, J., Solomons, R. S., Lombard, C., Redfern, A., Du Plessis, A. M. (2020). Risk-stratification of children presenting to ambulatory paediatrics with first-onset seizures: Should we order an urgent CT brain? Journal of Tropical Pediatrics, 66(3), 299-314. https://doi.org/10.1093/tropej/fmz071

Hirtz, D., Ashwal, S., Berg, A., Bettis, D., Camfield, C., Camfield, P., Crumrine, P., Elterman, R., Schneider, S., & Shinnar, S. (2000). Practice parameter: Evaluating a first nonfebrile seizure in children: Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology, 55(5), 616-623. https://doi.org/10.1212/WNL.55.5.616

Lateef, T. M., Tsuchida, T. N., Chang, T., Johnson, J., Gaillard, W. D., & Nelson, K. B. (2008). Diagnostic value of lumbar puncture in afebrile infants with suspected new-onset seizure. Journal of Pediatrics, 153(1), 140-142. https://doi.org/10/1016/j.jpeds.2008.02.030

Michelson, K. A., Lyons, T. W., Johnson, K. B., Nigrovic, L. E., Harper, M. B., & Kimia, A. A. (2017). Utility of lumbar puncture in children presenting with status epilepticus. Pediatric Emergency Care, 33(8), 544-547. https://doi.org/10.1097/PED.0000000000001225

Strobel, A. M., Gill, V. S., Witting, M. D., & Teshome, G. (2015). Emergent diagnostic testing for pediatric nonfebrile seizures, American Journal of Emergency Medicine, 33(9), 1261-1264. https://dx.doi.org/10.1016/j.ajem.2015.06.004

Trofimova, A., Milla, S. S., Ryan, M. E. Pruthi, S., Blount, J. P., Desai, N. K., Glenn, O. A., Islam, M. P., Kadom, N., Mirsky, D. M., Myseros, J. S., Partap, S., Radhakrishnan, R., Rose, E., Soares, B. P., Trout, A. T., Udayasankar, U. K., Whitehead, M. T., & Karmazyn, B. (2021). ACR appropriateness criteria^® seizures-child, Journal of the American College of Radiology: JACR, 18(5S), S199-S211. https://doi.org/10.1016/j.jacr.2021.02.020 

Veerapandiyan, A., Aravindhan, A., Takahashi, J. H., Segal, D., Pecor, K., & Ming, X. (2018). Use of head computed tomography (CT) in the pediatric emergency department in evaluation of children with new-onset afebrile seizure. Journal of Child Neurology, 33(11), 708-712. https://doi.org/10.1177/0883073818786086

Zuccarelli, B. D., & Hall, A. S. (2016). Utility of obtaining a serum basic metabolic panel in the setting of a first-time nonfebrile seizure. Clinical Pediatrics, 55(7), 650-653. https://doi.org/10.1177/0009922815627422

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.