Fits - seizures

Summary of changes

Addition: Acute management of seizures and Immediate follow-up after a seizure. ECG in ongoing care

Deletion: Remove advice to give paracetamol in person with fever

Medicines: Addition of levetiracetam as a 2nd line agent if person still fitting after 2 doses of midazolam

Other: Reorganisation of protocol for clarity

Primary references

  1. Children's Health Queensland Hospital and Health Service (2019) Status epilepticus - Emergency management in children, Queensland Paediatric Guidelines, accessed 22 July 2021.

  2. Expert Group for Neurology, version 5 (2019) Acute management of seizures and status epilepticus, Therapeutic Guidelines, accessed 11 January 2022.

  3. Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, Bare M, Bleck T, Dodson WE, Garrity L, Jagoda A, Lowenstein D, Pellock J, Riviello J, Sloan E, Treiman DM. (2016) 'Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society', Epilepsy Currents, 16(1):48-61, doi:10.5698/1535-7597-16.1.48

  4. Neurological Emergencies Treatment Trials: Pediatric Emergency Care Applied Research Network investigators (2020) 'Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial', The Lancet, 395(10231):1217-1224, doi:10.1016/S0140-6736(20)30611-5

  5. Paediatric Emergency Research in the United Kingdom & Ireland (PERUKI) collaborative (2019) 'Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial', The Lancet, 393(10186):2125-2134, doi:10.1016/S0140-6736(19)30724-X

  6. Rosenbloom E, Finkelstein Y, Adams-Webber T and Kozer E (2013) 'Do antipyretics prevent the recurrence of febrile seizures in children? A systematic review of randomized controlled trials and meta-analysis', European Journal of Paediatric Neurology, 17(6):585-8, doi:10.1016/j.ejpn.2013.04.008

  7. Steven C and Schachter MD (2021) Evaluation and management of the first seizure in adults, UpToDate, accessed 11 January 2022.

  8. The Royal Children's Hospital Melbourne (2019) Febrile Seizures, Clinical Practice Guidelines, accessed 22 July 2021.

  9. Zaccara G, Giannasi G, Oggioni R, Rosati E, Tramacere L and Palumbo P (2017) 'Challenges in the treatment of convulsive status epilepticus', Seizure, 47:17-24, doi:10.1016/j.seizure.2017.02.015