Summary
Definition
History and exam
Key diagnostic factors
- focal neurologic deficits
- focal neurologic symptoms (before or after seizure)
- premonitory sensation or experience (fear, epigastric sensation, déjà vu, jamais vu)
- temporary hemiparesis
- temporary aphasia
- fever, nuchal rigidity, altered mental status
Risk factors
- family history (extended or immediate) of generalized-onset epilepsy
- previous central nervous system (CNS) infection
- head trauma
- prior seizure events or suspected seizure events
- history of substance use
- premature birth
- multiple or complicated febrile seizures
Diagnostic investigations
1st investigations to order
- electroencephalogram (EEG)
- blood glucose
- CBC
- electrolyte panel
- toxicology screen
- head CT
- serum prolactin
- serum creatine kinase (CK)
Treatment algorithm
Contributors
Authors
Assistant Professor
Clinical Neurology
University of California, San Francisco
San Francisco
CA
Disclosures
VRR is an author of a number of references cited in this monograph. He served as a paid consultant for NeuroPace, Inc., manufacturer of the Responsive Neurostimulation (RNS) System.
Associate Professor
Clinical Neurology
University of California, San Francisco
San Francisco
CA
Disclosures
JDH has received research funding and consultancy funds from UCB Inc.
Dr Vikram R. Rao and Dr John D. Hixson would like to gratefully acknowledge Dr Daniel H. Lowenstein, a previous contributor to this topic. DHL declares that he has no competing interests.
Peer reviewers
Chief
Division of Epilepsy and Sleep
Department of Neurology
Brigham and Women's Hospital
Associate Professor of Neurology
Harvard Medical School
Boston
MA
Disclosures
EBB has received speaking fees from ICR Pharma, Novartis, Abbott Laboratories, GlaxoSmithKline, and Pfizer. He has received consulting fees from ICR Pharma, Genzyme, and Spherics, and research funding from UCB Pharma. Unfortunately we have since been made aware that EBB is deceased.
Honorary Clinical Senior Lecturer
University of Glasgow
Institute of Neurological Sciences
Glasgow
UK
Disclosures
Not disclosed.
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