Peds neuro question

[cbrons]

Was listening to a podcast on peds E.M. and the author stated something to the effect of "all new-onset pediatric seizure requires an EKG." Do you agree with this statement? I could have heard him wrong of course, I was playing video games at the time.

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[Stitch]

Not an EEG? It's not part of my routine work up for new onset seizures if there's a good history/story to go with it (and often parents come in with video). If people have evidence that an EKG is helpful in this scenario, I'm happy to consider it.

 

[cbrons]

Not an EEG? It's not part of my routine work up for new onset seizures if there's a good history/story to go with it (and often parents come in with video). If people have evidence that an EKG is helpful in this scenario, I'm happy to consider it.

Stitch, this is the podcast in which I heard this: http://www.pemed.org/blog/2014/12/21/pediatric-syncope-dfo-done-fell-out

 

[BigRedBeta]

In the midst of a podcast about syncope, I think you're getting into a very different set of "seizures". It's not uncommon for syncope to have convulsions with it, or for the descriptions of bystanders to call the event a seizure. The workup for syncope should include an EKG, and so in an age group where syncope is more common diagnosis, I agree with the statement. In infants and toddlers where new onset convulsions are actually seizures, it's less of a necessity.

We as pediatricians probably underorder EKG's in general and would be better off if we got them more often.

 

[Rutgers06]

At my hospital, we do EKGs for first time afebrile seizures because one of the causes for a seizure could be long QT syndrome.