Seizure presenting to the emergency department, Srinagarind Hospital
Tiamkao, S.; Sawanyawisuth, K.; Paowana, W.; Saengsuwan, J.; Arunpongpaisal, S.; Chaiyakum, A.; Phuttharak, W.; Aaauevitchayapat, N.; Vannaprasaht, S.; Tiamkao, S.; Phunikhom, K.; Jitpimolmard, S.
Journal of the Medical Association of Thailand 89(3): 362-367
2006
ISSN/ISBN: 0125-2208 PMID: 16696421 Document Number: 2505
The authors would like to evaluate the incidence, clinical manifestation, the appropriateness of treatment, and outcome of seizure at the emergency department (ED). All charts of patients who visited the ED of Srinagarind Hospital from I January 2003 to 31 December 2003 were reviewed The profiles of patients and management at the ED were recorded There were 33,508 cases who visited the ED with 104 cases (0. 31 %) presenting with seizure. Four cases (3.9%) were diagnosed as status epilepticus. Generalized tonic-clonic seizure was the most common type. Poor antiepileptic drug (AED) compliance with the low AED level was the main precipitating factor The normal physical examination and routine laboratory tests were normal in the majority of patients. Phenytoin intravenous loading was the commonest initial treatment even inpatients with non-status epilepticus. Fourteen patients (13.5%)were treated with intravenous diazepam even though seizures were discontinued Sixty patients (57.7%) were discharged after seizure was controlled The advice in seizure control was recorded in only 11 cases (10.6%). From this review, 12 patients presented at the ED for continuing medication without any seizures. In conclusion, seizure at the ED should he treated more appropriately with both laboratory investigation and drug treatment. Furthermore, patient education should be implemented.
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