Emergency Department Admission of Children With Unprovoked Seizure: Recurrence Within 24 Hours

Little is known about acute recurrence of seizures, and children with unprovoked seizure tend to be admitted for observation on the basis of the risk factors known for epilepsy. The purpose of this study is to define the clinical profile of pediatric seizure patients who are likely to be admitted and to analyze the incidence and the risk factors of acute recurrence of seizures in the admitted patients within 24 hours after admission. A retrospective chart review was performed on pediatric patients who arrived to the Schneider Children’s Hospital Emergency Department because of an unprovoked seizure who were not on antiepileptic medication. Fifty-nine percent of children who arrived to the emergency department were admitted. Emergency department physicians tend to admit children with younger age (P < 0.01), multiple seizures (P < 0.001), and children who were treated in the emergency department (P < 0.001). Twenty percent of admitted patients had one or more seizures within 24 hours. Multiple seizures before the emergency department arrival was a significant risk factor for acute recurrence (33%, P < 0.05). Based on our findings that 20% of admitted children had one or more seizures within 24 hours, we think it is justified to admit and observe the children with seizures who are not on antiepileptic medications if the follow-up cannot be ensured.