Article Text

Download PDFPDF
  1. Amy Edwards,
  2. Kevin Percival,
  3. Louisa Zouita,
  4. Jan Arevalo,
  5. John Philip O'Dwyer
  1. Frimley Park Hospital


Introduction Seizures represent 3% of all emergency department attendances.

Methods A list of all possible seizure mimics was generated from ED computerized triage systems from 1/1/12 to 31/12/13. Data was extracted manually from review of ED notes and analyzed.

Results 905 seizure attendances by 636 patients were examined over 2 years. 340 men and 296 women accounted for them, with average age 33±28 years. 245 patients had a history of epilepsy and were taking at least one AED. >2 AEDs were used by 32 patients. 22 had known Non-Epileptic Attacks (NEAD). Convulsive seizures occurred in 429 and Status Epilepticus in 13. The mode for the number of convulsive events in ED was 2 for NEAD patients and 1 for others. Lactate and neutrophils in NEAD were 1.3±0.3 mM and 4.4±1.2×10^9/L respectively. In other patients with convulsive seizures, they were 3.2 ±3.2 mM (median 2.1) and 6.6±3.1×10^9/L (median 6.1). 73 had neuroimaging acutely. Few patients with NEAD were admitted. 1/3 of convulsive seizures were admitted.

Conclusion This retrospective service audit indicates the burden of epilepsy attendance in a busy hospital. There is a potential role for more acute neurology input to prevent unnecessary admissions, and a pathway for non-epileptic attack sufferers.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.