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Evaluation and Management of New Onset and Breakthrough Seizures in Adults in the Emergency Department

  • Neurologic Emergencies (J Miller, Section Editor)
  • Published:
Current Emergency and Hospital Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review seeks to inform ED providers about best practices in the evaluation and treatment of new onset seizures in adults as well as those with established seizure diagnosis and breakthrough seizures.

Recent Findings

Current evidence suggests that early EEG has a higher rate of detecting epileptiform activity which is important as it can determine which patients need initiation of AED therapy. Early initiation of AEDs is important because although it does not have a mortality benefit or improve long-term remission it does improve quality of life and number of seizures.

Summary

Appropriate assessment and treatment of new onset and breakthrough seizures are crucial for this common presentation. Successfully ruling out other etiologies and ensuring timely follow-up and EEG/neuroimaging are key decisions ED providers must make in the care of these patients. Given the variability of neurology consultation and follow-up based on location, ED providers must understand and well utilize their available resources to advocate for best care for patients with seizures in their EDs.

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Author information

Authors and Affiliations

  1. Henry Ford Hospital Emergency Medicine Residency, 2799 W. Grand Blvd, CFP 253, Detroit, MI, 48202, USA

    Ross Taylor, Arion Lochner & Reba John

  2. Emergency Medicine/Internal Medicine Residency, Henry Ford Hospital, Detroit, MI, USA

    Daniel Grahf

  3. Residency Program Director/Vice Chair of Education, Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA

    Taher Vohra

  4. Department of Emergency Medicine, Vice Chair of Operations, Henry Ford Hospital, Detroit, MI, USA

    Seth Krupp

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  1. Ross Taylor
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Correspondence to Ross Taylor.

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Ross Taylor, Arion Lochner, Taher Vohra, Daniel Grahf, Reba John, and Seth Krupp declare that they have no conflict of interest.

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Taylor, R., Lochner, A., Grahf, D. et al. Evaluation and Management of New Onset and Breakthrough Seizures in Adults in the Emergency Department. Curr Emerg Hosp Med Rep 10, 99–106 (2022). https://doi.org/10.1007/s40138-022-00253-0

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