Diagnostic Algorithm for the Patient with Seizure in the Emergency Department

Does the history suggest a seizure?

 - Presence of aura

 - Collateral history from witnesses

 - Absence of additional symptoms (eg, palpitations, light-headedness, headache, speech abnormality, etc.)

Consider elements suggesting alternative diagnosis such as:

 - Syncope

 - Stroke

 - Atypical migraine

 - Pseudoseizure

Characterize seizure

 - Onset, aura

 - Duration

 - Partial vs. generalized

 - Postictal state



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