Welcome to the Emergency Medicine Cases Podcast. I'm your host, Dr. Anton Hellman, bringing you Canada's

brightest minds in emergency medicine from EMC Studios in Toronto.

Among the presentations we see in the emergency department, few command the same respect as seizure.

It is in itself both a diagnostic dilemma and, at times, a therapeutic nightmare. On one end of the spectrum,

we see patients all the time with medication noncompliance or simply poorly controlled epilepsy.

We'll find a low valproate level, top them up, follow-up outpatient

neuro, see you later. But hiding in a sea of benign causes are the sinister. There's brain

bleeds, trauma, lethal toxins. Unfortunately, the list goes on and on. There's a reason it's

the very first domino to fall in the dreaded sequence,

seizure, coma, death. And as if seizure wasn't difficult enough to diagnose, it can be nuanced

to manage. Sure, lot self-abort or love an I am dose of Madazalam, but ask anyone who's been down the

Propheaval route, and you're not likely to have forgotten the time they stared down a patient

who just wouldn't stop. Today, we're going to explore the world of seizure in the ED.

With me, I have epilepsy and seizure expert, neurologist and researcher, Dr. Eileen Reed.

So, Dr. Reed, could you just give us a little bit of your professional background?

Hi. So I am a neurologist at the University Health Network based out of the Toronto Western Hospital.

And I am a epileptologist. So in my clinical practice, I primarily

see patients with epilepsy, both in the clinic and in our inpatient epilepsy monitoring unit.

And I also run a basic science lab investigating some of the mechanisms behind certain types of epilepsy, including

post-traumatic epilepsy.

Epileptologist.

That's the first time I've said that word.

...