This is Steve Carroll, and you're listening to the EM Basic podcast. Today we'll be talking

about seizures. We see seizures a lot in the ED, so we need to know how to treat them. Today we're

going to be talking about adults with seizures. We won't be talking about febrival seizures and kids,

or seizures caused by trauma, because those are episodes unto themselves. We'll talk about how to initially

evaluate the patient who comes in, who is actively seizing, or has just had a seizure, and we'll also

talk about the topic of pseudo-seizure, since I know this is a confusing topic to say the least.

As always, this podcast doesn't represent the views or opinions of the Department of Defense, the U.S.

Army, or the Fort Hood Post Command. Let's start by talking about patients who have come in who are not

actively seizing, and then we'll talk about those patients who are actively seizing and may be critically

ill, so we get the basics down before we start talking about the critical care. As always,

it's important to read the triage note and look at the vitals. Most of these

patients who are not actively seizing will come in saying that they thought they had a seizure

or someone witnessed them having a seizure. Look for any history of a seizure disorder, any mention

of trauma, and look at the medication list to see if the patient is on any seizure medications.

When you go into the room, assess the patient to make sure they are awake.

Get a good history on exactly what happened.

It is really helpful if the patient is there with a family member or bystander who witnessed the episode,

and you want to involve them in the conversation.

Ask if the patient has had any

symptoms before their seizure, such as headache, vision changes, or any sort of aura. If the patient

has a history of seizures, they will probably have a projome that's familiar to them, so ask about

whether they had this feeling before the seizure started. Find out whether the patient has a

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