[Neuropediatric emergencies--epileptic seizures and acute hemiplegia]

Abstract

Status epilepticus and stroke are life-threatening neurological emergencies and immediate recognition and medical management are imperativ. There is a serious risk of neurological sequelae. To limit secondary brain damage a prolonged seizure has to be treated without delay. After a short history and clinical evaluation (principles of resuscitation) a benzodiazepine (usually diazepam or lorazepam) has to be administered and in case of persistence of seizure-activity phenytoin or phenobarbital. Blood- and urine-sample must be collected in the acute phase to perform further metabolic or toxic examinations. A paralysis with acute onset is suspicious for ischaemic or haemorrhagic stroke. A precise neurological examination is mandatory for accurate neuroradiological work-up and to initiate appropriate investigations for risk factors. These patients require an immediate interdisciplinary treatment in a tertiary care centre with neuropaediatry, neuroradiology and neurosurgery.