- Practice parameter endorsed by the AAP states that there is insufficient
evidence to support routine neuroimaging, laboratory studies or lumbar
puncture of all patients with new-onset afebrile seizures. These studies
were recommended based on specific clinical circumstances.2
- Current costs of evaluating a child is > $3,000 per child. More
judicial use of neuroimaging and laboratory studies could reduce the
cost of a basic ER visit to about $800.3
- Other studies have come to the same conclusion that emergent neuroimaging
is rarely indicated.4,5
S, Riviello JJ, Baskin MN. The role of emergent neuroimaging in children
with new-onset afebrile seizures. Pediatrics 2003; 111:1-5.
Parameter: evaluating a first nonfebrile seizure in children. Report
on the Quality Standards Subcommittee of the American Academy of Neurology,
the Child Neurology Society, and the American Epilepsy Society. Neurology
JM. Commentary: Less testing is needed in the emergency room after a
first afebrile seizure. Pediatrics 2003;111:194-6.
N, Gieron-Korthals M, Weibley RE, Panzarino V. New onset childhood seizures.
Emergency department experience. J Fla Med Assoc 1992;79:697-700.
J, Krauss JM, Novak G, et al. The role of brain computed tomography
in evaluating children with new onset of seizures in the emergency department.
Epilepsia 2000;41: 950-4.