ABSTRACT
This chapter presents a case study of a 10-year-old girl who is brought into the Emergency Department resuscitation room following her first generalised tonic-clonic seizure. The patient had a prolonged afebrile seizure. Prolonged convulsive epileptic seizure should be diagnosed if a convulsive seizure with loss of consciousness/responsiveness has persisted for more than 5 minutes, or if there is no awakening between shorter repetitive seizures for the same period of time. The initial management of prolonged seizures is as per the Advanced Paediatric Life Support (APLS) protocol. The airway should be protected either by lying on the child on their side, insertion of an oropharngeal airway or, if the seizure is prolonged, involving an anaesthetist who may consider oro-tracheal intubation. If the seizure is refractory, rapid sequence induction (RSI) with thiopentone and intubation and ventilation will need to be considered. The patient will need to be admitted into a higher dependency unit or intensive care unit.
