ABSTRACT
History Tom is a 4-year-old child known to have epilepsy. He is admitted to the resuscitation room in the emergency department (ED) with a fit. He was born at 26 weeks’ gestation and had a periventricular haemorrhage that has led to moderate learning difficulties. He has had a runny nose, cough and fever in the past few days. The coughing sometimes leads to vomiting and his mother states that he has vomited up several of his drug doses in the past few days. He is on sodium valproate and lamotrigine. He has had previous admissions with fits, but his mother says this is his longest fit. She has already administered buccal midazolam at home with no effect. No one in the family has had cold sores in the past few weeks.
