Seizure DDx

Seizure – Differential Diagnosis

Common causes

• Epilepsy
• Febrile convulsions (children)
• Alcoholand drug withdrawal
• Vasovagal syncope
• Non-epileptic seizures

Must Not Miss

• CVA / TIA
• Subarachnoid haemorrhage
• Head Injury
• Subdural haematoma
• Brain tumour
• Meningitis
• Encephalitis
• Brain abscess
• Arrhythmia
• Hypoglycaemia

Easily missed

• Electrolyte disturbance

Red flags

• Signs of Meningitis/Encephalitis
• ‘Thunderclap’ headache
• Focal neurological signs
• History of Malignancy
• Chronic alcoholism
• First ever seizure

Investigations to consider

• FBC, CRP/ESR
• U+Es, LFTs, Bone profile, Serum glucose, Magnesium
• ECG, CXR
• CT/MRI scan
• Lumbar puncture