Child Neurology Society's Brainstorm CNS Brainstorm Episode 41 "First Time Seizures" with guest Aaron Nelson, MD, MBS, FAAP, FCNS
May 31, 2025
Aaron Nelson, MD, MBS, FAAP, FCNS, an expert in pediatric neurology and director of epilepsy at Bellevue Hospital, explores critical insights about first-time seizures in children. He breaks down the implications of abnormal neuron firing and common misconceptions surrounding seizures. Nelson discusses the importance of diagnostic evaluations, the balance between treating children and addressing parental concerns, and how rescue medications can be managed. He also highlights the value of seizure monitoring devices and education for families navigating this challenging experience.
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First-Time Seizure Emergency Care
- Treat any first-time seizure as an emergency and evaluate airway, breathing, and circulation promptly.
- Identify and treat underlying causes like stroke, infection, or metabolic disturbances immediately.
Workup for First-Time Seizure
- Check if the seizure has stopped and the child returned to baseline; if not, consider stroke until proven otherwise.
- Use urgent neuroimaging, EEG monitoring, and treat ongoing seizures while evaluating for causes.
Genetic Testing Role
- Consider genetic testing for first-time seizures with syndromic features, genetic epilepsy signs, or concerning neuroimaging.
- Early genetic workup can provide quicker, cost-effective answers to guide diagnosis and treatment.