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From the National Institute of Neurological Disorders and Stroke (Dr. Hirtz), National Institutes of Health, Bethesda, MD; Department of Pediatrics (Dr. Ashwal), Loma Linda University School of Medicine, Loma Linda, CA; Department of Biological Sciences (Dr. Berg), Northern Illinois University, Dekalb; Dr. David Bettis, Boise, ID; Department of Pediatric Neurology (Drs. C. Camfield and P. Camfield), IW Killam Hospital for Children, Halifax, Nova Scotia; Department of Neurology (Dr. Crumrine), Children’s Hospital of Pittsburgh, PA; Dr. Roy Elterman, Dallas, TX; Dr. Sanford Schneider, Riverside, CA; and the Departments of Neurology and Pediatrics (Dr. Shinnar), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Address correspondence and reprint requests to QSS, American Academy of Neurology, 1080 Montreal Avenue, St. Paul, MN 55116; phone: 800-879-1960
OBJECTIVE: The Quality Standards Subcommittee of the American Academy of Neurology develops practice parameters as strategies for patient management based on analysis of evidence. For this practice parameter, the authors reviewed available evidence on evaluation of the first nonfebrile seizure in children in order to make practice recommendations based on this available evidence.
METHODS: Multiple searches revealed relevant literature and each article was reviewed, abstracted, and classified. Recommendations were based on a three-tiered scheme of classification of the evidence.
RESULTS: Routine EEG as part of the diagnostic evaluation was recommended; other studies such as laboratory evaluations and neuroimaging studies were recommended as based on specific clinical circumstances.
CONCLUSIONS: Further studies are needed using large, well-characterized samples and standardized data collection instruments. Collection of data regarding appropriate timing of evaluations would be important.
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