Do we need labs or a head CT after simple febrile or unprovoked seizures?

What this episode covers

<br /> Labs or CT scans are not necessary to provide additional diagnostic information or reassurance for most children who recover completely following simple febrile seizures or unprovoked first time generalized seizures. The rate of abnormalities on these studies is very low, and the cost and downsides are too high to justify ordering them on a regular basis.<br /> <br /> <br /> <br /> This podcast episode is designed to disseminate the important work of Choosing Wisely, an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not.<br /> <br /> <br /> <br /> The Choosing Wisely recommendation: Do not order laboratory testing or a CT scan of the head for a patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status<br /> <br /> <br /> <br /> <a href="Medicinehttps://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWEmergencyMedicine.pdf" data-type="link" data-id="Medicinehttps://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWEmergencyMedicine.pdf">The Choosing Wisely Pediatric Emergency Medicine Recommendations</a><br /> <br /> <br /> <br /> <a href="https://www.aap.org/en/news-room/campaigns-and-toolkits/choosing-wisely/" data-type="link" data-id="https://www.aap.org/en/news-room/campaigns-and-toolkits/choosing-wisely/">The Choosing Wisely Campaign Toolkit</a><br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a rel="noreferrer noopener" href="http://www.pwmblog.com" target="_blank">PEMBlog</a><br /> <br /> <br /> <br /> <a href="http://twitter.com/PEMTweets">@PEMTweets on&#8230; sigh &#8220;X&#8221; (Twitter)</a><br /> <br /> <br /> <br /> <a href="https://www.instagram.com/bradsobolewski/" target="_blank" rel="noreferrer noopener">My Instagram</a><br /> <br /> <br /> <br /> <a rel="noreferrer noopener" href="https://med-mastodon.com/@bradsobo" target="_blank">My Mastodon account @bradsobo</a><br /> <br /> <br /> <br /> References<br /> <br /> <br /> <br /> American Academy of Pediatrics, Subcommittee on Febrile Seizures. Neurodiagnostic evaluation of the children with a simple febrile seizure. Pediatrics. 2011;127(2):389-394. DOI: <a href="https://doi.org/10.1542/peds.2010-3318">https://doi.org/10.1542/peds.2010-3318</a><br /> <br /> <br /> <br /> Brugman J, Solomons RS, Lombard C, Redfern A, Du Plessis AM. Risk-Stratification of Children Presenting to Ambulatory Paediatrics with First-Onset Seizures: Should We Order an Urgent CT Brain?. J Trop Pediatr. 2020;66(3):299-314. doi:10.1093/tropej/fmz071<br /> <br /> <br /> <br /> Expert Panel on Pediatric Imaging, Trofimova A, Milla SS, et al. ACR Appropriateness Criteria® Seizures-Child. J Am Coll Radiol. 2021;18(5S):S199-S211. doi:10.1016/j.jacr.2021.02.020<br /> <br /> <br /> <br /> Fine A, Wirrell EC. Seizures in Children. Pediatr Rev. 2020;41(7):321-347. doi:10.1542/pir.2019-0134<br /> <br /> <br /> <br /> Hirtz D, Ashwal S, Berg A, et al. Practice parameter: Evaluating a first nonfebrile seizure in children. Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society. Neurology. 2000; 55(5):616-623. Reaffirmed October 17, 2020<br /> &lt