A common definition of a seizure is a transient, involuntary alteration of consciousness, behavior, motor activity, sensation, or autonomic function. A postictal period, often described as decreased responsiveness, usually follows most seizures. Epilepsy is a condition of recurrent seizures. Status epilepticus refers to continuous or recurrent seizure activity lasting >30 minutes without recovery of consciousness.

A seizure can have many possible causes, often due to an underlying pathologic process. Determining the cause will assist with making treatment decisions. Categories of diagnoses include infectious, neurologic, metabolic including electrolyte or glucose disturbances, traumatic, toxicologic, oncologic, or idiopathic. Obtaining a detailed history, including a description of the seizure will assist with making the diagnosis. Precipitating factors such as trauma, ingestion, fever, or signs of systemic illness should also be elucidated.

Regardless of a seizure’s cause, the acute management remains the same. Initial management should always include assessment of the ABCs: stabilization of the airway, breathing, and circulation, and then stopping the seizure. Most patients do require some type of pharmacologic intervention to stop the seizure.