Abstract. Objectives: Patients with seizure disorders are common in the emergency department (ED), yet little is known regarding the management of these patients. This study was performed to define the frequency of patients with seizure disorders in the ED patient population and to determine possible seizure etiologies, characteristics of diagnostic activities, treatments, and dispositions. Methods: Twelve EDs monitored all patients with a chief complaint related to seizure disorders presenting over 18.25 days (5% of the calender year) in late 1997. Retrospective chart review was used to gather specific data regarding these consecutive cases. Results: Of the 31,508 patients who presented to these 12 EDs during the study period, 368 (1.2%) had complaints related to seizures. Three hundred sixty-two charts were available for analysis and make up the study population. Two hundred fifty-seven (71%) utilized emergency medical services (EMS) for transport and care. Advanced care, including intravenous access, laboratory work, cardiac monitoring, or oxygen administration, was utilized in 304 (84%) patients. Antiepileptic drugs were given in 199 (55%) patients. Ethanol withdrawal or low antiepileptic drug levels were implicated as contributing factors in 177 (49%) of patients. New-onset seizures were thought to be present in 94 (26%) patients. Status epilepticus occurred in only 21 (6%) patients. Ninety-eight (27%) of all patients were admitted to the hospital. Conclusions: Patients with presenting complaints related to seizures are frequent in the ED population and make considerable demands on EMS and ED resources. Six percent of patients with seizure-related presentations were in status epilepticus and more than a fourth of all patients required hospitalization. P ATIENTS with seizures and presenting complaints related to seizure disorders are frequent in the emergency department (ED) population, but little is known of their demands on emergency medical services (EMS) and ED resources. The acuity of problems ranges from status epilepticus to requests for medication refills. Surprisingly, little research has been performed on seizure disorders in the emergency patient population; one study describes this population from the perspective of a single ED. This study was undertaken to determine the frequency of patients with a chief complaint related to seizures at a broad range of institutions and to determine characteristics of clinical care provided, including diagnostic tests, treatment actions, and disposition. Investigators were instructed to cast a wide net to capture all patients with presenting complaints related to seizures or a seizure disorder. The widest spectrum of patient presentations was to be included for study, ranging from active seizures to requests for medication refills. The project was a descriptive study providing a snapshot in time of seizure care in diverse EDs. To the best of our knowledge, this is the only multicenter study to date that attempts to describe the needs of patients with seizures in...

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