Spotlight on Research

Emergency medical services are frequently responding to care for younger children suffering from a convulsive disorder, but decision-making can be challenging in the out-of-hospital environment. Decision-making requires the clinician to differentiate between an epileptic and a non-epileptic seizure, but that differentiation in an out-of-hospital setting may be difficult.

An accurate recall of the event is key to determining its nature but parents who have seen their child having a seizure are often terrified and their emotional state can interfere with the memory of the episode. Misleading observations may lead to unnecessary investigations and inappropriate treatment. Recognising that an electroencephalogram (EEG) is useful in hospital but not available in an ambulance, the authors of this paper sought to establish whether an alternative marker may support differentiation between epileptic and non-epileptic seizures. The marker of choice was lactate.

The primary objective was to study the association between the value of capillary lactate measured by a mobile paediatric intensive care unit (MPICU) after a paroxysmal event to differentiate epileptic seizure from febrile seizure and non-epileptic events. The secondary objective was to assess the other factors associated with prehospital capillary lactate concentrations.