What is the role of lab testing in the diagnosis of pediatric first seizure?

Updated: Aug 16, 2018
  • Author: Shelley R Waite, MD; Chief Editor: Amy Kao, MD  more...
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Initial laboratory evaluation of a first seizure can include serum studies for levels of glucose, electrolytes, calcium, and magnesium and for toxicology. The American Academy of Neurology (AAN) recommends that clinicians use their clinical judgment. [5]

While it is not routinely tested, prolactin may help to distinguish seizures from nonepileptic events. [7]

Give particular attention to the laboratory evaluation of the neonate, as glucose and calcium abnormalities can be observed in the first week of life. When a metabolic abnormality is suspected in the neonate, consider a basic metabolic evaluation with serum ammonia, serum lactate and pyruvate, serum for amino acids, and urine for organic acids. Further metabolic studies should be guided by the history, examination, and clinical course.

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