your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Laboratory studies in child with status epilepticus

Patient population	Studies
All patients	Serum electrolytes
	Serum calcium, phosphate, and magnesium
	Serum glucose and a rapid point-of-care glucose
	Brain imaging (CT or MRI)*
	EEG
Postmenarchal females	Qualitative pregnancy test (urine or blood)
Epilepsy patients maintained on antiseizure medications	Antiseizure medication level
Febrile patients	CBC with differential
	Blood culture
	Urinalysis, urine culture
	CSF culture (once seizures stopped and if brain imaging excludes increased intracranial pressure)
Substance use or poisoning suspected	Serum and urine toxicology screen for drugs of abuse and prescription drugs (eg, tricyclics, antipsychotics)^¶
	Aspirin level
	Venous or arterial pH and pCO₂
	EKG once seizures stop
Infants <6 months of age^Δ	Blood gas
	Plasma ammonia
	Plasma amino acids
	PT, PTT
	Serum AST, ALT, LDH, alkaline phosphatase
	Blood lactate and pyruvate
	Urinalysis
	Urine for reducing substances
	Check newborn urine screening results if infant from country where instituted

CT: computed tomography; MRI: magnetic resonance imaging; EEG: electroencephalogram; CBC: complete blood count; CSF: cerebrospinal fluid; PCP: phencyclidine; pCO₂: partial pressure of carbon dioxide; EKG: electrocardiogram; PT: prothrombin time; PTT: partial thromboplastin time; AST: aspartate aminotransferase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase.
* Neuroimaging is essential when status is the first presentation of epilepsy as well as in children whose recovery does not follow the expected course.
¶ Children with a suspected poisoning and status epilepticus may require more comprehensive toxicology testing of blood and urine for diagnostic or forensic purposes, although these tests are not available in a timely manner and often do not change management. Consultation with a medical toxicologist or regional poison control center is advised to assist with selection of specific tests based upon clinical features and identifying laboratories capable of performing these tests.
Δ Consultation with pediatric neurologist and/or metabolic specialist strongly encouraged. Newborn screening assays are very comprehensive and should detect the vast majority of potentially treatable inborn errors of metabolism; most metabolic disorders are diagnosed genetically.

Graphic 69291 Version 8.0