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Arrange Follow-up

While 75% of otherwise healthy, typically developing children with a first-time nonfebrile seizure will not experience recurrence, 25% of these children may experience another nonfebrile seizure.  As such, we recommend all children be referred for outpatient routine EEG to evaluate for an underlying seizure tendency.  If the EEG returns abnormal, the child is at a higher risk for seizure recurrence and the family should be counseled regarding antiepileptic therapy.  The child may follow-up with their pediatrician if the EEG is normal.  Because seizures are common, occurring in 1 in 10 individuals, while epilepsy is much less common, occurring in 1 in 100 individuals, automatic follow-up with a subspecialist, a pediatric neurologist, is not necessarily warranted, particularly if the EEG is normal.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.