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5yr old girl is brought to physician 12 hrs after onset of GTCS. she never had similar episodes in the past.girl is otherwise healthy.temp is 37c.physical examination is unremarkable.no evidence that girl had fever at the onset of convulsions.parents fear seizure may damage child brain and may recur.what is the most appropriate next step in management?
a)provide reassurance
b)eeg
c)ct,mri brain
d)admit pt for further evaluation
e)start antiepileptics
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a?
may be follow-up in a few days for evaluation (EEG,etc)
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reassurance
after first seizure,70% child will not experience another seizure episode again.hence extensive lab work and admission is not necessary unless physical examination reveals some focal deficts related to seizure.however majority are idiopathic.two thrids of child may develop second episode but will not have additional seizures.medication given now may reduce the risk for second or third seizure but does not affect long term outcome.hence only reassurance to the child and parents that mostly child will not have seizures.
