Seizures - generalised tonic–clonic
Red flags
- Seizure lasting >5 minutes or repeated without recovery -> status epilepticus, treat immediately
- Failure to regain baseline consciousness within ~20-30 minutes -> consider non-convulsive status
- First seizure with focal neurological signs, papilloedema, or new headache -> structural lesion
- First seizure in pregnancy with hypertension/proteinuria -> eclampsia
- Fever with meningism or reduced consciousness -> CNS infection
- Seizure with cardiac chest pain/arrhythmia preceding -> consider convulsive syncope, not epilepsy
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