Approach to managing acute seizures in palliative care

Management of acute seizures in patients with palliative care needs depends on the cause and type of seizure, potential benefits and burdens of investigations and treatment, and the patient’s prognosis, preferences and goals of care—see Emergencies in palliative care.

Most seizures are brief (1 to 3 minutes) and do not require drug therapy. Management involves:

• giving supportive care—position the patient on their side, protect their airway and maintain oxygenation
• identifying the cause and managing as appropriate—this will often resolve the seizure.

If a seizure lasts longer than 5 minutes, or the patient has repeated seizures without full cognitive recovery between attacks, start drug treatment as for status epilepticus.