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Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!

You are seeing a child who has had a self-resolving 5 minute generalized tonic-clonic seizure for the first time. The patient is afebrile, previously healthy, and has a normal non-focal neurologic exam. There is no evidence on your evaluation of another cause for the seizure, such as meningitis or a toxicological cause. There is no associated headache or vomiting. Family history if non-contributory. MRI is unavailable from the ED.

1st time afebrile generalized seizure: do you CT?

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