Acute Convulsive Seizures: When is It Too Early to Treat?

Acute convulsive seizures are overwhelming events that require immediate attention from clinicians and practitioners, especially when witnessed in a hospital setting. Adequate management of inpatient-witnessed seizures lies in understanding the time-related pathophysiologic stages of the seizure. The anatomical location of the seizure origin is as important as seizure stage but might not be easy to determine in the acute setting, especially if the seizure is nonfocal. Although investigating and treating the cause of a seizure has high priority, understanding the interplay between the pathophysiologic responses and the various bodily responses are crucial in treatment. This interplay has interesting dynamics that change within minutes. Knowing such dynamics allows clinicians and practitioners to choose their best treatment options in the best time interval when a seizure occurs in an acute care facility. Our commentary provides an overview of such dynamics and how they can change the misconceptions that many clinicians and practitioners have in dealing with an acute convulsive seizure.