consciousness is impaired, can lead to hypoxia, hypercarbia, and respiratory acidosis Patients with impaired consciousness may be unable to protect their airway and are at risk for aspiration Prolonged skeletal muscle activity can lead to lactic acidosis, rhabdomyolysis, hyperkalemia, hyperthermia, and hypoglycemia ETIOLOGY It is important to remember that a seizure does not constitute a diagnosis but is merely a symptom of an underlying pathologic process that requires a thorough investigation ( Table 72.1 ) Often, no underlying condition is identified, and the diagnosis of idiopathic epilepsy is made However, it is important not to exclude potentially treatable causes prematurely For instance, seizures that result from metabolic derangements (e.g., hyponatremia, hypoglycemia) are often refractory to anticonvulsant therapy until the abnormality is corrected Therefore, rapid point-of-care testing for glucose and sodium are recommended for pediatric status Furthermore, every effort should be made to rule out a potentially lifethreatening cause of seizures (e.g., intracranial injury or hemorrhage, meningitis, ingestions) before a less serious diagnosis is accepted