OSCE — Seizures in Children · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Seizures in Children.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Seizures affect 5% of children (at least one seizure); epilepsy affects 1%. Febrile seizures are most common (2-5% of children aged 6 months to 5 years). ILAE classification 2017: focal, generalised, unknown onset. Key syndromes: childhood absence (3Hz spike-wave, ethosuximide), juvenile myoclonic (valproate), infantile spasms (ACTH/vigabatrin). Status epilepticus: over 5 min — lorazepam → levetiracetam → phenytoin.

Candidate tasks

Clarify onset, severity, associated features, and red-flag symptoms.
State focused examination priorities.
List first-line investigations and any named score/criteria.
Give immediate resuscitation steps.
Outline definitive management with doses/routes where standard.
Name complications and disposition (ward / HDU / theatre / discharge safety-net).
Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Domain	Pass behaviours
Definition	Correct working diagnosis language
Assessment	Focused, prioritised, red flags sought
Investigations	Appropriate first-line + interpretation
Emergency care	ABC / time-critical actions first
Definitive care	Specific drugs/procedures, not generic phrases
Safety	Recognise severe Seizures in Children
Safety	Escalate unstable patients immediately
Communication	Clear plan and safety-netting

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.