Approach | Possible investigations |
---|---|
Initial screen (for acute symptomatic seizures) | Liver function test Renal function test Calcium and magnesium Glucose Blood cultures Lumbar puncture Urine culture Cranial ultrasound/magnetic resonance imaging |
Possible second-line investigations | Electroencephalography Lactate Acylcarnitines Ammonia Urate Biotinidase Copper, caeruloplasmin and hair analysis Plasma and urine amino acids Urine organic acids Paired cerebrospinal fluid (CSF) and plasma amino acids (includes glycine and serine) Paired CSF and plasma glucose and lactate (if not done already for glucose transporter type 1 deficiency syndrome) Urine alpha aminoadipic semialdehyde (αAASA) (or plasma/CSF pipecolic acid if not available) Urine sulfites Congenital infection screen |