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Fits, Faints and Funny Turns

Checked: 03-06-2025 by Jenny Henry Next Review: 02-06-2027

Overview

Refer to the Fits, Faints and Funny Turns - referral pathway provided by Bristol Royal Hospital for Children. This document is written for use in the emergency setting but also applies to presentations in primary care.

If a cardiac cause is suspected please see the Syncope in Children page.

Red Flags

The following features would indicate more concerning causes or risk of further seizures that require same day referral to the BRHC emergency department via ambulance (taken from BRHC guideline above):

Age: Less than one year of age.
Neurological abnormality: GCS <15 (> 1 hour post seizure), focal deficit, abnormal pupils or posture, suspected infantile spasms(1).
Signs of Raised Intracranial Pressure: Persistent or preceding reduced consciousness, papilloedema, tense fontanelle, high blood pressure, bradycardia, irregular breathing.
Acutely Unwell: Irritable, lethargic, vomiting either preceding or following seizure, signs of meningitis or encephalitis,.
Complicated Seizures: Prolonged (>15 minutes), focal features, recurrent seizures.
Safeguarding concerns: bruising, history of concern.
Past History: high risk birth history, preceding illness, history of headache and/or vomiting, developmental delay, behavioural change or developmental regression, ventricular shunt in situ.

Resources

(1) Epilepsies in children, young people and adults | Guidance | NICE

(2) For medical professionals | UKIST - advice on Infantile spasms.

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