•Vital signs, emergency history and emergency physical examination, including

•Glasgow coma scale

•Signs of cerebral herniation (breathing pattern, elevated blood pressure, bradycardia, pupillary size and reactivity, extraocular movements, response of patient to verbal or physical stimuli) and of increased intracranial pressure (often subacute and nonspecific signs, fatigue, personality changes, intermittent headache, nausea, vomiting, abducens paresis)

•If signs of increased intracranial pressures are present, consider CT scan or MRI before lumbar puncture

•Laboratory analysis: blood gas analysis, complete blood count with differential count.

•Parameters of hemostasis (PT, aPTT, TT, fibrinogen), D-dimers, electrolytes, glucose, kidney and liver function tests, C-reactive protein (CRP)

•Radiology: CT scan or MRI

•EEG

18.13.3Treatment

•Life-saving measures. Stabilization of blood pressure, oxygenation, specific therapy in collaboration with oncology and intensive care experts

18.14Seizures

•Symptoms: focal seizures, generalized seizures according to primary disorder

•Laboratory analysis: complete blood count with differential count, electrolytes, glucose, kidney and liver function tests, CRP

•Radiology: CT scan or MRI of head

•EEG

18.14.3Treatment

•In collaboration with neurologist: anticonvulsive therapy: diazepam, chlorazepam, phenobarbital, phenytoin, and others

•Specific therapy of primary disorder after consultation with oncology, neurosurgery, and other departments