1)      Less than 1 yr

2)      GCS < 15 after 1 hr post fit

3)      Any neurological sign

4)      Papilloedema (RICP)

5)      Tense fontanelle (RICP)

6)      Irritable, disinterested, vomiting (sick child)

7)      Meningism  (Kernig’s positive, photophobia, neck stiffness)

8)      Complex seizure (prolonged > 15 mts), focal, recurrent)

9)      Respiratory distress

10)    High parental anxiety

11)    New onset seizures

12)    First seizure (high possibility of symptomatic etiology )

13)    Mental retardation

14)    Cerebral palsy

15)    Head injury

16)    Rapidly enlarging head circumference

17)    Facial port-wine stain and mental retardation (Sturge Weber syndrome)

18)    Hypoglycemic fits (fits occurring in fasting states – pediatric referral for further evaluation)

19)    Dehydration fits (mainly electrolyte disturbance)

20)    Past meningitis, head injury, subdural effusions (symptomatic epilepsy)

21)    Fever, alteration of consciousness, neurological signs (intracranial infections)