The second step in management is to exclude a serious underlying cause such as meningitis.
This can usually be achieved by clinical assessment, with the proviso that the characteristic features of meningitis may not be present in children under 18 months of age and may be masked in those who have received antibiotics.
Treatment with meningitic doses of an appropriate antibiotic and acyclovir should be instituted when there is concern that the seizure may be due to meningitis or encephalitis.