First-Time Seizure Patients have High Rate of Abnormalities on Emergency Department Performed Brain Computed Tomography: A Prospective Study
Authors: Derek Isenberg, Melissa Gunchenko, Allison Hameier
Journal: Journal of Emergency Medicine
Publication Date: June 21, 2023
Conclusions:
- 11.9% of patients with first-time seizures who presented to the ED had abnormal neuroimaging.
- These results reinforce the existing guidelines which suggest that emergent neuroimaging should be performed for adult patients who present with first-time seizures.
Methods:
- A prospective observational study was conducted.
- Involved patients were those who presented with a seizure complaint to three urban EDs over an 18-month period.
- Abnormal neuroimaging findings were predetermined and categorized into either acute or subacute/chronic categories.
Results:
- Out of 2505 patients presenting with a seizure, 242 (9.7%) had a first-time seizure.
- Drug intoxication and withdrawal were the top reasons for first-time seizures.
- 29 out of 242 patients (11.9%) had abnormal brain CT results.
- 13 (45%) displayed an acute finding.
- 16 (55%) showed a subacute/chronic finding.
- The most frequently observed overall abnormality, as well as the most common chronic anomaly, was ischemic changes.
- The predominant acute findings were traumatic intracranial hemorrhage and intracranial metastases.