CT in patients presenting with seizures


  • Adults presenting with 1st uncomplicated (full recovery, no neuro signs) seizure should be admitted to CDU for further workup
  • Adults presenting with first uncomplicated seizure do NOT require CT brain unless long term alcohol Hx
  • Adults with a first complicated (neuro. signs or not fully recovered) seizure should be admitted under the on-call medical team (they will always request a CT Brain anyway)
  • For adults with first seizure, cranial CT will change acute management in 9 to 17% of patients
  • In children presenting with first seizure, CT brain will change acute management in 3 to 8%
  • However, 50% of Children <6 months presenting with seizures have clinically relevant abnormalities on CT
  • Persons with immunodeficiency and first seizure have high rates of abnormalities (CNS toxoplasmosis frequent in AIDS)
  • Abnormal neurological examination, predisposing history, or focal seizure onset are predictive of an abnormal CT

Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 30/03/24 .