Background

• Adults presenting with 1^st 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

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Links/Reference

• CUH Patient info - Seizure
• C. L. Harden et al. Reassessment: Neuroimaging in the emergency patient presenting with seizure (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2007;69:1772-1780