Immediate non-contrast CT is possibly useful for emergency patients presenting with seizure to guide appropriate acute management especially where there is an abnormal neurological examination, predisposing history, or focal seizure onset
- For adults with first seizure, cranial CT will change acute management in 9 to 17% of patients
- CT in the ED for children presenting with first seizure will change acute management in 3 to 8%
- There is no clear difference between rates of abnormal emergent CT for patients with chronic seizures vs first
- 50% of Children <6 months presenting with seizures have clinically relevant abnormalities on CT
- Persons with AIDS and first seizure have high rates of abnormalities (CNS toxoplasmosis frequent)
- Abnormal neurological examination, predisposing history, or focal seizure onset are predictive of an abnormal CT.
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