CT in patients presenting with fitting
Immediate noncontrast CT is possibly useful for emergency patients presenting with seizure to guide appropriate acute management especially where there is an abnormal neurologic 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 neurologic examination, predisposing history, or focal seizure onset are predictive of an abnormal CT.
Reference
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
