Imaging in patients with a first seizure

Neuroimaging has important applications in the diagnosis and treatment of patients with seizures and epilepsy and can contribute to the proper classification of certain epileptic disorders. When a patient presents to the Accident and Emergency Department with a first seizure, the clinician may request brain imaging to determine the cause of the seizure. In new onset seizures or epilepsy with suspected focal pathology, computed tomography (CT) of the brain should be performed if the patient has not fully recovered or if magnetic resonance imaging (MRI) is not available within a reasonable time period. Otherwise, it is reasonable to forego CT and perform MRI. This report emphasises the need for appropriate imaging for accurate diagnosis of suspected new-onset partial epilepsy.