Brain CT Findings in Patients with First-Onset Seizure Visiting the Emergency Department in Mashhad, Iran

Regarding the complications and costs of CT imaging for patients, this study aimed at investigating the necessity of CT scans in patients visiting the emergency unit with first-onset seizure.

One hundred patients who had experienced their first seizure were enrolled. Their CT scan was studied, and based on the radiology report, the type of probable pathologies and their percentage were determined.

The patient's mean age was 39.78±17.43 yrs. CT scan abnormalities were reported in 27 cases as follows: nonspecific senile changes in 11 (40.7%), encephalomalacia in 3 (11.1%), acute infarct in 5 (18.5%), lacunar infarct in 3 (11.1%), mass-like lesion in 4 (14.8%) and cerebral venous thrombosis (CVT) evidence in 1 (3.7%). Acute infarct and mass-like lesions were seen together in the CT scan of one patient. In only 9 of the 27 abnormal CT scans, the findings were in accordance with seizure consisting of an acute infarct, mass-like lesion, and CVT evidence.

It seems that performing a CT scan in all patients referring to the emergency department with a first-onset seizure is not necessary.