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Related Experiment Videos

Seizure patient selection for emergency computed tomography

W R Reinus1, F J Wippold, K K Erickson

  • 1Department of Radiology, Jewish Hospital, St Louis, Missouri.

Annals of Emergency Medicine
|August 1, 1993
PubMed
Summary

Emergency noncontrast cranial computed tomography (CT) is most beneficial for seizure patients with an abnormal neurologic exam or a history of malignancy. These factors strongly correlate with CT findings, guiding diagnostic decisions.

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Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • Seizures are a common emergency department complaint.
  • The utility of noncontrast cranial computed tomography (CT) in evaluating seizures is debated.
  • Identifying appropriate indications for CT can optimize resource utilization.

Purpose of the Study:

  • To determine the diagnostic yield of emergency noncontrast cranial CT in patients presenting with seizures.
  • To identify clinical variables that predict positive CT findings in this patient population.

Main Methods:

  • Retrospective review of 115 consecutive patients presenting with seizures to a Level I trauma emergency department.
  • Analysis of medical records, including neurologic examination findings and noncontrast cranial CT results.

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  • Statistical correlation of clinical variables with CT findings.

    • Main Results:

    • An abnormal neurologic examination was highly predictive of positive CT scans (95% sensitivity).
    • A history of malignancy showed a statistically significant correlation with CT findings.
    • No other evaluated clinical variables demonstrated a significant association with CT results.

    Conclusions:

    • Emergency noncontrast cranial CT is most beneficial for seizure patients with an abnormal neurologic examination.
    • Patients with a history of malignancy also represent a group likely to benefit from emergency cranial CT.
    • These findings can help refine indications for CT in the emergency evaluation of seizures.