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Certain Seizure Patients Need Emergency CT Scan
Date:10/29/2007

ER staff should focus on those with first-ever attack, babies, and people with AIDS, guideline says

MONDAY, Oct. 29 (HealthDay News) -- Immediate CT brain scans should be used to screen certain emergency room patients with seizures to help doctors determine the right kind of treatment, according to a new guideline developed by the American Academy of Neurology.

The guideline authors analyzed all available scientific evidence on the topic and concluded that "immediate CT scans are a useful screening procedure, because the result can help doctors decide how to care for their patient, especially after the first seizure, and for very young children and people with AIDS," lead author Dr. Cynthia L. Harden, of Weill Cornell Medical College in New York, said in a prepared statement.

She and her colleagues found that immediate CT scan is particularly useful for seizure patients with: a predisposing history; focal seizure onset; an abnormal neurological exam; a history of AIDS; and those younger than six months old.

"Infants under six months old with seizure may have brain abnormalities on their CT scans 50 percent of the time. In addition, evidence shows people with AIDS who are treated in the emergency room for their first seizure have high rates of brain abnormalities. Central nervous system toxoplasmosis, an infectious disease caused by a parasite, is also frequently found in AIDS patients," Harden said.

Emergency CT scans should also be considered for adults and children with a first seizure, because evidence indicates that scan results would change treatment decisions in up to 17 percent of adult cases and up to 8 percent of children's cases. In these instances, abnormalities detected by CT scan that would change treatment include: tumors, traumatic brain injury with skull fracture; and stroke leading to bleeding in the brain.

The guideline is published in the Oct. 30 issue of the journal Neurology.<
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