Imaging Tests for Epileptic Seizures

Acute head trauma, prolonged alteration of consciousness, and a focal neurological examination at presentation were linked to a higher yield of emergency department (ED) neuroimaging in patients with seizures. Such imaging in adults presenting with new onset ('index') seizures leads to a change in care for 9-17% of patients, but it's unclear if such changes are made following imaging in the ED for seizures in adults with known seizure disorders ('non-index' seizures).

In an Epilepsia study of 822 ED visits for non-index seizures, neuroimaging was performed in nearly half of all patients. Of these, 3% of imaging tests led to an acute change in patient management, 2% after excluding false positive scans. Without any of these three clinical factors, the true positive yield of neuroimaging was zero.

The findings support a more conservative use of ED neuroimaging for non-index seizures, based on clinical factors at the time of presentation.

Source-Eurekalert