Clinical factors could reduce need to assess seizures on CT

Identifying key clinical factors in seizure cases may reduce the need for individuals with a known seizure disorder to undergo an emergency CT exam, according to an article published online July 18 in Epilepsia.

Researchers from Oregon Health and Science University examined the data of 381 adults who underwent a CT exam after presenting with a seizure. They classified these cases as "nonindex" seizures because each of the patients had a known seizure disorder.

Results from the CT exams led clinicians to change the management plan for 11 patients (3%) -- and only eight patients (2%) after excluding false positives. Relevant findings on the CT exams were associated with three clinical factors: acute head trauma, prolonged alteration of consciousness, and a focal neurologic examination at presentation. The clinicians did not change the management plan for any of the patients who did not meet these factors.

Basing the decision to perform a CT exam on these clinical factors for adults presenting with nonindex seizures may decrease unnecessary imaging with minimal loss of yield, the authors concluded.