First seizure in adults: a prospective study from the emergency department.
A prospective study of 98 consecutive adults with a first seizure to determine the most important etiological factors and the optimum diagnostics. 27 were thought to have cryptogenic seizures. Main causes of symptomatic seizures were: cerebral infarction, alcohol-withdrawal, CNS infections, tumors, vascular malformations, traumatism and miscellanea. Eight were infected by human immunodeficiency virus (HIV-1) representing 8.2% of all the patients with a first seizure and 20% of the 15-45-year age group. CT disclosed structural lesions in 33 cases. MRI in those with normal CT and no other explanation of seizure revealed additional lesions in 22.2%, but did not change management in any. We conclude that CT is essential in evaluation of adults with first seizure. MRI may be useful in selected cases. The HIV-infected now represent an important group with a first seizure.
Sempere
A P
AP
Neurology Department, 12 de Octubre, University Hospital, Madrid, Spain.
Villaverde
F J
FJ
Martinez-Menéndez
B
B
Cabeza
C
C
Peña
P
P
Tejerina
J A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D001927:Brain Diseases / Q000150:complications; D003937:Diagnosis, Differential; D004630:Emergencies; D004636:Emergency Service, Hospital; D004827:Epilepsy / Q000139:chemically induced / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications; D015497:HIV-1; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011446:Prospective Studies; D012640:Seizures / Q000139:chemically induced / Q000209:etiology*; D019966:Substance-Related Disorders / Q000150:complications
D013287:Illicit Drugs