Seizure patient selection for emergency computed tomography.
OBJECTIVE
We evaluated the need for emergency noncontrast cranial computed tomography (CT) among patients presenting to an emergency department with a complaint of seizure.


METHODS
We retrospectively evaluated the medical records of 115 consecutive patients who presented to a trauma Level I ED with a complaint of seizure and underwent a noncontrast cranial CT.


RESULTS
Sixty patients had a known seizure disorder, 38 had new-onset seizure, and 17 had possible seizure. The results of the neurologic examination and CT could be compared in 105 of the patients. An abnormal neurologic examination predicted 19 of 20 positive CT scans (95%) and demonstrated a strong association with CT results (P < .00004). Only a history of malignancy correlated to CT findings (P < .008). No other catalogued variable showed a statistical relationship with CT findings.


CONCLUSIONS
Our data suggest that patients with either a history of malignancy or an abnormal neurologic examination at the time of examination in the ED will derive the greatest benefit from emergency CT.
Reinus
W R
WR
Department of Radiology, Jewish Hospital, St Louis, Missouri.
Wippold
F J
FJ
Erickson
K K
KK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D011237:Predictive Value of Tests; D012640:Seizures / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers