J Korean Soc Emerg Med.  2004 Dec;15(6):594-599.

The Etiology and the Efficacy of Diagnostic Tools for Adult Patients Presenting with New-onset Seizure in an Emergency Department

• Hur JM
• Yoon SK
• Choi SC
• Kim GW
• Cho JP

Abstract

PURPOSE
This study was conducted to evaluate the etiology and the efficacy of diagnostic tools such as physical examination, laboratory studies, cranial computed tomography (CT) scans, and electroencephalograms (EEGs) in adult patients presenting with new-onset seizure in an emergency department.
METHODS
This is a retrospective study of a 4-year period during which 67 patients were admitted to an emergeny department complaining of new-onset seizure. Among them, 61 patients were eligible for inclusion in this study, and we reviewed their medical records, laboratory data, CT scans and EEG findings.
RESULTS
The etiologies of new-onset seizure were 1) unknown, 2) alcohol withdrawal, 3) ischemic stroke, and 4) central nervous system infection. An abnormal CT lesion was diagnosed in 27.5% of the patients with normal neurological examinations. An abnormal CT lesion was diagnosed in 30% of the patients whose EEG results had a focal-wave pattern. But, No statistical significance could be attached to the relationship between the CT lesion and EEG results (p>0.05).
CONCLUSIONS
The principal etiologies of new-onset seizure were 1) unknown, 2) alcohol withdrawl, 3) ischemic stroke. A CT scan should be performed in all patients with newonset seizure. A focal-wave pattern in the EEG may consider a necessity for brain imaging.

Keyword

Emergency department; Seizure; Computed tomography; Electroencephalogram

MeSH Terms

Adult*
Central Nervous System Infections
Electroencephalography
Emergencies*
Emergency Service, Hospital*
Humans
Medical Records
Neuroimaging
Neurologic Examination
Physical Examination
Retrospective Studies
Seizures*
Stroke
Tomography, X-Ray Computed