Emergency Literature of Note - By Ryan Radecki - July 27, 2018
"In the adult patient with new-onset seizure, it can be reasonable to pursue emergency neuroimaging in many cases. However, the vast majority of presentations to the Emergency Department for seizure are for those with known seizure disorders. In this population, the calculus is different...
A majority (78%) of ED seizure visits were for nonindex seizures. Neuroimaging was obtained in 381 of 822 nonindex seizure visits (46%). Of these, 11 imaging studies (3%) led to an acute change in patient management, 8 (2%) after excluding false-positive scans. Acute head trauma, prolonged alteration of consciousness, and a focal neurologic examination at presentation were associated with an increased yield of ED neuroimaging. Absent any of these 3 clinical factors the true positive yield of neuroimaging was zero..."