Investigating seizures (summary)
Updates to Article Attributes
This is a basic article for medical students and other non-radiologists
Seizures are are a common medical emergency and presentation to emergency departments 1-3. All new seizures or changes in seizure activity merit assessment with neurologists, and usually require neuro-imaging 3-4. They can be distressing to witness for patient, families and clinicians and can be caused by a number of factors.
Assessment
There are many classifications of seizures: partial partial, focal focal, generalised, absence, symptomatic, idiopathic. What is important to recognise at this stage is treatment of generalised seizures as these are emergencies, and takes priority over investigation.
A detailed history is often difficult without a collateral history from a witness. There are a number of important factors to document from history and examination:
- new focal neurology deficits
- persistent altered consciousness/confusion
- fever
- persistent headache
- significant medical history (malignancy, AIDS, previous neurosurgery)
- use of anticoagulants
Alcohol and narcotic use should be investigated. Driving status should be confirmed as seizures implicate driving.
Investigations
Imaging is used to identify any potential underlying structural lesions 4. This is best done with MRI (some units have dedicated epilepsy protocols) when the patient has returned to normal neurological status. In emergency situations, CT can be used to identify strokes or space occupying lesions which can act as epileptic foci.
Common pathology
Some important conditions which can lead to or provoke seizures include:
Teaching playlist
-<h6>This is a basic article for medical students and non-radiologists</h6><p><strong>Seizures</strong> are a common medical emergency and presentation to emergency departments <sup>1-3</sup>. All new seizures or changes in seizure activity merit assessment with neurologists, and usually require neuro-imaging <sup>3-4</sup>. They can be distressing to witness for patient, families and clinicians and can be caused by a number of factors.</p><h4>Assessment</h4><p>There are many classifications of seizures: partial, focal, generalised, absence, symptomatic, idiopathic. What is important to recognise at this stage is treatment of generalised seizures as these are emergencies, and takes priority over investigation.</p><p>A detailed history is often difficult without a collateral history from a witness. There are a number of important factors to document from history and examination:</p><ul>- +<h6>This is a basic article for medical students and other non-radiologists</h6><p><strong>Seizures</strong> are a common medical emergency and presentation to emergency departments <sup>1-3</sup>. All new seizures or changes in seizure activity merit assessment with neurologists, and usually require neuro-imaging <sup>3-4</sup>. They can be distressing to witness for patient, families and clinicians and can be caused by a number of factors.</p><h4>Assessment</h4><p>There are many classifications of seizures: partial, focal, generalised, absence, symptomatic, idiopathic. What is important to recognise at this stage is treatment of generalised seizures as these are emergencies, and takes priority over investigation.</p><p>A detailed history is often difficult without a collateral history from a witness. There are a number of important factors to document from history and examination:</p><ul>
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