Investigating seizures (summary)

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This is a basic article for medical students and other non-radiologists

Seizures are a common medical emergency and presentation to emergency departments . All new seizures or changes in seizure activity merit assessment with neurologists, and usually require neuroimaging . They can be distressing to witness for patient, families and clinicians and can be caused by a number of factors.

Reference article

This is a summary article; read more in our article on epilepsy.

Summary

  • questions
    • was the seizure focal or generalized?
    • has the patient had an EEG - what was the result?
    • any of the following?
      • new focal neurology deficits
      • persistent altered consciousness/confusion
      • fever
      • persistent headache
      • medical history (malignancy, AIDS, previous neurosurgery)
      • use of anticoagulants
  • investigations
    • CT head
      • acute presentation
        • new seizure
        • different seizure behavior
    • MRI brain
      • hasn't been previously investigated
      • change in seizure semiology
      • follow up of underlying tumor
  • making the request
    • why is imaging required?
    • what is the relative urgency?
      • why does it need to be done now?
    • what lateralizing features are there (clinical or investigations)?
  • common pathology

Teaching playlist

  • seizures playlist