The Usefulness of Emergency Brain Computerized Tomography in Children with First Seizures

ABSTRACT

PURPOSE: This study was performed to discover whether emergency brain computerized tomogra phy(CT) is useful for the diagnosis and management of patients with first seizure. METHODS: We studied retrostpectively all children(under 15-year-old) without a history of neu rologic illness who visited Hanyang University Hospital and took a brain CT because of a first seizure attack between January 1996 and June 1999. Total 96 children were enrolled in this study and divided into groups according to seizure type, EEG finding and provoked factor. RESULTS: Among ninety six children with a first seizure(male 60, female 36), 12 patients had brain abnormalities on CT; 3 with arachnoid cyst, 2 with vascular anomalies, 2 with brain atrophy, and so on. Forty seven patients had provoked seizures, and 56 had unprovoked seizures. Abnormalities on CT were more frequently seen in children with their first unprovoked seizure without the statistical significance(P=0.395) and in those children who had focal seizure and/or focal ab normalities on EEG(P=0.016). CONCLUSION: Emergency brain CT is a useful investigative tool for patients with first unprovoked seizure, particularly for the patients with focal seizure and/or focal EEG abnormalities. The decision to perform CT should be based on a detailed history and results of careful neurologic examination. (J Korean Pediatr Soc 2001;44562-568)