Computed Tomography Evaluation of Patients with First Onset Seizure


Authors : Dr. Sharoj Khan; Dr. Dambar Sah; Dr. Md Kalim Akhtar; Dr. Vandana Mourya

Volume/Issue : Volume 10 - 2025, Issue 9 - September

Google Scholar : https://tinyurl.com/yc2b37wp

Scribd : https://tinyurl.com/2jhk8mee

DOI : https://doi.org/10.38124/ijisrt/25sep243

PlumX Metrics

Semantic Scholar

ResearchGate

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Note : Google Scholar may take 30 to 40 days to display the article.

Abstract : Introduction Structural neuroimaging plays an important role in the evaluation, management and treatment of first onset seizure. Imaging is performed to establish etiology, assist in determining prognosis, and identifying patients in whom alternation in medical or surgical management would ensue. MRI is considered the imaging modality of choice. CT is the diagnostic imaging test of choice for patients with seizures in a resource limited areas and first onset seizure, where MRI is less practical.  General Objective To study the spectrum of Computed Tomography findings in patients with first onset seizure.  Methodology A cross section study of patients with first onset seizures who presented to department of radiology and underwent cranial CT scans within the study period. The data was collected through chart review, analyzed by SPSS version 25 and MS Excel 2016.  Results Seventy three patients with first onset seizures, 44 males and 29 females with a mean age of 30.1 years, had CT done during the specified period. Thirty-one patients (42.5 %) had normal CT results and forty-two patients (57.5 %) had abnormal results. Neurocysticercosis (NCC) (23.81%), calcified granuloma (21.43 %) and cerebral atrophy (11.9 %) were the most common abnormality. Generalized seizures were seen in 46 patients (63.0%) patients and remaining 27 patients (37 %) had partial seizures. In total 46 cases of generalized seizures, normal CT findings were found in 26 (83.9%) cases and abnormal CT findings were found in 20 (47.6%) of cases. In contrast, among 27 cases of partial seizures, abnormal CT findings were found in 22 (52.4%) of cases.  Conclusion Abnormal CT Scans Were More Commonly Seen in Patients with Partial Seizures.

Keywords : First Onset Seizure, Computed Tomography (CT).

References :

  1. Allen CMC, Lueck CJ, Dennis M. Davidson’s Principles and practice of Medicine.
  2. Lippincott& Wilkins. Epilepsy 2010; p. 29, 1172.
  3. Fauci A, Braunwald E, Kasper DL, Hauser SL, Longo DL Harrison’s principle of internal medicine. Mcgraw-hill. 2008; p.2498.
  4. Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in India. Epilepsia. 1999 May 1;40(5):631-6.
  5. Rajbhandari KC. Epilepsy in Nepal. Canadian journal of neurological sciences. 2004 May;31(2):257-60.
  6. American College of Emergency Physicians, Clinical Policies Committee. Clinical Policy: Critical issues in the evaluation of adult patients presenting to an emergency department with seizures. Ann Emerg Med. 2004; 43:605-25.
  7. Roy T, Pandit A. Neuroimaging in epilepsy. Annals of Indian Academy of Neurology. 2011 Apr;14(2):78.
  8. Gastaut H, Gastaut JL. Computerized transverse axial tomography in epilepsy. Epilepsia. 1976 Sep 1;17(3):325-36.
  9. Hirtz D, Ashwal S, Berg A, Bettis D, Camfield C, Camfield P, et al. Practice parameter: evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of the American Academy of Neurology, The Child Neurology Society, and The American Epilepsy Society. Neurology. 2000 Sep 12;55(5):616-23.
  10. Bernal  B,  Altman  NR.  Evidence-based  medicine:  neuroimaging  of  seizures.
  11. Neuroimaging Clinics. 2003 May 1;13(2):211-24.
  12. Lavados J, Germain L, Morales A, Campero M, Lavados P. A descriptive study of epilepsy in the district of El Salvador, Chile, 1984-1988. Acta Neurol Scand. 1992 Apr;85(4):249-56.
  13. Smith AB, Van Hoving DJ, Wallis LA. Emergency centre investigation of first-onset seizures in adults in the Western Cape, South Africa. S Afr Med J. 2013;103(10):723– 727.
  14. Arruda WO. Etiology of epilepsy. A prospective study of 210 cases. Arq Neuropsiquiatr. 1991;49(3):251–254.
  15. Yang PJ, Berger PE, Cohen ME, Duffner PK. Computed tomography and childhood seizure disorders. Neurology. 1979;29(8):1084LP- 1084.
  16. Pathan SA, Abosalah S, Nadeem S, Ali A, Hameed A. Computed Tomography Abnormalities and epidemiology of adult patients presenting with first seizure to the emergency department in Qatar. Academic Emegency Medicine. 2014:21(11):1264-1268.
  17. Kotisaari K, Virtanen P, Forss N, Strbian D, Scheperjans F. Emergency Computed tomography in patients with first onset seizure. Seizure 2017:48(1):89-93.
  18. Zarmehri B, Teimouri A, Ebrahimipour N, Foroughian M, Talebzadeh V, Saeidi M, et al.
  19. Brain CT Findings in Patients with First-Onset Seizure Visiting the Emergency Department in Mashhad, Iran. Open Access Emergency Medicine 2020:12(1):159-162.
  20. Schoenenberger R.A and Heim S.M. Indication for computed tomography of the brain in patients with first uncomplicated generalised seizure. BMJ. 1994 Oct 15; 309(6960): 986–989.
  21. Ashraf M, Irshad M, Chowdhary J, Malla RA, Akhter Y. Computed tomographic study in young epileptics in Kashmir, India. Al Ameen Journal of Medical Sciences. 2013;6(3).
  22. McAbee GN,  Barasch  ES,  Kurfist  LA.  Results of computed  tomography  in “neurologically normal” children after initial onset of seizures. Pediatric neurology. 1989 Apr 30;5(2):102-6.
  23. Garvey MA, Gaillard WD, Rusin JA, Ochsenschlager D, Weinstein S, Conry JA, Winkfield DR, et al. Emergency brain computed tomography in children with seizures: who is most likely to benefit?. The Journal of pediatrics. 1998 Nov 30;133(5):664-9.
  24. Nair KP, Jayakumar PN, Taly AB, Arunodya GR, Swamy HS, Shanmugam V. CT in simple partial seizures in children: a clinical and computed tomography study. Acta neurologica scandinavica. 1997 Apr 1;95(4):197-200.
  25. Poudel. P, Gupta MK, Kafle S Computerized Axial Tomography Findings in Children with Afebrile Seizures: A Hospital Based Study at Eastern Nepal. Journal of Nepal Health Research Council 2017:15(35): 61-6.
  26. Ojha AR, Ojha UR. Clinico-etiological profile of children with seizures admitted in a tertiary centre. Journal of Kathmandu Medical College. 2016 May 31;4(2):55-8.
  27. Gauchan E, Malla T, Basnet S, Rao KS. Variability of presentations and CT-scan findings in children with neurocysticercosis. Kathmandu University Medical Journal. 2012 Jun 10;9(2):17-21.
  28. Adhikari S, Sathian B, Koirala DP, Rao KS. Profile of children admitted with seizures in a tertiary care hospital of Western Nepal. BMC pediatrics. 2013 Mar 27;13(1):43.
  29. Acharya S, Tiwari A, Shrestha A, Sharma R, Prasad SR. Computed Tomography Findings in Patients with Seizure Disorder. Journal of Lumbini Medical College. 2016 Jun 30;4(1):7-10.
  30. Weisberg L. Granulomatous Diseases Of The CNS As Demonstrated By Computerized Tomography. Computerized Radiol 1984:8(5):309-317.
  31. Wadia RS, Makhale CN, Kelkar AV, Grant KB. Focal epilepsy in India with special reference to lesions showing ring or disc-like enhancement on contrast computed tomography. Journal of Neurology, Neurosurgery & Psychiatry. 1987 Oct 1;50(10):1298-301.
  32. Forsgren, L., Bucht, G., Eriksson, S. and Bergmark, L. , Incidence and Clinical Characterization of Unprovoked Seizures in Adults: A Prospective Population-Based Study. Epilepsia, 1996:37(3): 224-229.
  33. Myint PK, Staufenberg EFA, Sabanathan K. Post stroke seizure and post stroke epilepsy.
  34. Postgrad Med J. 2006 Sep; 82(971): 568–572. characterization of the scolex and lesion burden. American Journal of Neuroradiology. 2007 Sep 1;28(8):1501-4.
  35. Maschio M. Brain tumor related epilepsy Curr Neuropharmacol. 2012 Jun; 10(2): 124–133.
  36. Denis D, Chateil JF, Brun M, Brissaud O, Lacombe D, Fontan D, et al. Schizencephaly: clinical and imaging features in 30 infantile cases. Brain and Development. 2000 Dec 1;22(8):475-83.
  37. Arroyo S, Santamaria J. What is the relationship between arachnoid cysts and seizure foci?. Epilepsia. 1997 Oct;38(10):1098-102.
  38. Kalita J, Chandra S, Misra UK. Significance of seizure in cerebral venous sinus thrombosis. Seizure. 2012 Oct 1;21(8):639-42.
  39. Kilpatrick C. Epilepsy and brain abscess. Journal of Clinical Neuroscience. 1997 Jan 1;4(1):26-8.

Introduction Structural neuroimaging plays an important role in the evaluation, management and treatment of first onset seizure. Imaging is performed to establish etiology, assist in determining prognosis, and identifying patients in whom alternation in medical or surgical management would ensue. MRI is considered the imaging modality of choice. CT is the diagnostic imaging test of choice for patients with seizures in a resource limited areas and first onset seizure, where MRI is less practical.  General Objective To study the spectrum of Computed Tomography findings in patients with first onset seizure.  Methodology A cross section study of patients with first onset seizures who presented to department of radiology and underwent cranial CT scans within the study period. The data was collected through chart review, analyzed by SPSS version 25 and MS Excel 2016.  Results Seventy three patients with first onset seizures, 44 males and 29 females with a mean age of 30.1 years, had CT done during the specified period. Thirty-one patients (42.5 %) had normal CT results and forty-two patients (57.5 %) had abnormal results. Neurocysticercosis (NCC) (23.81%), calcified granuloma (21.43 %) and cerebral atrophy (11.9 %) were the most common abnormality. Generalized seizures were seen in 46 patients (63.0%) patients and remaining 27 patients (37 %) had partial seizures. In total 46 cases of generalized seizures, normal CT findings were found in 26 (83.9%) cases and abnormal CT findings were found in 20 (47.6%) of cases. In contrast, among 27 cases of partial seizures, abnormal CT findings were found in 22 (52.4%) of cases.  Conclusion Abnormal CT Scans Were More Commonly Seen in Patients with Partial Seizures.

Keywords : First Onset Seizure, Computed Tomography (CT).

CALL FOR PAPERS


Paper Submission Last Date
31 - December - 2025

Video Explanation for Published paper

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe