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J Korean Soc Emerg Med > Volume 15(6); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(6): 594-599.
The Etiology and the Efficacy of Diagnostic Tools for Adult Patients Presenting with New-onset Seizure in an Emergency Department
Jae Min Hur, Sang Kyu Yoon, Sang Cheon Choi, Gi Woon Kim, Joon Pil Cho
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea. 59club@hanmail.net
ABSTRACT
PURPOSE:
This study was conducted to evaluate the etiology and the efficacy of diagnostic tools such as physical examination, laboratory studies, cranial computed tomography (CT) scans, and electroencephalograms (EEGs) in adult patients presenting with new-onset seizure in an emergency department.
METHODS:
This is a retrospective study of a 4-year period during which 67 patients were admitted to an emergeny department complaining of new-onset seizure. Among them, 61 patients were eligible for inclusion in this study, and we reviewed their medical records, laboratory data, CT scans and EEG findings.
RESULTS:
The etiologies of new-onset seizure were 1) unknown, 2) alcohol withdrawal, 3) ischemic stroke, and 4) central nervous system infection. An abnormal CT lesion was diagnosed in 27.5% of the patients with normal neurological examinations. An abnormal CT lesion was diagnosed in 30% of the patients whose EEG results had a focal-wave pattern. But, No statistical significance could be attached to the relationship between the CT lesion and EEG results (p>0.05).
CONCLUSIONS:
The principal etiologies of new-onset seizure were 1) unknown, 2) alcohol withdrawl, 3) ischemic stroke. A CT scan should be performed in all patients with newonset seizure. A focal-wave pattern in the EEG may consider a necessity for brain imaging.
Key words: Emergency department, Seizure, Computed tomography, Electroencephalogram
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