Experts Issue Guidelines on Diagnosing Seizure

TUESDAY Nov. 20, 2007 -- Routine electroencephalogram (EEG) and MRI or CT brain scans should be considered when diagnosing and treating adults who've had their first unprovoked seizure, according to a new guideline released by the American Academy of Neurology.

Evidence indicates that this approach can often detect brain abnormalities that caused the seizure and predict future seizures, said the guideline, which is published in the Nov. 20 issue of the journal Neurology.

"Since even one seizure is a frightening, traumatic event with serious potential consequences, such as loss of driving privileges, limitations for employment and bodily injury, information about optimal, evidence-based approaches for treating people with a seizure is important," guideline author Dr. Allan Krumholz, a neurologist at the University of Maryland Medical Center and professor of neurology at the University of Maryland School of Medicine, said in a prepared statement.

He and his colleagues developed the guideline after a review of all available scientific studies on the topic.

"Evidence shows an EEG revealed abnormalities indicating epilepsy in about one in four patients and was predictive of seizure recurrence," Krumholz said.

In addition, the review found that MRI or CT brain scans detected abnormalities in 10 percent of patients who'd had an unprovoked first seizure.

"A CT scan or MRI may lead to the diagnosis of disorders such as a brain tumor, stroke, an infection, or other structural lesions and may help determine a person's risk for a second seizure," Krumholz said.

The findings from an EEG, CT or MRI will help doctors determine appropriate patient care and management, including the need for immediate hospitalization and follow-up, drug treatment, and patient and family counseling.

Posted: November 2007


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