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Epidemiología y Alteraciones en la Tomografía Computarizada de los Pacientes Adultos Atendidos por una Primera Crisis Epiléptica en un Servicio de Urgencias en Qatar.
Author(s) -
Pathan Sameer A.,
Abosalah Salem,
Nadeem Sana,
Ali Amjad,
Hameed Asma A.,
Marathe Mandar,
Cameron Peter A.
Publication year - 2014
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12508
Subject(s) - medicine , emergency department , neurocysticercosis , retrospective cohort study , pediatrics , epidemiology , brain metastasis , incidence (geometry) , rochester epidemiology project , cohort , subarachnoid hemorrhage , radiology , surgery , metastasis , cancer , physics , psychiatry , optics , population based study
Objectives There is little information available from the Middle Eastern region on adult patients presenting with first seizure. The objectives of this study were to describe epidemiological characteristics of patients presenting to the emergency department ( ED ) in Doha, Qatar, with first seizure and to determine the incidence of computed tomographic ( CT ) scan abnormalities. Methods A retrospective cohort study was conducted on all adult patients with first seizure presenting to Hamad General Hospital ED over a 1‐year period (June 2012 through May 2013). Electronic patient records were reviewed for demographics, neuroimaging, electroencephalography, laboratory test results, and medications administered. Results There were 439 patients who satisfied inclusion criteria. Patients were aged a mean of 35.3 years (95% confidence interval [ CI ] = 33.92 to 36.69 years) with a male‐to‐female ratio of five to one. CT abnormalities were detected in 154 patients (35.3%; 95% CI = 30.81% to 39.82%). Out of reported abnormal scans, 14.7% patients had significant abnormalities such as neurocysticercosis (9.2%); brain metastasis and neoplasm (3.4%); and subarachnoid and subdural hemorrhage, cavernous sinus thrombosis, acute stroke, and brain edema (2.0%). None of the patients had any electrolyte abnormalities, and three patients had hypoglycemia. Patients with initial abnormal CT brain results were more likely to have recurrent seizures ( OR = 1.65; 95% CI = 1.11 to 2.45) within 6 months. Conclusions Adults who presented with first seizure to the ED in Qatar had a young male predominance, and a high proportion of brain CT scans were reported as abnormal. It is recommended that all such patients in this population should undergo prompt CT scanning in the ED , but the utility of routine electrolyte tests requires further investigation.