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First seizure in adults: a prospective study from the emergency department
Author(s) -
Sempere A P.,
Villaverde F. J.,
MartinezMenéndez B.,
Cabeza C.,
Peña P.,
Tejerina J. A.
Publication year - 1992
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1992.tb05054.x
Subject(s) - etiology , medicine , prospective cohort study , epilepsy , human immunodeficiency virus (hiv) , infarction , emergency department , pediatrics , cerebral infarction , epileptic seizure , pathology , ischemia , psychiatry , immunology , myocardial infarction
A prospective study of 98 consecutive adults with a first seizure to determine the most important etiological factors and the optimum diagnostics. 27 were thought to have cryptogenic seizures. Main causes of symptomatic seizures were: cerebral infarction, alcohol‐withdrawal, CNS infections, tumors, vascular malformations, traumatism and miscellanea. Eight were infected by human immunodeficiency virus (HIV‐1) representing 8.2% of all the patients with a first seizure and 20% of the 15–45‐year age group. CT disclosed structural lesions in 33 cases. MRI in those with normal CT and no other explanation of seizure revealed additional lesions in 22.2%, but did not change management in any. We conclude that CT is essential in evaluation of adults with first seizure. MRI may be useful in selected cases. The HIV‐infected now represent an important group with a first seizure.