Which Patients Presenting with Seizure Need Head CT in the ED?

Acute neuroimaging of seizure patients in the emergency department is a matter of some practice variation. The American Academy of Neurology attempted to develop an evidence-based guideline to address this issue. A multispecialty panel that included emergency medicine specialists performed a literature review and a meta-analysis of studies published from 1966 to 2004 to identify historical and clinical features of acute seizure cases in which results of emergent, noncontrast, head computed tomography (CT) changed management. No randomized trials exist, so review was limited to retrospective studies and case series.

The panel found that an emergent CT might possibly change management and should therefore be considered in adults and children w…