ADULT 1ST GENERALIZED SEIZURE - ETIOLOGY, BIOLOGICAL TESTS, EEG, CT SCAN, IN AN ED

The purpose of this study was to evaluate adult first seizures in an e mergency department by analyzing etiologic and epidemiological data an d studying the usefulness of biological screening, electroencephalogra m (EEG), and cerebral computed tomography (CT) scan. This was a retros pective study of a 3-year period during which 247 patients were admitt ed to an emergency department for a first generalized seizure. A CT sc an had been performed in 247 patients and an EEG in 209. Etiologies we re found to be (1) unknown, (2) alcohol abuse, (3) stroke, and (4) tum or. Early recurrence rate was 18.5%. EEG was of low interest in emerge ncy. The rate of cerebral focal lesions on CT scan was significantly l ower when both examination results and EEG were normal. The rate of me tabolic abnormalities was 4.9%. It was concluded that (1) a short hosp italization is advisable because of recurrences, (2) recurrence rate d oes not increase significantly in patients with focal cerebral lesion, (3) metabolic screening is necessary, and (4) CT scan will be an outp atient procedure for most patients.