The utility of computed tomography for recent-onset partial seizures in childhood

To determine the diagnostic yield of computed tomography (CT) of the head in children presenting for the first time with partial seizures in a region with a high prevalence of tuberculosis and neurocysticercosis. Prospective cohort study. The secondary-level ambulatory service of Red Cross Children&...

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Bibliographic Details
Published in:South African medical journal 2006-09, Vol.96 (9), p.941-944
Main Authors: SWINGLER, George H, WESTWOOD, Anthony T. R, ILONI, Karen
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child
Child, Preschool
Diagnosis, Differential
Epilepsies, Partial - diagnostic imaging
Female
Follow-Up Studies
General aspects
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Infant
Male
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Prospective Studies
Reproducibility of Results
Tomography, X-Ray Computed - utilization
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Summary:To determine the diagnostic yield of computed tomography (CT) of the head in children presenting for the first time with partial seizures in a region with a high prevalence of tuberculosis and neurocysticercosis. Prospective cohort study. The secondary-level ambulatory service of Red Cross Children's Hospital, Cape Town. Children aged 6 months-12 years with a first partial seizure. Outcome measures. Abnormal CT findings; clinically unsuspected abnormal CT findings. Of 118 enrolled children, CT findings were available for 94 (80%). Sixteen (33%) of 49 children scheduled to return later for an initial CT scan failed to do so. Thirty-two scans (34%) were reported normal, 45 (48%) showed single or multiple granulomas, and 17 (18%) showed other findings. All 8 children with persistent specific CT findings were suspected of having the condition before CT scan. Of 68 cases with prospectively recorded clinically expected CT findings, normal scans were expected in 2 cases (3%) and occurred in 33 cases (49%). Routine CT scan for children presenting with a first partial seizure in an area with a high prevalence of neurocysticercosis failed to identify findings other than neurocysticercosis that meaningfully altered clinical management. Assuming a 70% relative reduction of seizures with albendazole treatment for neurocysticercosis, routine CT scanning in the study population would require 11 scans and 5 courses of albendazole to prevent 1 child from having seizures, compared with no CT scans and 11 courses of albendazole with blanket use of albendazole.
ISSN:0256-9574