An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa

SA Journal of Radiology

Field Value
Title An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa
Creator Mabaso, Sabelo H. Bhana-Nathoo, Deepa Lucas, Susan
Subject Radiation sciences; radiology new-onset; first-onset; adult-onset; seizure; CT findings
Description Background: Globally, adults presenting with seizures account for 1% – 2% of visits to emergency departments (EDs), of which 25% are new-onset seizures. Neuroimaging is essential as part of the initial workup. Multiple studies have demonstrated abnormal CT brain (CTB) findings in these patients.Objectives: To review the CTB findings in adults presenting with new-onset seizures in a resource restricted setting.Method: A retrospective review of 531 CTBs was conducted at a tertiary hospital in Gauteng on adults presenting to the ED with new-onset seizures.Results: The mean age of the patients was 45.6 ± 17.1 years, and the male to female ratio was 1.2:1. Generalised and focal seizure types were almost equally represented. Of the total 531 patients, 168 (31.6%) were HIV positive. The CTB findings were abnormal in 257 (48.4%) patients, albeit vascular pathology accounted for 21.9%. Infective pathology accounted for 14.1% with a statistically significant association with HIV (p = 0.003). Trauma related pathology was 2.4%, whilst neoplastic pathology was seen in 3.0%. Other causes included congenital pathology, calcifications, atrophy and gliosis. Clinical factors associated with abnormal CTB findings were age ≥ 40 years, HIV infection, hypertension, focal seizures, low Glasgow Coma Scale (GCS), raised cerebrospinal fluid (CSF) protein and presence of lymphocytes.Conclusion: A high yield of abnormal CTB findings was noted in adult patients who presented with new-onset seizures, supporting the use of urgent CTB in patients with certain clinical risk factors. Patients without these risk factors can be scanned within 24–48 h in a resource restricted setting.
Publisher AOSIS
Date 2022-01-20
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Audit
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajr.v26i1.2294
Source South African Journal of Radiology; Vol 26, No 1 (2022); 7 pages 2078-6778 1027-202X
Language eng
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
Coverage Africa; South Africa; Gauteng; Johannesburg; Soweto 2016-2018 Age; gender; seizure type; GCS; comorbidities; CT findings
Rights Copyright (c) 2022 Sabelo H. Mabaso, Deepa Bhana-Nathoo, Susan Lucas