Abstract:
OBJECTIVE:To investigate the presenting characteristics of new-onset afebrile seizures in infants (age 1-24 months) and the yield of neuroimaging. METHODS:Prospective data were obtained from a standardized evaluation and management plan mandated by a critical care pathway. A total of 317 infants presented with new-onset afebrile seizures between 2001 and 2007. EEG was performed on 90.3%, head CT was obtained on 94%, and MRI was obtained on 57.4%. RESULTS:We found half of the infants had partial features to their seizures, yet evidence for primary generalized seizures was rare. The majority had more than 1 seizure upon presentation. Seizures in this age group tended to be brief, with 44% lasting less than 1 minute. EEG abnormalities were found in half. One-third of CTs were abnormal, with 9% of all CTs requiring acute medical management. Over half of MRIs were abnormal, with cerebral dysgenesis being the most common abnormality (p < 0.05). One-third of normal CTs had a subsequent abnormal MRI-only 1 resulted in altered medical management. CONCLUSIONS:Infantile seizures are usually brief, but commonly recurrent, and strong consideration should be made for inpatient observation. Acute imaging with CT can alter management in a small but important number of infants. Due to the superior yield, strong consideration for MRI should be given for all infants, as primary generalized seizures are rare, and there is a high rate of cerebral dysgenesis.
journal_name
Neurologyjournal_title
Neurologyauthors
Hsieh DT,Chang T,Tsuchida TN,Vezina LG,Vanderver A,Siedel J,Brown K,Berl MM,Stephens S,Zeitchick A,Gaillard WDdoi
10.1212/WNL.0b013e3181c91847subject
Has Abstractpub_date
2010-01-12 00:00:00pages
150-6issue
2eissn
0028-3878issn
1526-632Xpii
74/2/150journal_volume
74pub_type
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