The use of neuroimaging in patients with seizures is discussed on the page Approach to epilepsy in the emergency department.
In the setting of a known seizure disorder, abnormal neuroimaging results rarely require acute intervention. Exceptions include finding an acute hemorrhage, suggestive of a possible rupture of an aneurysm or arteriovenous malformation, or finding acute hydrocephalus or imminent brain stem herniation due to mass effect.
In most cases, emergency physicians do not have access to old brain images, and it is rare that intervention needs to be undertaken in the emergency department, unless the patient becomes unstable. If the patientís treating physician cannot be reached, patients with worrisome lesions can be admitted overnight for observation and for formulation of a treatment plan by the next day.
Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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