Abstract | OBJECTIVE: To determine the etiology of new-onset generalized seizures in patients with AIDS presenting to an ED. Patients without HIV infection with a first-time seizure were used as a comparison group. With these data, the current American College of Emergency Physicians ( ACEP) guidelines on the workup of new-onset seizures were applied to determine whether they could safely be used in patients with AIDS. METHODS: The authors conducted a retrospective review of all patients with new-onset generalized seizures who presented to an academic medical center hospital ED in New York City over 2 years. A standard ED medical evaluation with history, physical examination, and routine laboratory studies-including at least a panel 7 chemistry, serum magnesium, and complete blood count-was performed. RESULTS: CONCLUSION: Four of 26 AIDS patients with immediately treatable CNS lesions could have been sent home for outpatient evaluation of their seizures on the basis of current guidelines for non-HIV-infected patients. However, the updated 1997 ACEP guidelines now include emergent brain neuroimaging studies on patients who have or are suspected of having AIDS. This study helps to strengthen this recommendation. Based on these findings, the authors suggest a neuroimaging study with a lumbar puncture, if indicated, in the ED or inpatient admission workup for all patients with AIDS or suspected AIDS presenting with new-onset generalized seizures.
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Authors | G R Pesola, R E Westfal |
Journal | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
(Acad Emerg Med)
Vol. 5
Issue 9
Pg. 905-11
(Sep 1998)
ISSN: 1069-6563 [Print] United States |
PMID | 9754504
(Publication Type: Journal Article)
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Topics |
- Acquired Immunodeficiency Syndrome
(complications)
- Adult
- Brain
(pathology)
- Electroencephalography
- Emergency Service, Hospital
(standards)
- Female
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neurologic Examination
(standards)
- Practice Guidelines as Topic
- Retrospective Studies
- Seizures
(etiology, therapy)
- Spinal Puncture
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