Original Research

Role of cranial computed tomography in human immunodeficiency virus-positive patients with generalised seizures

Chris van Zyl, Delmé Hurter, Vishesh Sood, Lizanne Koning
South African Journal of Radiology | Vol 20, No 1 | a965 | DOI: https://doi.org/10.4102/sajr.v20i1.965 | © 2016 Chris van Zyl, Delmé Hurter, Vishesh Sood, Lizanne Koning | This work is licensed under CC Attribution 4.0
Submitted: 06 December 2015 | Published: 14 June 2016

About the author(s)

Chris van Zyl, Department of Clinical Imaging Sciences, University of the Free State, South Africa
Delmé Hurter, Department of Radiology, Kimberley Hospital Complex, University of the Free State, South Africa
Vishesh Sood, Department of Radiology, Kimberley Hospital Complex, University of the Free State, South Africa
Lizanne Koning, Emergency Centre, Kimberley Hospital Complex, University of the Free State, South Africa


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Abstract

Background: Emergency neuroimaging of human immunodeficiency virus (HIV)-positive patients with generalised new onset seizures (NOS) and a normal post-ictal neurological examination remains controversial, with the general impression being that emergency imaging is necessary because immunosuppression may blur clinical indicators of acute intracranial pathology. The objectives of our study were to establish whether cranial computed tomography (CT) affects the emergency management of HIV-positive patients with generalised NOS and a normal post-ictal neurological examination.

Method: We conducted a prospective descriptive observational study. Consecutive HIVpositive patients of 18 years and older, who presented to the Kimberley Hospital Complex’s Emergency Department within 24 hours of their first generalised seizures and who had undergone normal post-ictal neurological examinations, were included. Emergency CT results as well as CD4-count levels were evaluated.

Results: A total of 25 HIV-positive patients were included in the study. The results of cranial CT brought about a change in emergency care management in 12% of patients, all of them with CD4 counts below 200 cells/mm3 .

Conclusion: We suggest that emergency cranial CT be performed on all HIV-positive patients presenting with generalised NOS and a normal post-ictal neurological examination, particularly if the CD4 count is below 200 cells/mm3.

Keywords: HIV; Seizures; CT Brain


Keywords

HIV; Seizures; CT Brain;

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