JOHN R. FEUSSNER, M.D.; EUGENE W. LINFORS, M.D.; CAROL L. BLESSING, B.S.; C. FRANK STARMER, Ph.D.
We evaluated the usefulness of computed tomography (CT) brain scanning in alcoholic patients with withdrawal seizures (n = 151) and other neurologic problems (n = 87) and compared the findings of a detailed neurologic examination to the results of CT scanning. In patients with seizures, nearly 50% of CT scans were normal, 34% showed generalized cerebral atrophy, and only 15% showed focal structural lesions. When focal neurologic deficits were present, 30% of CT scaris showed focal structural lesions compared to 6% when such deficits were absent (p < 0.0002). The frequency of potentially reversible lesions was 18% in patients with and 1% in patients without focal neurologic deficits (p < 0.0002). Of patients treated surgically, 9% had focal neurologic deficits and 1% did not (p < 0.03). Results were similar in alcoholic patients with other neurologic problems. Careful use of the neurologic examination adequately determines which patients need prompt CT scanning. In the absence of either focal deficits on neurologic examination or signs of acute head trauma, CT brain scanning does not improve the evaluation of patients with alcohol withdrawal seizures.
FEUSSNER JR, LINFORS EW, BLESSING CL, STARMER CF. Computed Tomography Brain Scanning in Alcohol Withdrawal Seizures: Value of the Neurologic Examination. Ann Intern Med. ;94:519–522. doi: 10.7326/0003-4819-94-4-519
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Published: Ann Intern Med. 1981;94(4_Part_1):519-522.
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