Value of computed tomography scan in evaluation of adult onset seizures in north-central Nigeria

Abstract

Background: Seizure is a sudden onset of paroxysmal event from abnormal excessive neuronal activity in the brain. Computed tomography (CT) is a veritable tool for evaluation of seizures in view of the relationship between the age of onset, clinical presentation, and radiologic findings. Aim: This article highlights common brain computed tomographic findings among patients with adult-onset seizures in Abuja, Nigeria. Methods: This was a retrospective study of the imaging records of 115 patients referred to the Radiology Department of University of Abuja Teaching Hospital for brain CT on account of adult-onset seizures from January 2014 to June 2017. Results: The mean age of the 115 adult patients studied was 41.2 ± 19.4 years with male-to-female ratio of 1.1:1. Sixty-five (56.5%) patients were less than 40 years whereas 50 patients (43.5%) were above 40 years. Majority (56.5%) of the patients had abnormalities in their cranial CT with 50 cases (43.5%) reported as normal. Patients with abnormal CT scan findings were older (49.9 ± 20.4 years) than those with normal CT scan (29.9 ± 9.9 years) with a higher incidence of abnormal CT findings in males (63.95%). Abnormal CT scan was seen in 21 (32.3%) of cases in 40-year age group. The most common structural abnormalities were brain atrophy (13.9%), intracranial tumors (12.2%), and brain infarction (10.4%). Conclusion: A single institutional study in Abuja, Nigeria, showed a high frequency of structural abnormalities on brain-computed tomograms of patients with adult-onset seizures with a significant increase with age.