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Intracranial lesions shown by CT scans in 259 cases of first alcohol-related seizures

Departments of Neurology (Dr. Earnest) and Emergency Medicine (Dr. Marx), Denver General Hospital, Denver, CO; Richmond General Hospital (Dr. Feldman), Vancouver, BC, Canada; University of Colorado School of Medicine (Mr. Harris), Denver, CO; Department of Neurology (Dr. Biletch), University of Wisconsin, Madison, WI; and Department of Neurology (Dr. Sullivan), University of Colorado Health Sciences Center, Denver, CO.

We obtained CTs in 259 patients with a first alcohol-related convulsion. Each subject had generalized convulsions, recent abstinence from alcohol abuse, and no obvious etiology for seizures other than alcohol withdrawal. Patients with only focal seizures, major head injury, coma, or a severe toxic-metabolic disorder were excluded. We recorded history and signs of minor head injury, presence of headache, level of consciousness, neurologic signs, routine medical examination findings, and subsequent clinical course. Sixteen patients (6.2%) had intracranial lesions on CT. Eight had subdural hematomas or hygromas, two had vascular malformations, two had neurocysticercosis, and one each showed a Berry aneurysm, possible tumor, skull fracture with subarachnoid hemorrhage, and probable cerebral infarction. In ten cases (3.9%), clinical management was altered because of the CT result. History or signs of minor head trauma, headache, level of consciousness, or focal neurologic signs did not significantly correlate with CT abnormality.

Address correspondence and reprint requests to Dr. Earnest, Department of Neurology, Denver General Hospital, 777 Bannock Street, Denver, CO 80204-4507.

Presented in part at the thirty-ninth annual meeting of the American Academy of Neurology, New York, NY, April 1987.

Received February 16, 1988. Accepted for publication in final form April 7, 1988.

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