CT scans unnecessary in kids presenting with first seizure


By Nicola Garrett

3 May 2018

CT scans should be avoided in children and adolescents presenting with their first seizure, the Australia and New Zealand Child Neurology Society says.

The advice is one of five recommendations released by the society as part of the RACP’s Evolve initiative in which professional societies list their top 5 clinical practices that may be overused, provide little or no medical benefit or cause unnecessary harm to patients.

Professor Peter Procopis, adjunct Professor in Paediatrics & Child Health and senior RACP Fellow, said that last year more than 9,800 MBS-funded CT scans of the head were performed on children under the age of 15.

But given the increased risk of cancer in children exposed to CT scans it was important to reduce unnecessary neurological testing in young people.

“[the] increased risk of cancer is very small, with one additional cancer for every 1,400-2,000 CT scans…but  it’s still important that we reduce instances where doctors may conduct this test if it isn’t necessary,” he said.

The ANZCNS recommends that before undertaking a CT scan doctors use a combination of clinical examination, the patient’s clinical history and an electroencephalograph (EEG) if required.

ANZCNS Top 5 list ‘do not do’ clinical practices

  1. Do not routinely perform electroencephalographs (EEGs) for children presenting with febrile seizures
  2. Do not routinely perform computed tomography (CT) scanning of children presenting with new onset seizures
  3. Do not routinely undertake repeat blood level monitoring of antiepileptic drug (AED) treatments
  4. Do not routinely undertake neuroimaging for new onset primary headache without first examining for neurological abnormality
  5. Do not routinely perform electroencephalographs (EEGs) for children presenting with syncope (fainting)

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