Is the routine use of intravenous contrast justified in the work-up of adult-onset seizure patients with a normal pre-contrast brain scan?

Abstract

The indications for the administration of intravenous contrast media to adult patients presenting with first time seizures and a normal pre-contrast study are not clear. A retrospective audit of such patients was done and compared with the post-contrast study. In our study sample of 205 patients all the post-contrast scans were reported as normal, indicating that contrast can be omitted if the precontrast study was normal. This only applies to computed tomography, and magnetic resonance imaging was not included.