What is the initial imaging study recommended for a patient with new onset seizures?

For a patient experiencing new onset seizures, a CT scan is typically the recommended initial imaging study. This is primarily because a CT scan can quickly assess for acute intracranial conditions that could be causing the seizures, such as hemorrhages, tumors, or other structural abnormalities. Given that seizures can be a manifestation of serious underlying issues, prompt imaging is crucial for timely diagnosis and intervention.

The CT scan offers rapid imaging capabilities, making it particularly advantageous in emergency settings where time is critical. It is also widely available in most healthcare facilities compared to other imaging modalities.

While MRI of the brain can provide more detailed images and is often used in the follow-up evaluation or to investigate persistent seizures, its longer acquisition time is a disadvantage in acute scenarios. An X-ray of the skull is generally not useful for evaluating seizures since it does not provide information about the brain tissue itself. An EEG, although essential for diagnosing seizure types and epilepsy, does not provide anatomical information and is not a primary imaging modality, thus is not the first step in evaluating new onset seizures.

Overall, the choice of a CT scan aligns with best practices in acute care settings for patients presenting with seizures, allowing for swift identification of potentially life-threatening conditions.