• For many years the recommendations for managing new-onset seizure (NOS) in the emergency department did not include any specific instruction for such patients with HIV/AIDS.
• A study done by Pesola and colleagues found that, infact, AIDS patients with NOS require additional vigilence in terms of their management.
• This study found that over 15% of AIDS patients with NOS would have erroneously been sent home without appropriate treatment had the standard recommendation for NOS management been followed; these patients were found to have intracranial lesions related to toxoplosmosis and lymphoma, and did not necessarily have focal neurologic deficits.
• It is therefore recommended that all AIDS patients with NOS undergo neuroimaging with lumbar puncture, as indicated.

References

• Pesola GR, Westfal RE. "New-onset generalized seizure in patients with AIDS presenting to an emergency department." Academic Emergency Medicine 5(9); 905-11: June 2008.