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.
