Key Points
■ Neuroimaging (MRI/CT) in children with seizures rules out life-threatening brain lesions requiring immediate medical or surgical treatment (moderate evidence).
■ Magnetic resonance imaging is the neuroimaging study of choice in the workup of first unprovoked seizure (moderate evidence).
■ Emergency imaging with CT or MR should be performed in cases of long-lasting post-ictal confusion or focal deficit, in first unprovoked seizure (limited to moderate evidence).
■ Magnetic resonance is indicated in children with motor or developmental delays or under 1 year of age with symptomatic seizures (moderate evidence).
■ Neuroimaging is not recommended for a simple febrile seizure (limited evidence).
■ MRI is more sensitive than CT in detecting temporal lobe pathology (limited evidence).
■ The presence of a focal lesion on MRI is a strong predictor of intractable seizures in children with new onset of temporal lobe epilepsy (TLE) (moderate evidence).
■ Abnormal MRI may be found in more than 35% of patients with TLE (moderate evidence).
■ Generalized abnormalities in neuroimaging are correlated with higher risk of status epilepticus (moderate evidence).
■ Use of fMR increases importantly the post-test probabilities of hemispheric language dominance in patients with epilepsy (Bayesian analysis).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Karande S. Indian J Med Sci 2007;61:161–172.
Cowan LD, Leviton A, Bodensteiner JB, Doherty L. Paediatr Perinat Epidemiol 1989;3:386–401.
Cowan LD, Bodensteiner JB, Leviton A, Doherty L. Epilepsia 1989;30:94–106.
Leviton A. Cowan LD. Neuroepidemiology 1982;1:40–83.
Chiofalo N, Kirschbaum A, Fuentes A, Cordero ML, Madsen J. Epilepsia 1979;20:261–266.
Gomez JG, Arciniegas E, Torres J. Neurology 1978;28:90–94.
Medina MT, Durón RM, Martínez L, Osorio JR, Estrada AL, Zúniga C et al. Epilepsia 2005;46:124–131.
Beilmann A, Napa A, Sööt A, Talvik I, Talvik T. Epilepsia 1999;40:1011–1019.
Bell GS, Sander JW. Seizure 2001;10:306–314
Kramer U, Nevo Y, Neufeld MY, Fatal A, Leitner Y et al. Pediatr Neurol 1998;18:46–50.
Kwong KL, Chak WK, Wong SN, So KT. Pediatr Neurol 2001;24:276–282.
Hauser WA, Annegers JF, Rocca WA. Mayo Clin Proc 1996;71:576–586.
Knudsen FU. Arch Dis Child 1985;60:1045–1049.
Offringa M, Bossuyt PM, Lubsen J, Ellenberg JH, Nelson KB, Knudsen FU et al. J Pediatr 1994;124:574–584.
Berg AT, Shinnar S. Neurology 1996;47:562–568.
Argumosa A, Herranz JL. Epileptic Disord 2004;6:31–40.
Begley CE, Lairson DR, Reynolds TF, Coan S. Epilepsy Res 2001;47:205–215.
Shinnar S, O‘Dell C, Mitnick R, Berg AT, Moshe SL. Epilepsy Res 2001;43:261–269.
Sharma S, Riviello JJ, Harper MB, Baskin MN. Pediatrics 2003;111:1–5.
Berg AT, Testa FM, Levy SR, Shinnar S. Pediatrics 2000;106:527–532.
Khodapanahandeh F, Hadizadeh H. Arch Iran Med 2006;9:156–158.
Byars AW, deGrauw TJ, Johnson CS, Fastenau PS, Perkins SM, Egelhoff JC et al. Epilepsia 2007;48:1067–1074.
Garvey MA, Gaillard WD, Rusin JA, Ochsenschlager D, Weinstein S, Conry JA et al. J Pediatr 1998;133:664–669.
Harvey AS, Berkovic SF, Wrennall JA, Hopkins IJ. Neurology 1997;49:960–968.
Sztriha L, Gururaj AK, Bener A, Nork M. Epilepsia 2002;43:75–80.
Spooner CG, Berkovic SF, Mitchell LA, Wrennall JA, Harvey AS. Neurology 2006;67:2147–2153.
Sinclair DB, Wheatley M, Aronyk K, Hao C, Snyder T, Colmers W et al. Pediatr Neurosurg 2001;35:239–246.
Maytal J, Krauss JM, Novak G, Nagelberg J, Patel M. Epilepsia 2000;41:950–954.
Hirtz D, Ashwal S, Berg A, Bettis D, Camfield C, Camfield P et al. Neurology 2000;55:616–623.
Novak G, Maytal J, Alshansky A, Ascher C. Neurology 1997;49:533–537.
KarasalIho Glu S, Oner N, Celtik C, Celik Y, Biner B et al. Pediatr Int 2003;45:429–434.
Mazurkiewicz-Bełdzińska M, Szmuda M, Matheisel A. Folia Neuropathol 2006;44:314–318.
Tekgul H, Gauvreau K, Soul J, Murphy L, Robertson R, Stewart J et al. Pediatrics 2006;117:1270–1280.
Chen LS, Wang N, Lin MI. Pediatr Neurol 2002;26:282–287.
Duchowny M, Jayakar P, Resnick T, Harvey AS, Alvarez L, Dean P et al. Epilepsia 1998;39:737–743.
Ferrier CH, Engelsman J, Alarcón G, Binnie CD, Polkey CE. J Neurol Neurosurg Psychiatr 1999;66:350–356.
Hennessy MJ, Elwes RD, Honavar M, Rabe-Hesketh S, Binnie CD et al. J Neurol Neurosurg Psychiatr 2001;70:450–458.
Goldstein R, Harvey AS, Duchowny M, Jayakar P, Altman N, Resnick T et al. J Child Neurol 1996;11:445–450.
Offringa M, Moyer VA. West J. Medicine 2001;175:254–259.
American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996;97:769–772
Teng D, Dayan P, Tyler S, Hauser WA, Chan S, Leary L et al. Pediatrics 2006;117:304–308.
Harvey AS, Berkovic SF, Wrennall JA, Hopkins IJ. Neurology 1997;49:960–968.
Medina LS, Bernal B, Dunoyer C, Cervantes L, Rodriguez M, Pacheco E et al. Radiology 2005;236:247–253.
Medina LS, Bernal B, Ruiz J. Radiology 2007; 242:94–100.
Medina LS, Aguirre E, Bernal B, Nolan A. Radiology 2004; 230:49–54.
Lee JJ, Kang WJ, Lee DS, Lee JS, Hwang H, Kim KJ et al. Seizure 2005; 14: 213–220.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Bernal, B., Altman, N. (2010). Pediatric Neuroimaging of Seizures. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_10
Download citation
DOI: https://doi.org/10.1007/978-1-4419-0922-0_10
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-0921-3
Online ISBN: 978-1-4419-0922-0
eBook Packages: MedicineMedicine (R0)