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Evidence-Based Imaging in Pediatrics pp 127–140Cite as

Pediatric Neuroimaging of Seizures

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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).

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Author information

Authors and Affiliations

  1. Department of Radiology, Miami Children’s Hospital, 33155, Miami, FL, USA

    Byron Bernal & Nolan Altman MD (Chief)

Authors
  1. Byron Bernal
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  2. Nolan Altman MD
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Correspondence to Byron Bernal .

Editor information

Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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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

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  • DOI: https://doi.org/10.1007/978-1-4419-0922-0_10

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0921-3

  • Online ISBN: 978-1-4419-0922-0

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