the place of neuroimaging

Last reviewed 01/2018

• neuroimaging is not routinely indicated in every case of childhood epilepsy e.g. in those with a well-defined benign syndrome such as benign Rolandic epilepsy of childhood. Also neuroimaging is not routinely indicated in children with a definite diagnosis of an idiopathic generalised epilepsy syndrome e.g. juvenile myoclonic epilepsy, typical absence epilepsy
• neuroimaging is always indicated if the child has evidence of:
• developmental regression, a neurological deficit, or a neurocutaneous syndrome (e.g. neurofibromatosis, tuberose sclerosis)
• a partial onset of seizures (simple and/or complex)
• myoclonic seizures (other than juvenile myoclonic epilepsy)
• infantile spasms
• seizures refractory to treatment, unclassifiable seizures
• if there is unexplained loss of previously good seizure control

Also, a child who has previously had a normal brain scan, but whose epilepsy remains poorly controlled, should probably have repeat imaging, ideally 12-18 months after previous 'normal' scan .

Magnetic resonance imaging is the recommended neuroimaging technique. It is superior to computerised tomography in terms of sensitivity and specificity.