Early Detection and Diagnosis of Pediatric Epilepsy
Understanding early symptoms and diagnosis methods helps in timely intervention and better outcomes for children with suspected seizures.
Key Diagnostic Symptoms
Epilepsy can be diagnosed by three main symptoms:
- Unprovoked recurrent seizures
- Abnormal brain activity detected on EEG
- Associated developmental or neurological signs
1. Clinical description of seizures
2. Thorough medical history
3. Neurologic assessment from a specialty epilepsy center
4. Neuroimaging and neurophysiological monitoring
Perform thorough physical and neurological examinations for children with suspected seizures.
- Record vital signs, including temperature.
- Essential tests: serum electrolytes (glucose, calcium, magnesium, sodium) & CSF analysis.
- Consider white blood cell count in children with fever.
Different diagnostic approaches for epilepsy:
- EEG detects abnormalities in brain electrical activity and brainwave dynamics.
EEG approach to diagnosis:
CT Scan: Creates detailed 2D images
MRI: Provides detailed images of body structures
PET Scan: Reveals tissue and organ function
SPECT: Assesses neuronal activity by quantifying cerebral blood flow
HRMRI: High-resolution MRI using 1.5 T field with focused view
Proton-MRS: Measures N-acetyl aspartate (NAA) levels for neuronal
integrity
Abbreviations
- EEG: Electroencephalogram
- CT: Computed Tomography
- MRI: Magnetic Resonance Imaging
- PET: Positron Emission Tomography
- SPECT: Single Photon Emission Tomography
- HRMRI: High-Resolution MRI
- MRS: Magnetic Resonance Spectroscopy
References
- Minardi C, Minacapelli R, Valastro P, Vasile F, Pitino S, Pavone P, Astuto M, Murabito P. Epilepsy in children: from diagnosis to treatment with focus on emergency. Journal of Clinical Medicine. 2019 Jan 2;8(1):39.
- Smith AW, Gutierrez-Colina AM, Guilfoyle SM, Modi AC. Pediatric epilepsy. In: Adherence and Self-Management in Pediatric Populations. Academic Press; 2020. p. 207–233.
- Bashiri FA. Childhood epilepsies: What should a pediatrician know? Neurosciences (Riyadh). 2017 Jan;22(1):14-19.
- Bandopadhyay R, Singh T, Ghoneim MM, Alshehri S, Angelopoulou E, Paudel YN, Piperi C, Ahmad J, Alhakamy NA, Alfaleh MA, Mishra A. Recent developments in diagnosis of epilepsy: scope of MicroRNA and technological advancements. Biology. 2021 Oct 25;10(11):1097.
- Kim EH, Shin J, Lee BK. Neonatal seizures: diagnostic updates based on new definition and classification. Clin Exp Pediatr. 2022 Aug;65(8):387-397.