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Imaging epilepsy in childhood

¹ Section of Academic Radiology, Floor C, Royal Hallamshire Hospital, University of Sheffield, Glossop Road, Sheffield S10 1SJ and ² >The Department of Paediatric Neurology, Sheffield Children's Hospital, UK

• Epilepsy is the condition where seizure activity becomes established and chronic.
  
• Close collaboration between the epilepsy physician and the imaging specialist is vital to maximize the chance of detecting a structural abnormality.
  
• Imaging is not routinely indicated following a simple febrile convulsion.
  
• Urgent imaging is necessary in the child presenting with a first seizure and other neurological signs/symptoms to exclude infection, haemorrhage or tumour, which may require urgent intervention. CT is generally the first line modality.
  
• The majority of problems arise in imaging children with chronic seizure disorders, partcularly demonstrating subtle abnormalities and in deciding where the epileptogenic focus is in cases of dual pathology.
  
• A highly detailed MR examination is required to identify mesial temporal sclerosis, the most important structural abnormality found in children with chronic complex partial seizures.
  

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