Electroencephalographic and neuroradiologic evaluation of children with epilepsy

In summary, CT scans are frequently abnormal in children with partial seizures. Although most of the abnormalities will not alter management of the child, in a small but significant percentage an unexpected neoplasm or other treatable lesion will be discovered. In addition, even when the CT scan does not alter therapeutic management, it may offer the clinician valuable information regarding the etiology of the seizures. A normal CT scan also serves to ensure both the physician and the parent that "nothing is being missed." As a guideline, I would recommend that all patients, with the exception of those with absence seizures, benign rolandic epilepsy, febrile seizures, and typical absence seizures have a CT scan with and without contrast enhancement. Even with a normal CT scan, however, the physician should follow the patient closely because a change in neurologic examination or the development of focal slowing on the EEG indicates the necessity for a repeat study.