Imaging Methods for New-Onset Seizures at Canadian Pediatric Hospitals.

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Medical Imaging

Background:

• Seizures are common in children, necessitating neuroimaging for diagnosis.
• Magnetic resonance imaging (MRI) is preferred over computed tomography (CT) for pediatric seizure evaluation due to superior sensitivity and absence of ionizing radiation.
• Current practices for pediatric seizure imaging protocols and sedation in Canada lack national guidelines.

Purpose of the Study:

• To assess current neuroimaging practices for pediatric new-onset seizures across Canadian tertiary pediatric centers.
• To evaluate the use of dedicated seizure MRI protocols, sedation, and non-sedated MRI techniques.

Main Methods:

• A cross-sectional survey was distributed to radiologists at 16 Canadian tertiary pediatric centers.
• The survey collected data on MRI protocols for new-onset seizures, sedation practices, and strategies for non-sedated MRI.
• Response rate was 94% (15 centers).

Main Results:

• Significant variability in MRI protocols was observed; only 13% used dedicated new-onset seizure protocols, while 67% used epilepsy-specific protocols.
• Sedation practices varied widely, with a median sedation age range from 3 months to 6 years.
• Non-sedated techniques like feed-and-swaddle (93%) and natural sleep (27%) were common in infants; video goggles (67%) and child life support (53%) aided older children.

Conclusions:

• Substantial heterogeneity exists in MRI protocols and sedation use for pediatric new-onset seizures across Canadian centers.
• The findings highlight an urgent need for national consensus guidelines to standardize imaging, minimize sedation, and improve patient care.
• Standardization could enhance diagnostic accuracy and patient experience in pediatric seizure management.