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Computed tomography and childhood seizure disorders
Neurology
|August 1, 1979
Summary
Computerized tomography (CT) scans are valuable for diagnosing seizure disorders in children, with abnormal findings more likely in partial or complex seizures. Normal neurological exams and electroencephalograms (EEGs) significantly reduce the likelihood of abnormal CT results.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Epileptology
Background:
- Seizure disorders are common in children, necessitating accurate diagnostic tools.
- Computerized tomography (CT) plays a role in evaluating pediatric neurological conditions.
- Understanding the yield of CT scans based on seizure characteristics is crucial for efficient diagnosis.
Purpose of the Study:
- To determine the diagnostic yield of computerized tomography (CT) in children with seizure disorders.
- To identify seizure types and clinical factors associated with a higher incidence of abnormal CT scans.
- To assess the utility of CT in conjunction with neurological examination and electroencephalogram (EEG) findings.
Main Methods:
- Retrospective analysis of 256 children with seizure disorders who underwent CT scans.
- Correlation of CT findings with seizure type, neurological examination, and EEG results.
- Categorization of patients into low-yield and high-yield groups based on seizure characteristics and clinical data.
Main Results:
- Overall abnormality rate in CT scans was 33%.
- Abnormal neurologic examination increased abnormal CT incidence to 64%.
- High-yield groups included partial seizures, complex symptomatology, known etiology, and neonatal seizures; low-yield groups included idiopathic generalized seizures with normal exams/EEGs.
- Only focal slowing on EEG significantly increased abnormal CT incidence.
- Seven children (2.7%) had surgically relevant intracranial abnormalities.
- When both neurological examination and EEG were normal, the yield of abnormal CT scans was only 5%.
Conclusions:
- CT scan findings in children with seizure disorders are significantly influenced by seizure type and clinical presentation.
- CT is a valuable tool, particularly for partial seizures and in cases with abnormal neurological examinations.
- In children with normal neurological examinations and EEGs, the diagnostic yield of CT is low, suggesting a selective approach may be beneficial.
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