Computed tomography and childhood seizure disorders

Yang, Peter J.; Berger, Paul E.; Cohen, Michael E.; Duffner, Patricia K.

doi:10.1212/wnl.29.8.1084

Cited by 81 publications

(35 citation statements)

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“…20,21 Extrapolation of data from the literature on the use of CT in neurologically healthy children who have generalized epilepsy has shown that clinically important intracranial structural abnormalities in this patient population are uncommon. 22,23 …”

Section: Action Statementmentioning

confidence: 99%

Febrile Seizures: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure

Seizures¹

2011

Pediatrics

387

190

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OBJECTIVE:To formulate evidence-based recommendations for health care professionals about the diagnosis and evaluation of a simple febrile seizure in infants and young children 6 through 60 months of age and to revise the practice guideline published by the American Academy of Pediatrics (AAP) in 1996. METHODS:This review included search and analysis of the medical literature published since the last version of the guideline. Physicians with expertise and experience in the fields of neurology and epilepsy, pediatrics, epidemiology, and research methodologies constituted a subcommittee of the AAP Steering Committee on Quality Improvement and Management. The steering committee and other groups within the AAP and organizations outside the AAP reviewed the guideline. The subcommittee member who reviewed the literature for the 1996 AAP practice guidelines searched for articles published since the last guideline through 2009, supplemented by articles submitted by other committee members. Results from the literature search were provided to the subcommittee members for review. Interventions of direct interest included lumbar puncture, electroencephalography, blood studies, and neuroimaging. Multiple issues were raised and discussed iteratively until consensus was reached about recommendations. The strength of evidence supporting each recommendation and the strength of the recommendation were assessed by the committee member most experienced in informatics and epidemiology and graded according to AAP policy. CONCLUSIONS:Clinicians evaluating infants or young children after a simple febrile seizure should direct their attention toward identifying the cause of the child's fever. Meningitis should be considered in the differential diagnosis for any febrile child, and lumbar puncture should be performed if there are clinical signs or symptoms of concern. For any infant between 6 and 12 months of age who presents with a seizure and fever, a lumbar puncture is an option when the child is considered deficient in Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae immunizations (ie, has not received scheduled immunizations as recommended), or when immunization status cannot be determined, because of an increased risk of bacterial meningitis. A lumbar puncture is an option for children who are pretreated with antibiotics. In general, a simple febrile seizure does not usually require further evaluation, specifically electroencephalography, blood studies, or neuroimaging.

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Section: Action Statementmentioning

confidence: 99%

Febrile Seizures: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure

Seizures¹

2011

Pediatrics

387

190

View full text Add to dashboard Cite

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“…48 In the Class I study in which 19 CT scans were done in selective cases (first seizures if greater than age 6 years, head trauma, or focal seizure), there was one significant abnormality (age of the patient was not given), a subdural hematoma, not predicted by history and physical examination. 14 Of the 14 Class II studies, nine involved children only (n = 2559), 17,19,[49][50][51][52][53][54][55][56] four were of adults only (n = 666), 24,42,57,58 and one involved children and adults (n = 109). 59 Only a small percentage of children in these studies (0 to 7%) had lesions on CT that altered or influenced management.…”

Section: Recommendationsmentioning

confidence: 99%

“…The yield of abnormality on CT when the neurologic examination and EEG were normal was 5 to 10%. 50,54 In a Class II study in which seven children (14% of children with nonfebrile seizures) had CT scans that influenced management, five had focal or complex partial seizures. Abnormalities on neuroimaging were associated with a higher recurrence risk.…”

Section: Recommendationsmentioning

confidence: 99%

Practice parameter: Evaluating a first nonfebrile seizure in children

Hirtz¹,

Ashwal²,

Berg³

et al. 2000

Neurology

345

230

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Article abstract-Objective: The Quality Standards Subcommittee of the American Academy of Neurology develops practice parameters as strategies for patient management based on analysis of evidence. For this practice parameter, the authors reviewed available evidence on evaluation of the first nonfebrile seizure in children in order to make practice recommendations based on this available evidence. Methods: Multiple searches revealed relevant literature and each article was reviewed, abstracted, and classified. Recommendations were based on a three-tiered scheme of classification of the evidence. Results: Routine EEG as part of the diagnostic evaluation was recommended; other studies such as laboratory evaluations and neuroimaging studies were recommended as based on specific clinical circumstances. Conclusions: Further studies are needed using large, well-characterized samples and standardized data collection instruments. Collection of data regarding appropriate timing of evaluations would be important.

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“…In a study conducted by Yang P et al, 17 out of 34 children with partial seiZlil';S had an abnormal cr. the commonest being atrophy [14]. Five cases had focal calcification [Fig 3) on cr of which two had a history of having been treated for tuberculosis and in one there were multiple calcification suggestive of healed granulomas.…”

Section: Discussionmentioning

confidence: 99%

Role of Ct Scan in Partial Seizures in Children

Kanitkar

Purkayastha²,

Deshpande

1994

Medical Journal Armed Forces India

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ABSTRAcr 50 consecutive cases of partial seizures hospitalised over a period of 2 years, were studied. cr Scans were done once at presentation and thereafter cases were followed up with repeat cr scans to evaluate treatment response wherever a treatable cause was found. cr scan diagnosis was correlated with clinical signs and other baseline investigations including an EEG. cr scan abnormality was detected in 66% cases. Single or multiple tuberculomas were noted in 24% cases, cortical atrophy in 14% cases, focal calcification in 10%, haemorrhage in 3% and subdural effusions in 2%. With positive clinical signs, 81% of cr scans were abnormal. 20% of patients with partial seizures having no clinical signs and normal base line investigations including an EEG, had a cr scan abnormality mainly a tuberculoma. MJAFI 1994; 50: 23-26

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Computed tomography and childhood seizure disorders

Cited by 81 publications

References 0 publications

Febrile Seizures: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure

Febrile Seizures: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure

Practice parameter: Evaluating a first nonfebrile seizure in children

Role of Ct Scan in Partial Seizures in Children

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