Diagnostic imaging tools in the management childhood epilepsy

Abstract

Epilepsy is a major public health challenge and it is known to affect the paediatric population. Early diagnosis which includes history, physical examination and investigations and treatment is imperative for favourable outcomes in terms of seizure control and neurocognitive development. The management of paediatric epilepsies presents multiple challenges to the clinician because of non-epileptic imitators, evolving classification approaches, clinical presentations, limited clinical trial data for medications, and the toxicities of therapies. Although the diagnosis of epilepsy is clinical, there are many basic neuoroimaging techniques that are currently available for diagnostic classification. Many of the advanced techniques are not universally available; functional neuroimaging techniques, including positron emission tomography (PET) scanning, magnetic resonance spectroscopy (MRS), magnetic source imaging (MSI), single-photon emission computerized tomography (SPECT) scanning, and functional magnetic resonance imaging (fMRI), can be extremely beneficial in the localisation of the epileptogenic zone and for mapping functional areas of the brain. This article presents an understanding of the basic diagnostic systems in paediatric epilepsy and to identify the major challenges in the diagnosis of epilepsy.