What is the role of neuroimaging studies in the diagnosis of absence seizures?

Updated: Sep 25, 2018
  • Author: Scott Segan, MD; Chief Editor: Selim R Benbadis, MD  more...
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Neuroimaging findings are normal in idiopathic epilepsies by definition, and therefore, neuroimaging is not indicated if the typical clinical pattern is present.

However, neuroimaging is often ordered by primary care providers and the emergency department, especially if a child presents with a generalized tonic-clonic seizure, to rule out significant structural causes of seizures. A normal result helps to support the diagnosis of idiopathic epilepsy. For cryptogenic and symptomatic generalized epilepsies, neuroimaging can help in the diagnosis of any underlying structural abnormality.

If imaging is performed, magnetic resonance imaging (MRI) is preferred to computed tomography (CT) scanning. MRI is more sensitive for certain anatomic abnormalities.

A review of 134 MRI scans in patients with idiopathic generalized epilepsies found nonspecific abnormalities in 24%. [33]

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