Diagnostic importance of interictal electroencephalogram and neuroimaging of brain in new-onset idiopathic generalized epilepsy of childhood (IGEC)

Background: in the initial assessment of children with new-onset seizures,the suggestion that electroencephalography (eeg) is a standardinvestigation but neuroimaging of brain should be optional in theevaluation of patients with idiopathic generalized epilepsy of childhood (igec) has been questioned.aims: the purpose of this research was to describe the frequency of abnormalities in eeg,ct/mri-brain and their mutual correlation among children with new-onset idiopathic generalized epilepsy (igec).duration: from 1st november 2005 to 31st november2008.study type: cross-sectional observational.place: the neurophysiology department of the children's hospita lahore-pakistan patients and methods: 700 children aged 1month to 16 years were recruited when first diagnosed with epilepsy by 2005-2008. definitions for idiopathic generalized epilepsy of childhood etiology was as published by the international league against epilepsy. eeg records of all the study population and neuroimaging of those who had unifocal or multifocal interictal eeg abnormalities had been ordered as part of clinical workup.available ct/mri scans of brain of the study population with no or generalized interictal eeg abnormalities were included as the part of initial work-up. frequency prevalence of the abnormalities among these investigations and their mutual correlation were evaluated.results: among 700 children with new onset ige,interictal eeg findings were; 58% no abnormality and 42% had interictal eeg abnormalities (27.2% generalized abnormalities,11.6 % unifocal abnormalities,5.2 % multifocal abnormalities and 4% non-epileptic abnormalities). neuroimaging abnormalities were found in about 8% of the patients with no or generalized interictal eeg abnormalities (almost the percentage among both the groups). among the 103 patients with focal interictal eeg abnormalities,ct scan brain was abnormal in 74% and 67% was concordant in this group. whereas mris of the brain was abnormal in 79% and out of these 77% of these records were concordant with eeg findings. conclusion and recommendations: in children with newly diagnosed epilepsy who had focal eeg abnormalities,neuroimaging reveals a small but significant number of serious abnormalities not previously suspected. neuroimaging should be considered during the evaluation of children with newly diagnosed epilepsy,especially for those who have focal eeg abnormalities.