Evidence map›Paper›PMID 41894169›Full record

GuidelineEpilepsia2026

Recommendations for structural magnetic resonance imaging in infants with first afebrile seizure or new onset epilepsy: Evidence-based recommendations from the ILAE Neuroimaging Task Force.

Gavin P Winston, Simone Salemme, Gaetano Cantalupo, Fernando Cendes, Felice D Arco, Paolo Federico, William D Gaillard, Eliane Kobayashi, Edward J Novotny, Godwin Ogbole and 6 more

Abstract readSystematic ReviewPractice Guideline
In one paragraph

Guideline in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Gavin P WinstonDivision of Neurology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.ORCID https://orcid.org/0000-0001-9395-1478
Simone SalemmeDepartment of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID https://orcid.org/0000-0002-9260-9993
Gaetano CantalupoDepartment of Engineering for Innovation Medicine, University of Verona, Verona, Italy.ORCID https://orcid.org/0000-0003-1343-8434
Fernando CendesDepartment of Neurology, University of Campinas, Campinas, Brazil.ORCID https://orcid.org/0000-0001-9336-9568
Felice D ArcoDepartment of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.ORCID https://orcid.org/0009-0000-3109-1599
Paolo FedericoDepartment of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, , Alberta, Canada.ORCID https://orcid.org/0000-0002-9555-3569
William D GaillardDivision of Neurology, Children's National Hospital, George Washington University, Washington, District of Columbia, USA.ORCID https://orcid.org/0000-0001-5709-0033
Eliane KobayashiDepartment of Neurology, University of Texas Southwestern Medical Center and Peter O'Donnell Jr. Brain Institute, Dallas, Texas, USA.ORCID https://orcid.org/0000-0002-1713-1563
Edward J NovotnyDivision of Child Neurology, Department of Neurology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0001-9726-0447
Godwin OgboleDepartment of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria.ORCID https://orcid.org/0000-0003-0431-7198
Abdul Kareem PullattayilQueen's University Library, Kingston, Ontario, Canada.ORCID https://orcid.org/0000-0002-6718-5228
Domenico TortoraNeuroradiology Unit, Department of Services, IRCCS Istituto Giannina Gaslini, Genoa, Italy.ORCID https://orcid.org/0000-0002-5621-4046
Matthew T WhiteheadDivision of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0001-5077-693X
Taoyun YiDepartment of Pediatrics, Peking University First Hospital, Beijing, China.ORCID https://orcid.org/0000-0003-0098-3257
Francesco BrigoInnovation, Research, and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University, Bolzano, Italy.ORCID https://orcid.org/0000-0003-0928-1577
Anna Elisabetta VaudanoDepartment of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.ORCID https://orcid.org/0000-0002-6280-7526

Funding

International League Against Epilepsy
6 · The paper itself

Abstract

Infants aged 1-24 months with new onset epilepsy frequently present with structural brain abnormalities, yet no updated evidence-based magnetic resonance imaging (MRI) guidelines exist for this population. The International League Against Epilepsy (ILAE) Neuroimaging Task Force developed evidence-based recommendations for structural brain MRI in infants with a first afebrile seizure or new onset epilepsy. A multidisciplinary panel defined three PICO (patients, intervention, comparison group, outcome under consideration) questions, conducted a systematic review (PROSPERO [Prospective Register of Systematic Reviews] CRD42024592653), and reported the results in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Risk of bias was evaluated using the JBI (Joanna Briggs Institute) checklist. GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology was used to assess certainty of evidence and formulate recommendations for the following: (1) the effectiveness of MRI in identifying underlying etiologies, (2) clinical predictors of MRI abnormalities, and (3) MRI protocols. Seventeen studies (n = 1209) were included. Among 753 infants who underwent MRI, 438 (58.2%) had abnormal findings. Despite heterogeneity in MRI protocols and reporting, the evidence supports the utility of MRI in this population. Specific clinical features (focal seizure semiology, abnormal neurological examination, seizure duration > 5 min, focal electroencephalographic abnormalities, developmental delay, and perinatal complications) were associated with abnormal MRI findings, although methodological limitations reduce certainty. Only six studies provided data on MRI sequences; however, none reported findings specifically in relation to the diagnostic accuracy or yield of individual protocols, precluding the development of evidence-based recommendations on MRI protocol selection. MRI is conditionally recommended in all infants with a first afebrile seizure or new onset epilepsy. MRI could be prioritized in those with specific clinical features indicative of higher likelihood of abnormal findings. Recommendations are based on very low certainty of evidence. These are the first ILAE-endorsed, evidence-based recommendations for MRI in infants with first afebrile seizure or new onset epilepsy. Further prospective studies with standardized protocols are needed to refine MRI indications and optimize diagnostic yield in this age group.

Indexed as

BrainEpilepsyMagnetic Resonance ImagingNeuroimagingSeizuresSeizures, FebrileAdvisory CommitteesEvidence-Based MedicineHumansInfantafebrile seizureepilepsyinfantsMRIneuroimaging

Identifiers

PMID41894169
PMCPMC13285247

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.