Demystifying neurological investigations: a practical guide for the child with seizures

The epilepsies of childhood are a markedly heterogeneous group of diseases with different presentations, outcomes and aetiologies. There is no single, gold-standard investigation that will unequivocally diagnose an epilepsy. The range of aetiologies includes genetic, structural brain malformations and metabolic; in many, there may be a combination of causes. Despite major advances in neuro-imaging and genetics, a cause will not be identified in approximately 40% of all children with epilepsies. This article outlines the available investigations and provides a practical and structured approach on their most effective use in the childhood epilepsies.