Screening and diagnostic pathway for childhood epilepsy under 7

A first seizure in a young child is a clinical-urgency event, not a therapy-first one — the pathway begins with prompt medical evaluation.

In short

Childhood epilepsy (ICD-11 8A6Z) in children under 7 is diagnosed clinically — by a detailed seizure history, witnessed-event description and examination — supported by EEG and, where indicated, neuroimaging. Refer any child with a suspected unprovoked seizure to a paediatrician or paediatric neurologist promptly; this is a medical-urgency pathway, not a developmental-therapy entry point. Developmental and learning support runs alongside medical management, never instead of it.

The diagnostic pathway

1. History first. The single most valuable diagnostic tool is a structured account of the event — onset, semiology, duration, post-ictal state, triggers, and any developmental regression. Home video of episodes is invaluable. Distinguish epileptic seizures from breath-holding spells, syncope, parasomnias and stereotypies.

2. Examination and screening. Full neurological and developmental examination; screen for comorbid developmental delay, which is common in early-onset epilepsy and shapes prognosis.

3. Investigations. EEG (ideally including sleep/sleep-deprived recording) after a first unprovoked seizure; MRI brain for focal features, abnormal examination, or onset under 2 years; metabolic and genetic work-up where the phenotype suggests a syndrome. Per NICE, EEG supports classification — it does not confirm or exclude epilepsy on its own.

4. Classification and follow-up. Define seizure type, epilepsy type and, where possible, syndrome — this drives treatment and counselling.

The Pinnacle way

Medical diagnosis and any anti-seizure treatment sit with your neurology team. A clinical AbilityScore® and any developmental diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care — never from an app or form. Where seizures coexist with developmental delay, we map functioning across domains and coordinate developmental therapy and speech therapy around the child's medical plan.

Trusted sources

NICE guidance on epilepsies in children and young people; WHO ICD-11 (8A6Z); AAP guidance on the evaluation of the first seizure.

Next step — Have a child with suspected seizures? Ensure prompt paediatric-neurology referral first, then partner with Pinnacle for coordinated developmental support.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.