{"h1":"Screening and diagnostic pathway for childhood epilepsy under 7","faq":[{"a":"Diagnosis is primarily clinical, based on history and witnessed-event description. EEG supports seizure and syndrome classification and is recommended after a first unprovoked seizure, but a normal EEG does not exclude epilepsy, nor does an abnormal one confirm it in isolation.","q":"Is EEG required to diagnose epilepsy in a young child?"},{"a":"Consider MRI for focal seizure features, an abnormal neurological examination, developmental regression, or seizure onset under 2 years. It helps identify structural causes that influence treatment and prognosis.","q":"When is MRI brain indicated?"},{"a":"Medical evaluation and seizure control take priority and should not be delayed. Developmental and learning support is coordinated alongside the medical plan, particularly where epilepsy coexists with developmental delay.","q":"Should developmental therapy start before the diagnosis is confirmed?"}],"lang":"en","slug":"what-is-the-recommended-screening-and-diagnostic-pathway-for-childhood-epilepsy-in-children-under-7","title":"Childhood Epilepsy: Diagnostic Pathway Under 7","entity":{"key":"epilepsy","kind":"condition","name":"Childhood Epilepsy","slug":"childhood-epilepsy"},"lenses":[{"kind":"stakeholder","label":"Doctor","value":"doctor"},{"kind":"domain","label":"Context","value":"context"},{"kind":"intent","label":"Assessment","value":"assessment"},{"kind":"lifecycle","label":"Measure","value":"measure"},{"kind":"route","label":"Special-Education","value":"special-education"},{"kind":"empowerment","label":"Early Clarity","value":"early_clarity"}],"parent":{"key":"conditions","label":"Conditions"},"related":[{"lang":"en","slug":"how-is-childhood-epilepsy-assessed-in-children-under-7","title":"How Childhood Epilepsy Is Assessed in Children Under 7"},{"lang":"en","slug":"what-early-indicators-of-childhood-epilepsy-should-a-paediatrician-watch-for","title":"Early Indicators of Childhood Epilepsy"},{"lang":"en","slug":"how-is-childhood-epilepsy-assessed-in-a-young-child","title":"How Childhood Epilepsy Is Assessed in a Young Child"},{"lang":"en","slug":"which-standardised-tools-are-used-to-assess-childhood-epilepsy-in-early-childhood","title":"Standardised assessment tools for childhood epilepsy"},{"lang":"en","slug":"what-does-current-research-show-about-early-intervention-outcomes-for-childhood-epilepsy-in-children-under-7","title":"Early Intervention Outcomes in Childhood Epilepsy Under 7"},{"lang":"en","slug":"what-clinical-red-flags-for-childhood-epilepsy-warrant-referral-in-a-young-child","title":"Childhood Epilepsy red flags warranting referral in young children"}],"summary":"Childhood epilepsy (ICD-11 8A6Z) in children under 7 is a medical-urgency pathway: diagnosis rests on detailed seizure history and examination, supported by EEG and, where indicated, MRI and metabolic/genetic work-up. Refer promptly to paediatric neurology; developmental support runs alongside medical management, never instead of it.","answer_md":"*A first seizure in a young child is a clinical-urgency event, not a therapy-first one — the pathway begins with prompt medical evaluation.*\n\n## In short\nChildhood 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.\n\n## The diagnostic pathway\n**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.\n\n**2. Examination and screening.** Full neurological and developmental examination; screen for comorbid developmental delay, which is common in early-onset epilepsy and shapes prognosis.\n\n**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.\n\n**4. Classification and follow-up.** Define seizure type, epilepsy type and, where possible, syndrome — this drives treatment and counselling.\n\n## The Pinnacle way\nMedical diagnosis and any anti-seizure treatment sit with your neurology team. A clinical [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated) 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](/childhood-epilepsy) and [speech therapy](/speech-therapy) around the child's medical plan.\n\n## Trusted sources\nNICE guidance on epilepsies in children and young people; WHO ICD-11 (8A6Z); AAP guidance on the evaluation of the first seizure.\n\n**Next step —** Have a child with suspected seizures? Ensure prompt paediatric-neurology referral first, then [partner with Pinnacle](/childhood-epilepsy) for coordinated developmental support.\n\nThis is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.","canonical":"https://pinnacleblooms.org/ask/what-is-the-recommended-screening-and-diagnostic-pathway-for-childhood-epilepsy-in-children-under-7","editorial":{"reviewed_at":"2026-06-11T20:12:18.613642+00:00","reviewed_by":null,"developed_by":"SETU Consortium · Pinnacle Blooms Network"},"alternates":[{"href":"https://pinnacleblooms.org/ask/what-is-the-recommended-screening-and-diagnostic-pathway-for-childhood-epilepsy-in-children-under-7","lang":"en","indexable":true},{"href":"https://pinnacleblooms.org/ask/what-is-the-recommended-screening-and-diagnostic-pathway-for-childhood-epilepsy-in-children-under-7-te","lang":"te","indexable":true}],"dimensions":[{"key":"conditions","label":"Conditions"}],"meta_title":"Childhood Epilepsy Under 7: Diagnostic Pathway","meta_robots":"index, follow, max-image-preview:large","everyday_tip":"Ask families to record any suspected episode on a phone — semiology on video often clarifies diagnosis faster than any single test.","published_at":"2026-06-10T10:22:00.074758+00:00","reading_paths":[{"key":"understand","items":[{"lang":"en","slug":"what-does-current-research-show-about-early-intervention-outcomes-for-childhood-epilepsy-in-children-under-7","title":"Early Intervention Outcomes in Childhood Epilepsy Under 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EEG.","authority_links":[{"url":"https://icd.who.int/","code":"8A6Z","label":"WHO ICD-11: Childhood epilepsy"},{"url":"https://www.nice.org.uk/","label":"NICE: Epilepsies in children and young people"},{"url":"https://www.aap.org/","label":"AAP: Evaluation of the first seizure"}],"last_reviewed_at":"2026-06-10T10:22:00.074758+00:00","meta_description":"Clinician guide to screening and diagnosing childhood epilepsy (ICD-11 8A6Z) in children under 7 — history, EEG, imaging, classification and referral.","related_materials":[],"related_techniques":[]}