{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:41:42Z","timestamp":1790163702425,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100030695","name":"International League Against Epilepsy","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030695","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Infants aged 1\u201324\u2009months with new onset epilepsy frequently present with structural brain abnormalities, yet no updated evidence\u2010based magnetic resonance imaging (MRI) guidelines exist for this population. The International League Against Epilepsy (ILAE) Neuroimaging Task Force developed evidence\u2010based 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\u2010Analyses) 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                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091209) 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 &gt;\u20095\u2009min, 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\u2010based 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\u2010endorsed, evidence\u2010based 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.\n                  <\/jats:p>","DOI":"10.1002\/epi.70205","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:25:07Z","timestamp":1774628707000},"page":"2725-2738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Recommendations for structural magnetic resonance imaging in infants with first afebrile seizure or new onset epilepsy: Evidence\u2010based recommendations from the\n                    <scp>ILAE<\/scp>\n                    Neuroimaging Task Force"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-1478","authenticated-orcid":false,"given":"Gavin P.","family":"Winston","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Medicine Queen's University  Kingston Ontario Canada"},{"name":"Centre for Neuroscience Studies Queen's University  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9260-9993","authenticated-orcid":false,"given":"Simone","family":"Salemme","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic, and Neural Sciences University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1343-8434","authenticated-orcid":false,"given":"Gaetano","family":"Cantalupo","sequence":"additional","affiliation":[{"name":"Department of Engineering for Innovation Medicine University of Verona  Verona Italy"},{"name":"Child Neuropsychiatry Unit Verona University Hospital, Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"},{"name":"Center for Research on Epilepsy in Pediatric Age Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9336-9568","authenticated-orcid":false,"given":"Fernando","family":"Cendes","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3109-1599","authenticated-orcid":false,"given":"Felice","family":"D\u2032Arco","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Great Ormond Street Hospital for Children NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9555-3569","authenticated-orcid":false,"given":"Paolo","family":"Federico","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary , Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5709-0033","authenticated-orcid":false,"given":"William D.","family":"Gaillard","sequence":"additional","affiliation":[{"name":"Division of Neurology Children's National Hospital, George Washington University  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1713-1563","authenticated-orcid":false,"given":"Eliane","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas Southwestern Medical Center and Peter O'Donnell Jr. Brain Institute  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9726-0447","authenticated-orcid":false,"given":"Edward J.","family":"Novotny","sequence":"additional","affiliation":[{"name":"Division of Child Neurology, Department of Neurology Seattle Children's Hospital, University of Washington  Seattle Washington USA"},{"name":"Norcliffe Foundation Center for Integrative Brain Research  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-7198","authenticated-orcid":false,"given":"Godwin","family":"Ogbole","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Medicine University of Ibadan  Ibadan Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6718-5228","authenticated-orcid":false,"given":"Abdul Kareem","family":"Pullattayil","sequence":"additional","affiliation":[{"name":"Queen's University Library  Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5621-4046","authenticated-orcid":false,"given":"Domenico","family":"Tortora","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit, Department of Services, IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5077-693X","authenticated-orcid":false,"given":"Matthew T.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Department of Radiology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Radiology Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-3257","authenticated-orcid":false,"given":"Taoyun","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Peking University First Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0928-1577","authenticated-orcid":false,"given":"Francesco","family":"Brigo","sequence":"additional","affiliation":[{"name":"Innovation, Research, and Teaching Service (SABES\u2010ASDAA), Teaching Hospital of the Paracelsus Medical Private University  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-7526","authenticated-orcid":false,"given":"Anna Elisabetta","family":"Vaudano","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic, and Neural Sciences University of Modena and Reggio Emilia  Modena Italy"},{"name":"Neurophysiology Unit and Epilepsy Center, Neuroscience Department Modena Azienda Ospedaliera\u2010Universitaria  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101157.1993.tb02586.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101157.1997.tb01226.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.15612"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2009.02075.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13057"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17312"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.09.012"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_10_1","volume-title":"JBI manual for evidence synthesis","author":"Moola S","year":"2020"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_11_12_1","unstructured":"GronsethGS CoxJ GlossD MerillatS ArmstrongMJ GetchiusTSD.Clinical Practice Guideline Process Manual 2017 ed. (2017 ed.) [Process Manual]. on behalf of the Guideline Development Dissemination and Implementation Subcommittee of the American Academy of Neurology.2017."},{"key":"e_1_2_11_13_1","volume-title":"GRADE handbook for grading quality of evidence and strength of recommendations","author":"Sch\u00fcnemann H","year":"2013"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16701"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2016.10.008"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7193"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2018.12.013"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13574"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp187"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.3.527"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018\u20100672"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.342.14807"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2014.06.003"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/aian.aian_842_22"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.47009\/jamp.2022.4.3.20"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/jpn.JPN_61_18"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2022.256"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010022\u201003668\u20106"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12046"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c91847"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.13115"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2023.107946"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/epd2.20050"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2009.02.032"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528\u20101167.2005.00339.x"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.5.616"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi.70205","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T12:25:22Z","timestamp":1782131122000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi.70205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/epi.70205"],"URL":"https:\/\/doi.org\/10.1002\/epi.70205","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"assertion":[{"value":"2026-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}