Differential Diagnosis for Seizures in Young Children

Single Most Likely Diagnosis

• Febrile Seizure: This is the most common cause of seizures in young children, typically occurring between 6 months and 5 years of age, often associated with a fever but without the presence of intracranial infection or other defined cause.

Other Likely Diagnoses

• Epilepsy: A neurological disorder characterized by recurrent, unprovoked seizures. It's a common cause of seizures in children and can be due to various underlying factors such as genetic predisposition, brain injury, or infections.
• Infection (Meningitis, Encephalitis): Infections of the brain and meninges can cause seizures in young children. These conditions are medical emergencies and require prompt diagnosis and treatment.
• Head Trauma: Accidental or non-accidental head injuries can lead to seizures in children. The history and physical examination are crucial in identifying this cause.

Do Not Miss Diagnoses

• Metabolic Disorders (Hypoglycemia, Hyponatremia, etc.): Certain metabolic imbalances can precipitate seizures in children. These conditions are potentially life-threatening and require immediate correction.
• Intracranial Hemorrhage: Bleeding within the brain can cause seizures and is a medical emergency, especially in newborns and young infants.
• Ingestion or Toxins: Exposure to certain toxins or substances can lead to seizures. Identifying and treating the underlying cause is critical.
• Central Nervous System (CNS) Tumors: Although rare, CNS tumors can present with seizures in children. Early diagnosis is essential for effective management.

Rare Diagnoses

• Autoimmune Encephalitis: A rare condition where the immune system attacks the brain, leading to inflammation and seizures.
• Mitochondrial Disorders: A group of rare genetic disorders affecting the mitochondria, which can cause a variety of symptoms including seizures.
• Tuberous Sclerosis Complex (TSC): A rare genetic disorder that can cause seizures, developmental delay, and tumors in various organs.
• Pyridoxine-Dependent Epilepsy: A rare condition where seizures are resistant to conventional antiepileptic drugs but respond to pyridoxine (vitamin B6) supplementation.

Each of these diagnoses requires careful consideration based on the child's clinical presentation, history, and diagnostic findings to ensure appropriate management and treatment.