The diagnostic value of semiology, <scp>EEG</scp> and <scp>MRI</scp> in new‐onset pediatric bilateral tonic–clonic seizures: A multimodal analysis

Children who experience a first-time convulsive seizure need an accurate diagnosis to guide appropriate treatment. In our study of 249 children with new onset bilateral tonic-clonic seizures, we found that no single diagnostic tool, whether seizure description, EEG, or MRI, was sufficient on its own. However, when these tools were combined, clinicians were able to correctly determine the seizure type in more than 80% of cases. We also found that some signs typically considered focal, such as head turning, may still appear in generalized seizures. These findings underscore the importance of a multimodal approach to ensure optimal diagnosis and treatment planning for children with new onset seizures.