Feasibility of Non-sedated Brain MRI in Young Children With New-Onset Seizures: A Pilot Study of Clinical Utility and Caregiver Experience

Brain magnetic resonance imaging (MRI) is recommended to rule out structural abnormalities in children presenting with new-onset unprovoked seizures. Although non-pharmacologic methods enable successful non-sedated MRIs in neonates and older children, monitored anesthesia care (MAC) remains the standard approach for those aged 1 month to 3 years. However, anesthesia exposure may be associated with adverse neurodevelopmental outcomes, increased health care costs, and longer wait times. We evaluated the feasibility, clinical utility, and family experiences of non-sedated MRI in 31 children aged 1 month to 3 years requiring brain MRI following new-onset seizures. Image quality was assessed by a neuroradiologist, and caregivers completed experience surveys. Completed MRI images were obtained in 27 of 31 participants (87%), and 26 of those 27 participants (96%) had diagnostic-quality images. Ninety percent of caregivers were satisfied and willing to repeat non-sedated MRI. These findings support non-sedated MRI as a feasible and caregiver-accepted alternative to anesthesia in young children.