On the basis of a thorough physical examination, the following points should be noted in the diagnosis of childhood epilepsy: 1. Head shape and size: Head size is one of the most important indicators of brain development. Head circumference should be measured in every patient with epilepsy. Intrauterine infections, severe perinatal ischemic-hypoxic encephalopathy, neonatal asphyxia or intracranial infections can affect the development of the head, and these diseases are often common causes of secondary epilepsy as well. The first thing you need to do is to look at the face and see if there are any abnormalities. Pay attention to whether the inner canthus is too large, whether the eyes are too small (small cornea), the length of the human middle, whether the position of the outer ear is too low, whether the jaw is too small, and whether the jaw arch is too high. 3, limbs, external genitalia deformities: some chromosomal abnormalities or endocrine disorders can cause secondary epilepsy. The abnormalities of the limbs are often present. The presence of multiple fingers (toes) or parallel fingers (toes), external genitalia abnormalities, testicular size in boys, etc. should be noted. 4. Skin: Many neurocutaneous syndromes are combined with epilepsy and have obvious skin abnormalities, which can be detected with a little attention. For example, in tuberous sclerosis, white depigmented spots can be seen on the skin during infancy, and angiofibromas can appear on the face after the age of 5 to 6. In neurofibromatosis, coffee milk spots are common. In cerebral angiomatosis (Sturge2Weber disease), red vascular nevi can be seen on the face. Pigmentary disorders are characterized by localized abnormal pigmentation of the skin. In Ito pigmentary disorders, large areas of pigment loss can be seen in the skin of the limbs or trunk in the form of cords or patches. 5, the presence of special smell: in some children with abnormal amino acid metabolism diseases, in addition to convulsions, due to the increase of abnormal metabolites in the body, and excreted by urine, sweat, patients have some special smell, such as phenylketonuria (rat urine smell); maple sugar urine disease (caramel smell); hypermethionine blood (boiled cabbage water smell), etc. 6.With or without movement disorder: Cerebral palsy patients are often combined with epilepsy. Patients with cerebral palsy often show central movement disorders, abnormal posture, muscle tone and reflexes, and backward motor development.