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Updated: Jul 20, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Focal and global cortical hypometabolism in patients with newly diagnosed infantile spasms
L Metsähonkala1, E Gaily, H Rantala
1Department of Pediatrics, Turku University Central Hospital, PL52 20521 Turku, Finland. liisa.metsahonkala@tyks.fi
Insights
Focal brain glucose metabolism defects are common in infantile spasms but often transient. These findings, particularly in the occipital region, do not predict seizure outcomes in infants.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Metabolic Imaging
Background:
- Infantile spasms are a severe epilepsy syndrome in infants.
- The etiology can be symptomatic or cryptogenic.
- Understanding brain metabolism in infantile spasms is crucial for prognosis.
Purpose of the Study:
- To investigate the presence and prognostic significance of focal cerebral cortical glucose metabolism defects in infants with newly diagnosed infantile spasms.
- To compare metabolic findings between symptomatic and cryptogenic infantile spasms.
- To assess the evolution of these metabolic defects over time.
Main Methods:
- Utilized Magnetic Resonance Imaging (MRI), video-electroencephalography (video-EEG), and Positron Emission Tomography (PET) with fluorodeoxyglucose (FDG).
- Evaluated 17 infants within 2 weeks of diagnosis.
- Repeated PET scans at 1 year of age in 12 patients.
Main Results:
- Cortical hypometabolic foci were identified in 77% of infants with newly diagnosed spasms.
- These hypometabolic foci, especially in the occipital cortex, often resolved by age 1.
- Focal PET findings correlated with focal video-EEG abnormalities, but neither predicted seizure outcome.
Conclusions:
- Transient focal cortical hypometabolism, particularly occipital, is a frequent finding in infantile spasms.
- These metabolic changes are not always linked to structural brain abnormalities.
- The presence and resolution of these foci do not indicate a poor prognosis for seizure control.
Objective:
To evaluate the occurrence and prognostic importance of focal defects in cerebral cortical glucose metabolism in infants with newly diagnosed symptomatic and cryptogenic infantile spasms.
Patients And Methods:
Ten children with symptomatic and seven with cryptogenic infantile spasms underwent MRI, video-EEG, and PET using fluorodeoxyglucose as a tracer within 2 weeks of diagnosis. PET was repeated at 1 year of age in 12 patients.
Results:
Cortical hypometabolic foci were found in 13 children (77%) with newly diagnosed spasms (six cryptogenic and seven symptomatic). The hypometabolic foci disappeared in seven of nine reexamined at age 1. The occipital foci disappeared in all (n = 6). Focal findings on PET correlated well with focal findings on video-EEG. There was no difference in quantitative cortical or subcortical glucose metabolic rate at the onset of infantile spasms between children with cryptogenic and symptomatic etiology of spasms. The glucose metabolic rate at the onset of spasms or focal lesions in glucose metabolism did not have prognostic value for seizure outcome.
Conclusions:
Infantile spasms are often associated with transient cortical, especially occipital, hypometabolic foci that are not necessarily associated with structural lesions and do not indicate a poor prognosis.
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