Ictal PET in Ohtahara Syndrome With Hemimegalencephaly

Area of Science:

• Neurology
• Pediatric Epilepsy
• Medical Imaging

Background:

• Ohtahara syndrome is a rare, severe form of infantile epilepsy.
• It is characterized by refractory seizures and specific electroencephalogram (EEG) patterns.
• Structural brain anomalies are frequently associated with this condition.

Observation:

• A 5-month-old female infant presented with intractable seizures.
• The patient was diagnosed with Ohtahara syndrome and concurrent hemimegalencephaly.
• Standard diagnostic workup included EEG and neuroimaging.

Findings:

• 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) was utilized during a seizure event (ictal).
• Ictal FDG PET/CT imaging effectively localized the epileptic focus within the brain.
• This imaging modality proved crucial for identifying the source of the refractory seizures.

Implications:

• FDG PET/CT can be a valuable tool for precisely localizing seizure foci in complex pediatric epilepsy syndromes like Ohtahara syndrome.
• Accurate seizure focus localization is essential for guiding potential therapeutic interventions.
• This case highlights the utility of advanced neuroimaging in managing challenging pediatric neurological disorders.