¹⁸ F-FDG PET Brain Findings in a Case of Idiopathic Benign Rolandic Epilepsy of Childhood

Area of Science:

• Pediatric Neurology
• Epileptology
• Neuroimaging

Background:

• Idiopathic benign rolandic epilepsy, also known as benign childhood epilepsy with centrotemporal spikes (BCECTS), is a common epilepsy syndrome in children.
• It typically has a favorable prognosis and is characterized by specific EEG findings.

Observation:

• A 5-year-old female presented with focal seizures involving the right side of her face since 6 months of age.
• She had normal development, unremarkable neurological examination, and no perinatal insults.
• Electroencephalogram confirmed rolandic spikes suggestive of BCECTS.

Findings:

• The patient's seizures were refractory to two antiepileptic drugs.
• Brain MRI showed no structural lesions.
• Interictal 18F-FDG PET revealed hypometabolism in the left lower rolandic region.

Implications:

• This case illustrates a rare presentation of refractory BCECTS.
• Neuroimaging, particularly 18F-FDG PET, may reveal metabolic changes even in the absence of structural lesions in some epilepsy syndromes.
• Further research into the neurobiological underpinnings of refractory BCECTS is warranted.