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Positron emission tomographic study of late-onset cryptogenic symptomatic seizures
J De Reuck1, P Santens, D Decoo
1Department of Neurology, University Hospital, Ghent, Belgium.
Clinical Neurology and Neurosurgery
|August 1, 1995
Summary
Late-onset epilepsy in older adults may signal a progressive, unknown brain disorder. Positron emission tomography revealed widespread reduced cerebral blood flow and oxygen metabolism, not focal deficits, suggesting a systemic encephalopathy.
Area of Science:
- Neurology
- Neuroimaging
- Epileptology
Background:
- Epilepsy developing after age 50 in patients without cognitive decline is uncommon.
- The underlying pathophysiology of late-onset epilepsy of unknown origin requires further investigation.
Purpose of the Study:
- To investigate cerebral blood flow and oxygen metabolism in patients with late-onset epilepsy.
- To explore the potential link between late-onset seizures and underlying progressive encephalopathy.
Main Methods:
- Positron emission tomography (PET) with steady-state 15O technique was employed.
- Ten epilepsy patients (onset >50 years, no cognitive decline) were studied.
- Cerebral blood flow and oxygen metabolism were quantified.
Main Results:
- Significant decreases in cerebral blood flow and oxygen metabolism were observed across all cortical areas.
- No focal hypometabolic regions were identified.
- Phenytoin treatment did not alter the observed metabolic patterns.
Conclusions:
- Late-onset epilepsy may represent early clinical manifestations of an undiagnosed progressive encephalopathy.
- Widespread cortical hypometabolism, rather than focal lesions, characterizes this epilepsy subtype.
- Further research is warranted to elucidate the etiology and progression of this condition.