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Related Experiment Videos

Neuroimaging studies in children with temporal lobectomy

H Otsubo1, P A Hwang, H J Hoffman

  • 1Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|May 1, 1995
PubMed
Summary

Magnetic resonance imaging (MRI) is crucial for identifying seizure-causing abnormalities in children, especially mesial temporal sclerosis. Single photon emission computed tomography (SPECT) also aids in pinpointing these foci, complementing electroencephalogram (EEG) findings.

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Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Epilepsy Surgery

Background:

  • Intractable seizures in children often necessitate surgical intervention like temporal lobectomy.
  • Accurate localization of epileptogenic foci is critical for successful surgical outcomes.
  • Various neuroimaging modalities are employed to identify the source of seizures.

Purpose of the Study:

  • To evaluate the effectiveness of electroencephalogram (EEG), MRI, SPECT, and CT in localizing epileptogenic foci in children undergoing temporal lobectomy.
  • To determine the diagnostic yield of each imaging technique for specific pathologies like mesial temporal sclerosis and cortical dysplasia.

Main Methods:

  • Retrospective study of 28 children with intractable seizures who underwent temporal lobectomy.
  • Utilized prolonged video EEG telemetry, MRI, SPECT, and CT for epileptogenic focus localization.

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  • Correlated imaging findings with surgical pathology and outcomes.

    • Main Results:

    • MRI identified abnormalities in 21/25 patients, particularly useful for mesial temporal sclerosis and cortical dysplasia.
    • SPECT showed abnormalities in 17/22 patients, with 15 demonstrating interictal decrease in regional cerebral blood flow.
    • CT detected abnormalities in 16/28 patients, effectively identifying benign neoplasms with calcification.

    Conclusions:

    • MRI is essential for localizing epileptogenic abnormalities in pediatric epilepsy, especially mesial temporal sclerosis and cortical dysplasia.
    • SPECT complements EEG in localizing epileptogenic foci, particularly in cases with single pathologies.
    • CT is valuable for detecting benign temporal lobe neoplasms causing complex partial seizures.