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Published on: February 27, 2018
High-resolution (2.6-mm) PET in partial complex epilepsy associated with mesial temporal sclerosis
P E Valk1, K D Laxer, N M Barbaro
1Department of Radiology, University of California, San Francisco.
Radiology
|January 1, 1993
Summary
Positron emission tomography (PET) accurately identified the seizure focus in most patients with refractory partial epilepsy. This neuroimaging technique aids in localizing the epileptogenic zone before epilepsy surgery.
Area of Science:
- Neurology
- Nuclear Medicine
- Neurosurgery
Background:
- Medically refractory partial seizures pose a significant challenge in epilepsy management.
- Accurate localization of the epileptogenic zone is crucial for successful epilepsy surgery.
- Electroencephalography (EEG) and Magnetic Resonance (MR) imaging are standard tools, but their limitations exist.
Purpose of the Study:
- To evaluate the utility of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in lateralizing the epileptogenic focus in patients with medically refractory partial seizures.
- To compare FDG-PET findings with electroencephalography (EEG) and magnetic resonance (MR) imaging.
Main Methods:
- Eleven patients with refractory partial seizures, selected for temporal lobe resection, underwent FDG-PET.
- Patients with excluded structural lesions via MR imaging were studied.
- EEG was used to demonstrate the side of the focal abnormality.
Main Results:
- Ten out of eleven patients showed ipsilateral temporal cortical hypometabolism on FDG-PET, correlating with EEG findings.
- Two patients exhibited mesial temporal hypometabolism only.
- No incorrectly lateralizing PET results were observed.
- MR imaging identified an abnormality in seven patients; one patient had normal PET and MR findings.
- Histologic examination confirmed mesial temporal sclerosis in all resected temporal lobes.
Conclusions:
- FDG-PET is a valuable tool for lateralizing the epileptogenic focus in patients with medically refractory partial epilepsy.
- FDG-PET findings correlate well with EEG and surgical outcomes.
- This neuroimaging modality can aid in pre-surgical evaluation for epilepsy surgery.
