Document Detail


Correlation of SPECT with pathology and seizure outcome in children undergoing epilepsy surgery.
MedLine Citation:
PMID:  12418792     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SPECT can be used to image regional cerebral blood flow (rCBF) and has been shown to help localize the seizure focus in partial epilepsies as part of the presurgical evaluation. Few studies have explored the possible relation between preoperative SPECT and underlying pathology, or any relation to postsurgical outcome. In this study preoperative ictal and interictal rCBF in relation to the histopathological diagnosis and outcome in a series of 35 children (24 females, 11 males; mean age 9.6 years, age range 11 months to 18 years) who had undergone resective surgery for epilepsy were retrospectively evaluated. A correlation between ictal hyperperfusion and the underlying responsible pathology was shown, with a consistent ictal increase in perfusion in developmental pathologies and Rasmussen's encephalitis, and consistent interictal hypoperfusion in hippocampal sclerosis (HS). No rCBF study parameter appeared to relate to outcome but in the group with HS the best outcome was seen in those with localizing ictal rCBF. The varied group of pathologies from hemispherectomy had excellent outcome but the SPECT findings had little to contribute over the abnormalities detected on MRI. In conclusion, rCBF studies remain a useful presurgical investigation in children with partial epilepsy, especially where HS, cortical dysplasia, or inflammatory disease are the underlying pathology. However, rCBF studies add little to the investigation of children with seizures secondary to benign tumours or cerebral infarcts, or where hemispherectomy is the likely preferred surgical option.
Authors:
L M Hartley; I Gordon; W Harkness; B Harding; B G R Neville; J H Cross
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Developmental medicine and child neurology     Volume:  44     ISSN:  0012-1622     ISO Abbreviation:  Dev Med Child Neurol     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-06     Completed Date:  2002-11-19     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0006761     Medline TA:  Dev Med Child Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  676-80     Citation Subset:  IM    
Affiliation:
Neuroscience Unit, Great Ormond Street Hospital for Children NHS Trust, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Brain / abnormalities,  blood supply*,  pathology
Brain Diseases / pathology,  radionuclide imaging*,  surgery
Cerebral Cortex / abnormalities,  blood supply,  pathology
Child
Child, Preschool
Encephalitis / pathology,  radionuclide imaging,  surgery
Epilepsies, Partial / pathology,  radionuclide imaging*,  surgery
Female
Follow-Up Studies
Hippocampus / pathology,  radionuclide imaging,  surgery
Humans
Infant
Male
Psychosurgery*
Regional Blood Flow / physiology
Retrospective Studies
Sclerosis
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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