Document Detail


FDG-positron emission tomography and invasive EEG: seizure focus detection and surgical outcome.
MedLine Citation:
PMID:  9024188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study the value of [18F]2-deoxyglucose (FDG)-positron emission tomography when surface ictal EEG is nonlocalizing. METHODS: FDG-PET scans were performed in 46 patients with complex partial seizures (CPS) not localized by ictal surface-sphenoidal video-EEG (VEEG) telemetry. Interictal PET was performed with continuous EEG monitoring, and images were analyzed with a standard template. Forty patients subsequently had subdural and 6 had depth electrodes (invasive EEG, IEEG); 22 had bilateral implants. A focus was detected in 40, and 35 had temporal lobectomy based on IEEG localization. RESULTS: There was a close association between IEEG and PET localization (p < 0.01): 26 patients had relative unilateral temporal FDG-PET hypometabolism, all had congruent IEEG, and 18 of 23 were seizure-free after temporal lobectomy. Five patients had unilateral frontotemporal hypometabolism (3 of 5 were seizure-free), 1 had frontal hypometabolism, and 14 had no lateralized PET abnormality (4 of 7 were seizure-free). Patients who became seizure-free had significantly higher lateral temporal asymmetry index (AI). PET showed > or = 15% relative temporal hypometabolism (AI) in 12 of 22 patients with nonlateralized surface ictal VEEG and was capable of distinguishing between frontal and temporal foci in 16 of 24 patients with lateralized, but not localized, surface ictal video-EEG. CONCLUSIONS: FDG-PET provides valuable data in patients with unlocalized surface ictal EEG and can reduce the number of patients who require IEEG studies. Quantitation is necessary for optimal PET interpretation.
Authors:
W H Theodore; S Sato; C V Kufta; W D Gaillard; K Kelley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  38     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-27     Completed Date:  1997-02-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  81-6     Citation Subset:  IM    
Affiliation:
Clinical Epilepsy Section, NINDS NIH, Bethesda, Maryland 20892, USA.
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MeSH Terms
Descriptor/Qualifier:
Brain / metabolism,  radionuclide imaging
Deoxyglucose / analogs & derivatives,  diagnostic use
Diagnosis, Differential
Electrodes, Implanted
Electroencephalography / methods*
Epilepsies, Partial / diagnosis,  radionuclide imaging,  surgery
Epilepsy, Complex Partial / diagnosis*,  radionuclide imaging,  surgery
Fluorodeoxyglucose F18
Functional Laterality
Glucose / metabolism
Humans
Monitoring, Physiologic
Telemetry
Temporal Lobe / surgery
Tomography, Emission-Computed*
Treatment Outcome
Videotape Recording
Chemical
Reg. No./Substance:
154-17-6/Deoxyglucose; 50-99-7/Glucose; 63503-12-8/Fluorodeoxyglucose F18

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