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Significance of FDG-PET Hypermetabolism in Children with Intractable Focal Epilepsy.

Significance of FDG-PET Hypermetabolism in Children with Intractable Focal Epilepsy.

Authors :
Schur S
Allen V
White A
Mirsky D
Stence N
O'Neill B
Handler M
Dudley R
Laoprasert P
Source :
Pediatric neurosurgery [Pediatr Neurosurg] 2018; Vol. 53 (3), pp. 153-162. Date of Electronic Publication: 2018 Apr 19.
Publication Year :
2018

Abstract

Background: Interictal 18F-fluorodeoxyglucose-positron emission topography (FDG-PET) hypometabolism is routinely used in the presurgical workup of children with medically intractable epilepsy (MIE). FDG-PET hypermetabolism, however, is rarely seen, and the significance of this finding in the epilepsy workup is not well established.<br />Methods: We performed a retrospective study of patients who underwent FDG-PET during the presurgical workup of MIE over a 4-year period, between 1 January 2010 and 31 December 2013, at the Children's Hospital Colorado, CO, USA.<br />Results: Focal FDG-PET hypermetabolism was identified in 7 (2.2%) of 317 patients. The median age was 124 months, all cases with catastrophic epilepsy. Surface electroencephalography (EEG) performed concomitantly with FDG injections revealed ictal EEG discharges in 2 patients, frequent interictal epileptiform discharges (IEDs) in 3, occasional IEDs in 1, and no IEDs in 1. All 7 patients underwent functional hemispherectomies. Histopathology revealed type 1 focal cortical dysplasia in all patients. Six (86%) were completely seizure-free (Engel class I) and 1 had extremely infrequent seizures (Engel class II) (mean follow-up, 47.4 months).<br />Conclusion: While a rare finding, interictal PET hypermetabolism does occur, may help identify epileptogenic zones, and assessment to reveal it should be made by concomitant use of surface EEG during PET scans.<br /> (© 2018 S. Karger AG, Basel.)

Details

Language :
English
ISSN :
1423-0305
Volume :
53
Issue :
3
Database :
MEDLINE
Journal :
Pediatric neurosurgery
Publication Type :
Academic Journal
Accession number :
29672310
Full Text :
https://doi.org/10.1159/000487088