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

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. 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. 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). 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.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Schur S,Allen V,White A,Mirsky D,Stence N,O'Neill B,Handler M,Dudley R,Laoprasert P

doi

10.1159/000487088

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

153-162

issue

3

eissn

1016-2291

issn

1423-0305

pii

000487088

journal_volume

53

pub_type

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