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PET Scanning in Partial Epilepsy

Published online by Cambridge University Press:  18 September 2015

Jerome Engel Jr.
Jerome Engel Jr.*
Affiliation:
Departments of Neurology and Anatomy, Laboratory of Nuclear Medicine, and Brain Research Institute, UCLA School of Medicine, Los Angeles
*
Reed Neurological Research Center, UCLA School of Medicine, Los Angeles, California, U.S.A. 90024
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Abstract:

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Many biologically active tracers are available for positron emission tomography (PET) investigations, but most studies of epilepsy have utilized l8F-fluorodeoxyglucose (FDG) to measure local cerebral metabolic rate for glucose. Over 70% of patients with medically refractory partial seizures demonstrate an interictal zone of hypometabolism corresponding to the epileptogenic region. This metabolic defect commonly involves the temporal lobe in patients with complex partial seizures of mesial temporal origin, and is encountered less consistently with seizures of extratemporal neocortical origin. Although false localization is less likely with FDG-PET than with EEG, the hypometabolic zone merely reflects a focal functional deficit and its epileptogenicity must still be demonstrated electrophysiologically. When hemispherectomy or large multilobar resections are planned in small children, FDG-PET also provides useful supporting evidence that the contralateral hemisphere is functioning normally. It is difficult to obtain FDG-PET scans and to interpret results during spontaneous partial seizures. Ictal scans can be more easily obtained with single photon emission computed tomography (SPECT), which may provide information for planning surgical resections.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 18 , Issue S4 , November 1991 , pp. 588 - 592
Copyright
Copyright © Canadian Neurological Sciences Federation 1991

References

REFERENCES

1.Phelps, ME, Hoffman, EJ, Mullani, NA, et al. Application of annihilation coincidence detection to transaxial reconstruction tomography. J Nucl Med 1975; 16: 210–224.Google ScholarPubMed
2.Engel, J Jr. Approaches to localization of the epileptogenic lesion. In: Engel, J Jr, ed. Surgical treatment of the epilepsies. New York: Raven Press, 1987; 75–96.Google Scholar
3.Phelps, ME, Mazziotta, JC, Schelbert, HR, et al. Clinical PET: what are the issues? J Nucl Med 1985; 26: 1353–1358.Google Scholar
4.Abou-Khalil, BW, Siegel, GJ, Sackellares, JC, et al. Positron emission tomography studies of cerebral glucose metabolism in chronic partial epilepsy. Ann Neurol 1987; 22: 480–486.CrossRefGoogle ScholarPubMed
5.Engel, J Jr, Brown, WJ, Kuhl, DE, et al. Pathological findings underlying focal temporal lobe hypometabolism in partial epilepsy. Ann Neurol 1982; 12: 518–528.CrossRefGoogle ScholarPubMed
6.Engel, J Jr, Kuhl, DE, Phelps, ME, et al. Comparative localization of epileptic foci in partial epilepsy by PCT and EEG. Ann Neurol 1982; 12: 529–537.CrossRefGoogle ScholarPubMed
7.Engel, J Jr, Kuhl, DE, Phelps, ME, et al. Interictal cerebral glucose metabolism in partial epilepsy and its relations to EEG changes. Ann Neurol 1982; 12: 510–517.CrossRefGoogle ScholarPubMed
8.Franck, G, Sadzot, B, Salmon, E, et al. Regional cerebral blood flow and metabolic rates in human focal epilepsy and status epilepticus. In: Delgado-Escueta, AV, Ward, AA Jr, Woodbury, DM, Porter, RJ, eds. Advances in Neurology, Vol. 44: Basic mechanisms of the epilepsies, molecular and cellular approaches. New York: Raven Press, 1986; 935–948.Google Scholar
9.Theodore, WH, Newmark, ME, Sato, S, et al. 18F-fluorodeoxyglucose positron emission tomography in refractory complex partial seizures. Ann Neurol 1984; 14: 429–437.CrossRefGoogle Scholar
10.Yamamoto, YL, Ochs, R, Gloor, P, et al. Patterns of rCBF and focal energy metabolic changes in relation to electroencephalographic abnormality in the inter-ictal phase of partial epilepsy. In: Baldy-Moulinier, M, Ingvar, D-H, Meldrum, BS, eds. Current problems in epilepsy: 1. Cerebral blood flow, metabolism and epilepsy. London: John Libbey, 1983: 51–62.Google Scholar
11.Bernardi, S, Trimble, MR, Frackowiak, RSJ, et al. An interictal study of partial epilepsy using positron emission tomography and the oxygen — 15 inhalation technique. J Neurol Neurosurg Psychiatry 1983; 46: 473–477.CrossRefGoogle ScholarPubMed
12.Kuhl, DE, Engel, J Jr, Phelps, ME, et al. Epileptic patterns of local cerebral metabolism and perfusion in humans determined by emission computed tomography of l8FDG and l3NH3. Ann Neurol 1980; 8: 348–360.CrossRefGoogle Scholar
13.Engel, J Jr.Positron emission tomography in frontal lobe epilepsy. Epilepsia 1988; 29: 213 (Abstract).Google Scholar
14.Henry, TR, Mazziotta, JC, Engel, J Jr. The functional anatomy of frontal lobe epilepsy studied with PET. In: Delgado-Escutea, AV, Chandel, P, Halgren, E, Bancaud, J, eds. The Frontal Lobe Epilepsies (in press).Google Scholar
15.Theodore, WH, Fishbein, D, Dubinsky, R.Patterns of cerebral glucose metabolism in patients with partial seizures. Neurology 1988; 38: 1201–1206.CrossRefGoogle ScholarPubMed
16.Henry, TR, Mazziotta, JC, Engel, J Jr, et al. Quantitative interictal metabolic anatomy of human temporal lobe epilepsy. (Submitted)Google Scholar
17.Engel, J Jr, Henry, TR.Neuroimaging and EEG. In: Wada, JA, Ellingson, RJ, eds. Handbook of Electroencephalography and Clinical Neurophysiology: Clinical Neurophysiology of Epilepsy Revised Series. Amsterdam: Elsevier (in press).Google Scholar
18.Engel, J Jr, Sutherling, WW, Cahan, Let al. The role of positron emission tomography in the surgical therapy of epilepsy. In: Porter, RJ, Mattson, RH, Ward, AA Jr, Dam, M, eds. Advances in epileptology: XV epilepsy international symposium. New York: Raven Press, 1984; 427–432.Google Scholar
19.Risinger, MD, Engel, J Jr, Van Ness, PL, et al. letal localization of temporal lobe seizures with scalp/sphenoidal recordings. Neurology (in press).Google Scholar
20.Engel, J Jr, Crandall, PH, Rausch, R.The partial epilepsies. In: Rosenberg, RN, ed. The clinical neurosciences, vol. 2. New York: Churchill Livingstone, 1983; 1349–1380.Google Scholar
21.Engel, J Jr, Crandall, PH.Falsely localizing ictal onsets with depth EEG telemetry during anticonvulsant withdrawal. Epilepsia 1983; 24: 344–355.CrossRefGoogle ScholarPubMed
22.Engel, J Jr. Comparison of positron emission tomography and electroencephalography as measures of cerebral function in epilepsy. In: Pfurtscheller, G, Lopes da Silva, FH, eds. Functional Brain Imaging. Bern: Hans Huber, 1988; 229–238.Google Scholar
23.Henry, TR, Engel, J Jr, Davis, C, et al. Seizure recency and frequency effects on the probability of finding focal hypometabolism on interictal fluorodeoxyglucose PET scans in complex partial epilepsy. Epilepsia 1987; 28: 619 (Abstract).Google Scholar
24.Rausch, R, Babb, TL, Engel, J Jr, et al. Memory following intracarotid sodium amytal injection contralateral to hippocampal damage. Arch Neurol (in press).Google Scholar
25.Engel, J Jr, Babb, TL, Phelps, ME.Contribution of positron emission tomography to understanding mechanisms of epilepsy. In: Engel, J Jr, Ojemann, GA, Liiders, HO, Williamson, RD, eds. Fundamental mechanisms of human brain function. New York: Raven Press, 1987; 209–218.Google Scholar
26.Chugani, HT, Shewmon, DA, Peacock, WJ, et al. Surgical treatment of intractable neonatal seizures: the role of positron emission tomography. Neurology 1988; 28: 1178–1188.CrossRefGoogle Scholar
27.Engel, J Jr, Kuhl, DE, Phelps, ME, et al. Local cerebral metabolism during partial seizures. Neurology 1983; 33: 400–413.CrossRefGoogle ScholarPubMed
28.Engel, J Jr, Kuhl, DE, Phelps, ME, Patterns of human local cerebral glucose metabolism during epileptic seizures. Science 1982; 218: 64–66.CrossRefGoogle ScholarPubMed
29.Ackermann, RF, Engel, J Jr, Baxter, L.PET and autoradiographic studies of glucose utilization following electroconvulsive seizures in humans and rats. Ann NY Acad Sci 1986; 462: 263–269.CrossRefGoogle Scholar
30.Baxter, LR Jr, Schwartz, JM, Phelps, ME, et al. Localization of the neurochemical effects of cocaine and other stimulants in the human brain. J Clin Psychiatry 1988; 49 (2, suppl): 23–26.Google ScholarPubMed
31.Engel, J Jr. The role of neuroimaging in the surgical treatment of epilepsy. Acta Neurol Scand 1988; 117: 84–89.CrossRefGoogle ScholarPubMed
32.Liiders, H, Lesser, RP, Dinner, DS, et al. Commentary: chronic intracranial recording and stimulation with subdural electrodes. In: Engel, J Jr, ed. Surgical Treatment of the Epilepsies. New York: Raven Press, 1987; 297–321.Google Scholar
33.Walter, RD.Principles of clinical investigation of surgical candidates. In: Purpura, DP, Penry, JK, Walter, RD, eds. Advances in Neurology, Vol. 88, Neurosurgical Management of the Epilepsies. New York: Raven Press, 1975; 49–58.Google Scholar
34.Chugani, HT, Mazziotta, JC, Engel, J Jr, et al. The Lennox-Gastaut syndrome: metabolic subtypes determined by 2-deoxy-2[18F]flu-oro-D-glucose positron emission tomography. Ann Neurol 1987; 21: 4–13.CrossRefGoogle ScholarPubMed
35.Bonte, FJ, Stokely, EM, Devous, MD, et al. Single-photon tomographic study of regional blood flow in epilepsy. A preliminary report. Arch Neurol 1983; 40: 267–270.CrossRefGoogle ScholarPubMed
36.Lang, W, Podreka, I, Suess, E, et al. Single photon emission computerized tomography during and between seizures. J Neurol 1988; 235: 277–284.CrossRefGoogle ScholarPubMed
37.Lee, BI, Markand, ON, Siddiqui, AR, et al. Single photon emission computed tomography (SPECT) brain imaging using N,N,N’trimethyl-N’-(2 hydroxy-3-methyl-5-1231-iodobenzyl)-1,3-propanediamine 2 HC1 (HIPDM): Intractable complex partial seizures. Neurology 1986; 36: 1471–1477.CrossRefGoogle Scholar
38.Lee, BI, Markand, ON, Wellman, HN, et al. HIPDM single photon emission computed tomography brain imaging in partial onset secondarily generalized tonic-clonic seizures. Epilepsia 1987; 28: 305–311.CrossRefGoogle ScholarPubMed
39.Lee, BI, Markand, ON, Wellman, HN, et al. HIPDM-SPECT in patients with medically intractable complex partial seizures. Arch Neurol 1988; 45: 397–402.CrossRefGoogle ScholarPubMed
40.Sanabria, E, Chauvel, P, Askienazy, S, et al. Single photon emission computed tomograph (SPECT) using 123I-isopropyl-iodo-amphetamine (IAMP) in partial epilepsy. In: Baldy-Moulinier, M, Ingvar, D-H, Meldrum, BS, eds. Current problems in epilepsy: 1. cerebral blood flow, metabolism and epilepsy. London: John Libbey, 1983; 82–87.Google Scholar