Significance of FDG-PET in a Non-Invasive Protocol of Temporal Lobe Epilepsy
Abstract number :
1.218
Submission category :
Year :
2001
Submission ID :
2000
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
J. von Oertzen, M.D., Dept. of Epileptology, University of Bonn, Bonn, Germany; K.A. Lowasz, Dept. of Epileptology, University of Bonn, Bonn, Germany; H.J. Biersack, M.D., Dept. of Nuclear Medicine, University of Bonn, Bonn, Germany; C.E. Elger, M.D., F.R
RATIONALE: In medically intractable temporal lobe epilepsy, qualitative analysis of interictal FDG-PET shows hypometabolism in 70-85% of patients on the epileptic onset side. The aim of the present study is to assess the value of FDG-PET in a non-invasive protocol of presurgical evaluation of temporal lobe epilepsy. FDG-PET was performed in lesional temporal lobe epilepsy if standard components as seizure semiology, interictal and ictal EEG recordings, neuropsychological testing, and localization of lesion detected by MRI were slightly non-concordant (e.g. concordant results but artificial ictal EEG patterns).
METHODS: Inclusion criteria: 1) medically intractable temporal lobe epilepsy, 2) purely non-invasive presurgical evaluation, 3) with FDG-PET and 4) surgical intervention with appropriate follow up. 99 consecutive patients were included. Mean follow up interval was more than 12 month.
RESULTS: 91 % showed cortical hypometabolism, 3 % cortical hypermetabolism and 6% no abnormalities in glucose metabolism. Concerning the localization of the epileptogenic focus, concordant regional abnormalities were found in 83%, abnormalities of a more widespread area in additional 5 % and false localized abnormalities in 6%. However, 69% of patients revealed excellent surgical outcome (Engel class 1), whereas in 26% of those, FDG-PET showed no or false localization of glucose metabolism.
CONCLUSIONS: FDG-PET is a useful complematary examination in non-invasive localization or at least lateralization of the epileptogenic area in temporal lobe epilepsy patients if standard components are slightly non-concordant. False localization or no localization in PDG-PET is not necessarily a contraindication for surgical intervention.
Support: No funding.