Abstracts

Rationale: Infantile spasms (IS) have various underlying etiologies. Glucose metabolism PET studies in children with cryptogenic IS have revealed different patterns of cortical areas of hypometabolism interictally. Methods: We retrospectively analyzed 30 children with IS (13 boys, 17 girls) who underwent PET over 1 year old from January 2005 to January 2007 at Severance Children’s Hospital. We investigated the cortical glucose patterns and their etiologies in patients with IS. Results: 40% (12/30) of patients with IS showed normal findings in brain MRI scans. However, 97% (29/30) of cases revealed the abnomal cortical glucose metabolisms. The cortical glucose metabolism PET studies were normal 3.3% (1/30). The abnormal PET results composed of unifocal 16.7% (5/30), bifocal 20.0% (6/30), multifocal 26.7% (8/30), diffuse 33.3% (10/30). The most common cause of unifocal cortical glucose hypometabolism was cortical dysplasia 80.0%(4/5). The cause of bifocal cortical glucose hypometabolism was also cortical dysplasia 66.6% (4/6). The underlying etiologies of multifocal cortical glucose hypometabolism were tuberous sclerosis 25.0%(2/8), metabolic diseases 25.0%(2/8) such as a mitochondrial cytopathy, hypoxic ischemic encephalopathy 12.5%(1/8), cortical dysplasia 12.5%(1/8). The etiologies of diffuse cortical glucose hypometabolism were metaboilic disease 20.0%(2/10) including the mitochondrial cytopathy, diffuse cortical dysplasia 30%(3/10), hypoxic ischemic encephalopathy 10.0%(1/10). Conclusions: The pattern of glucose hypometabolism in children with IS is a useful guide to decide whether a medical or surgical approach should be pursued. PET may be powerful tool in evaluation the children with IS.