Localizing Value of FDG-PET in Extratemporal Epilepsy
Abstract number :
1.216
Submission category :
Year :
2001
Submission ID :
3117
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
K.A. Lowasz, Dept. of Epileptology, University of Bonn, Bonn, Germany; J. von Oertzen, M.D., Dept. of Epileptology, University of Bonn, Bonn, Germany; H.J. Biersack, M.D., Dept. of Nuklear Medicine, University of Bonn, Bonn, Germany; C.E. Elger, M.D., F.R
RATIONALE: In focal epilepsies of extratemporal origin, abnormalities of glucose metabolism are less frequent than in temporal lobe epilepsy. The aim of this study is to evaluate the localizing value of FDG-PET in medically intractable extratemporal epilepsy.
METHODS: Inclusion criteria: medically intractable extratemporal epilepsy, and presurgical evaluation including FDG-PET. FDG-PET was performed, if seizure semiology included temporal components or if electrode implantation might be avoided. 49 consecutive patients were included. Surgical intervention was performed in 26 patients. Mean follow up interval of operated patients was more than 12 month.
RESULTS: 67 % showed cortical hypometabolism, 8 % cortical hypermetabolism and 25 % no abnormalities in glucose metabolism. Concerning the localization of the epileptogenic focus of the operated patients, concordant regional abnormalities were found in 58%, false localized abnormalities in 23 %, and no abnormalities in 19%. However, 65% of patients revealed excellent surgical outcome (Engel class 1), whereas in 41 % of those, FDG-PET showed no or false localization of glucose metabolism. Concordant localization of FDG-PET and outcome Engel class 1a showed statistical significance (p=0.05).
CONCLUSIONS: FDG-PET gives moderate complimentary information in localization or at least lateralization of the epileptogenic area in extratemporal temporal epilepsy patients. However, in spite of the significant relation of localizing FDG-PET and outcome Engel class 1a, false localization or no localization in PDG-PET is not necessarily a contraindication for surgical intervention.
Support: No funding.