| Semin Nucl Med 1992 Oct;22(4):247-253 |
The use of positron emission tomography in the clinical assessment of
epilepsy.
Chugani HT.
Positron emission tomography (PET) of local cerebral glucose utilization is highly
sensitive in detecting epileptogenic regions that correspond to electrographic
localization in patients with epilepsy. In medically refractory temporal lobe epilepsy for
which surgical resection of the epileptogenic zone is a therapeutic option, the
application of PET enables more than 50% of adults and older children to be successfully
operated on without the necessity for chronic intracranial electrographic monitoring. In
infants with intractable infantile spasms and various types of partial epilepsy, PET has
uncovered focal areas of cortical dysplasia and other anatomic abnormalities, which, after
resection, have resulted in cessation of seizures and developmental improvement. The
distribution of PET abnormality is in excellent agreement with the extent of the
epileptogenic zone as determined by intraoperative electrocorticography, thus avoiding the
necessity for chronic intracranial electrographic monitoring in 90% of these infants. As a
result of PET, the preoperative evaluation of intractable epilepsy in both adults and
children has become less invasive and less costly.
