We performed interietal [18F]fluorodeoxyglucose positron emission tomography (FDG PET) in 24 patients with partial epilepsy of neocortical origin. Two-thirds of patients had regions of hypometabolism. The zone of intracranially recorded electrographic ictal onset was always located in a region of hypometabolism, in those with hypometabolism. Hypometabolic regions in partial epilepsies of neocortical origin were usually associated with structural imaging abnormalities. Regional hypometabolism occasionally occurred without localizing ictal scalp EEG and cerebral magnetic resonance imaging findings, however. FDG PET may be useful in directing placement of intracranial electrodes for presurgical evaluation of refractory neocortical seizures.
Bibliographical noteFunding Information:
Dr. Henry's work was partially supported by the Merritt-Putnam Clinical Research Fellowship of the Epilepsy Foundation of America. This work was also partially supported by NIH Grants NS 02808 and NS 20806. We thank Dr. J. Bruce Jacobs, Dr. David E. Kuhl, Dr. Robert B. Lufkin, Dr. Michael R. Sperling, Dr. Paul C. VanNess, Dr. M. Anthony Verity, Dr. Harry V. Vinters and Dr. Gabriel H. Wilson for providing clinical interpretations of EEG, MRI, PET and histopathologic studies and information on postoperative seizure control. We thank Sally Mouilleseaux and Kay Neff for assistance in preparing the manuscript.
- Cerebral metabolism
- Partial epilepsy