Refractory Epilepsy: The Role of Positron Emission Tomography
| Autor: | David A. Steven, Tommy Lik Hang Chan, Jorge G. Burneo, Jonathan Romsa |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Drug Resistant Epilepsy medicine.medical_specialty Neurosurgery 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Image Processing Computer-Assisted medicine Humans Epilepsy surgery Neuropsychological assessment Seizure semiology Aged Retrospective Studies medicine.diagnostic_test business.industry Electroencephalography Magnetic resonance imaging General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Treatment Outcome medicine.anatomical_structure Neurology Positron emission tomography Positron-Emission Tomography Scalp Refractory epilepsy Female Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 45:30-34 |
| ISSN: | 2057-0155 0317-1671 |
| Popis: | Rationale: Presurgical localization of the epileptogenic focus is critical to successful surgery. Traditionally, localization of the epileptogenic focus depends on seizure semiology, scalp video-electroencephalography (vEEG), magnetic resonance imaging (MRI), neuropsychological assessment, and, when needed, intracranial EEG (iEEG). We aimed to explore the role of positron emission tomography (PET) in the presurgical evaluation of patients with refractory epilepsy. Methods: A retrospective review was conducted on patients from London Health Sciences Centre (London, Ontario) with refractory epilepsy who underwent PET from September of 2011 to April of 2016. The accuracy of epileptogenic focus localization was compared between different investigative modalities (MRI, vEEG, iEEG, PET), and the outcomes were documented, including seizure freedom after surgical resection, improvement of seizure frequency, guidance for further investigations, and exclusion of patients from further evaluation. Patients who underwent surgery were followed up at 3 months and onward. Results: We identified 62 patients with refractory epilepsy who underwent PET. The mean age was 34 years (range=20-68). A total of 36 had concordant PET and vEEG findings: 6 had surgical resection and either became seizure-free (29.4%) or had improvement in seizure frequency (5.9%) at 3 months; 11 had surgical resection and either became seizure-free (29.4%) or had improvement in seizure frequency (35.3%) at 3 months, but required iEEG for final verification. Conclusions: PET has an important role in presurgical evaluation of patients with refractory epilepsy. It may allow resection of the epileptogenic focus without the need for iEEG, guiding intracranial electrode placement for further localization of the epileptogenic focus, or exclusion of patients from further evaluation. |
| Databáze: | OpenAIRE |
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