Neuroimaging in Intractable Partial Epilepsy of Children Comparison of MRI, SPECT and PET

Abstract

In order to investigate pathophysiological changes in intractable partial epilepsy of childhood onset, magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT) and positron emission computed tomography (PET) were performed on 24 patients (12 with temporal lobe epilepsy, 6 with occipital lobe epilepsy and 6 with frontal lobe epilepsy). All patients with frontal lobe epilepsy showed a frontal onset of ictal discharges on simultaneous EEG-VTR recording. Fourteen patients displayed MRI abnormalities, 15 SPECT and 20 PET abnormalities. MRI was abnormal in 10 of 12 patients with temporal lobe epilepsy, 5 of whom had MRI abnormalities suggesting mesial temporal sclerosis. Nine of these 12 patients had abnormalities on SPECT, and 11 on PET. Four of 6 patients with occipital lobe epilepsy showed abnormalities in the occipital area on MRI, 5 on SPECT and 6 on PET. Those who had visual seizures displayed decreased glucose metabolism in the primary visual cortex, whereas those who did not showed normal metabolism in this region. In all 6 patients with frontal lobe epilepsy, MRI and SPECT were normal or equivocal, whereas PET displayed focal or regional hypometabolism in 3 patients. PET is the most sensitive neuroimaging technique to localize epileptogenic foci. © 1992, JAPAN EPILEPSY SOCIETY. All rights reserved.