Frontal lobe epilepsy: Clinical characteristics, surgical outcomes and diagnostic modalities

Lee, Jung Ju; Lee, Sang Kun; Lee, Seo-young; Park, Kyung‐Il; Kim, Dong Wook; Lee, Dong Hoon; Chung, Chun Kee; Nam, Heerim

doi:10.1016/j.seizure.2008.01.007

Cited by 81 publications

(83 citation statements)

References 27 publications

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“…Of these studies, 12 were retrospective [8][9][10][11][12][13][14][15][16][17][18][19] and one was part of a prospective observational study. 45 Good surgical outcome was considered in patients with Engel class I, II, or III.…”

Section: Patients With Good Surgical Outcomementioning

confidence: 99%

“…8,11,17 In contrast, the sensitivity of PET ranged from 36% to 66% (weighted mean = 50%) in extratemporal lobe epilepsy patients only. [12][13][14][15] PET was able to further *Sensitivity = number of surgical candidates with positive PET findings/total number of patients eligible for surgery (positive PET finding is defined as imaging abnormality in the area of surgical resection or conclusive evidence consistent with the final consensus decision regarding surgical candidacy). † Specificity = number of patients considered ineligible for surgery on the basis of PET findings/total number of patients ineligible for surgery.…”

Section: Patients With Good Surgical Outcomementioning

confidence: 99%

“…9,[12][13][14][15] In one study, 18 only the sensitivity for correct lateralization was reported (86%); therefore, it is not clear as to whether this is separate from or considered with localization. Lateralizing information gained from PET imaging is useful for planning an invasive study.…”

Section: |mentioning

confidence: 99%

“…For MRI and EEG, the reported sensitivity (MRI 41-83%; EEG 36-81%) also varied greatly across the studies. [8][9][10][11][12][13][14][15][16]18,19 Perhaps of greater importance is when PET results were combined with MRI or EEG, the sensitivity of detecting patients with good outcome increased by 8 to 23%. [8][9][10]13 In children, the addition of PET to magnetoencephalography increased the sensitivity to 95% and decreased the number of false-negative tests for seizure-free outcome.…”

mentioning

confidence: 99%

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The Utility of Positron Emission Tomography in Epilepsy

Burneo

Poon

Kellett

et al. 2015

Can. J. Neurol. Sci.

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The role of fludeoxyglucose F 18 positron emission tomography (PET) in the presurgical evaluation of patients with medically intractable epilepsy continues to be refined. The purpose of this study was to systematically review the literature to assess the diagnostic accuracy and utility of PET in this setting. Thirty-nine studies were identified through MEDLINE and EMBASE databases that met the inclusion criteria. In adult patients, PET hypometabolism showed a 56 to 90% agreement with seizure onset localized by intracranial electroencephalogram (pediatric: 21 to 86%). In temporal lobe epilepsy patients with good surgical outcome, PET displayed moderate to high sensitivity in localizing the seizure focus (range: 71 to 89%). The sensitivity increased by 8 to 23% when PET results were combined with magnetic resonance imaging or electroencephalogram. PET has been shown to affect patient management by improving the guidance of intracranial electrodes placement, altering the decision to perform surgery, or excluding patients from further evaluation.RÉSUMÉ: Utilité de la tomographie par émission de positons dans l'épilepsie. Le rôle de la tomographie par émission de positons (PET scan) au 18F fluodésoxyglucose (18F-FDG) dans l'évaluation préchirurgicale de patients présentant une épilepsie réfractaire au traitement médical est constamment raffiné. Le but de cette étude était de revoir systématiquement la littérature afin d'évaluer la précision du diagnostic et l'utilité du PET scan dans ce contexte. Nous avons identifié 39 études dans les bases de données MEDLINE et EMBASE qui rencontraient nos critères d'inclusion. Chez les patients adultes, un hypométabolisme au PET scan concordait entre 56 et 90% avec le début de la crise localisé par l'électroencéphalographie intracrânienne (patients pédiatriques: entre 21 et 86%). Chez les patients atteints d'épilepsie temporale chez qui le résultat chirurgical avait été favorable, le PET scan avait une sensibilité de modérée à élevée pour localiser le foyer épileptogène (écart : 71 à 89%). La sensibilité augmentait de 8 à 23% quand les résultats du PET scan étaient combinés à l'imagerie par résonance magnétique ou à l'électroencéphalographie. Il est démontré que le PET scan influence le traitement du patient en améliorant le guidage lors de la mise en place des électrodes intracrâniennes, en modifiant la décision de procéder à une chirurgie ou en évitant de procéder à des examens plus poussés chez certains patients.

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Section: Patients With Good Surgical Outcomementioning

confidence: 99%

Section: Patients With Good Surgical Outcomementioning

confidence: 99%

Section: |mentioning

confidence: 99%

mentioning

confidence: 99%

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The Utility of Positron Emission Tomography in Epilepsy

Burneo

Poon

Kellett

et al. 2015

Can. J. Neurol. Sci.

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show abstract

“…Neuropathologists use several approaches to classify the tissue pathology including immunohistochemistry to define proteins such as neurofilaments, glial fibrillary acidic protein, and markers of cell division or inflammation. Many resected areas will exhibit a clear pathological abnormality such as FCD, low-grade tumors, vascular malformation (e.g., AVM), hypoxic-ischemic damage, or gliosis [27]. In one study of 62 frontal lobe epilepsy patents, 46 exhibited FCD [27].…”

Section: Neuropathology In Neocortical Epilepsy: Does Nonlesional Neomentioning

confidence: 99%