Predictive value of metabolic and perfusion changes outside the seizure onset zone for postoperative outcome in patients with refractory focal epilepsy

Haemels, Maarten; Weehaeghe, Donatienne Van; Cleeren, Evy; Dupont, Patrick; Loon, Johan van; Theys, Tom; Laere, Koen Van; Paesschen, Wim Van; Goffin, Karolien

doi:10.1007/s13760-020-01569-y

Acta Neurol Belg

2021

DOI: 10.1007/s13760-020-01569-y

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Predictive value of metabolic and perfusion changes outside the seizure onset zone for postoperative outcome in patients with refractory focal epilepsy

Maarten Haemels

Donatienne Van Weehaeghe

Evy Cleeren

et al.

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Cited by 4 publications

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“…Use of advanced techniques allows one not only to understand the SOZ but also to uncover propagation pathways and the severity of the seizures (1,(14)(15)(16). Subtraction 18 F-FDG PET is novel and can localize the SOZ for intracranial recording or for surgical resection in lesional and nonlesional epilepsy.…”

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confidence: 99%

Making the Case for Brain¹⁸F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Djekidel¹

2022

J. Nucl. Med. Technol.

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F-FDG PET plays a major role in the presurgical evaluation of medically refractory epilepsy patients. The current standard of care is performing interictal evaluations of glucose metabolism. Use of this method is related mostly to the tracer kinetics of 18 F-FDG because of a long uptake phase that would translate into ictal injections that have low sensitivity and low specificity and demonstrate not only ictal but postictal changes. This limitation can be overcome in some status epilepticus scenarios in which prolonged seizures can then correlate better with 18 F-FDG uptake kinetics. In these cases, focal visual qualitative hot spots are suggestive of the seizure-onset zone. However, by using advanced subtraction techniques, the prolonged 18 F-FDG uptake phase can be overcome in a variety of other cases as well, opening the door to a slightly larger set of patients who may benefit from this higher-resolution PET method. This article presents 4 cases in which a novel subtraction 18 F-FDG PET technique was used and elucidates its impact in these specific cases.

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confidence: 99%

Making the Case for Brain¹⁸F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Djekidel¹

2022

J. Nucl. Med. Technol.

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Combined [18F]FDG-PET with MRI structural patterns in predicting post-surgical seizure outcomes in temporal lobe epilepsy patients

et al. 2022

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A different look on the importance of lateralization and localization of figure 4 symptoms in epilepsy

Morkavuk

Isık²,

Leventoğlu

2022

Egypt J Neurol Psychiatry Neurosurg

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Background Clinical seizure semiology provides valuable information in the evaluation of focal-onset bilateral tonic–clonic seizures. In the evaluation of these patients, long-term video-EEG monitoring (VEM) and neuroimaging studies are of great significance in determining lateralization together with clinical semiology. In this study, we examined the features of the figure 4 sign that we detected in patients with refractory epilepsy whom we followed up in the VEM unit. Methods In the study, 175 patients followed in the VEM unit were examined. Twenty-two patients for whom the figure 4 sign was detected were included in the study. Patients with the side indicated by the figure 4 sign comply with ictal EEG compatible were named as 1st group (G1), and those not were named as 2nd group (G2). Demographic characteristics, seizure type, number of seizures per month, duration of epilepsy, number of seizures during VEM, duration of figure 4 sign, medical history, and cranial MRI characteristics were compared between the two groups. Results When G1 and G2 were compared, it was observed that temporal lobe seizures were statistically significantly higher in G1. When the figure 4 sign durations were examined, this period was 16.3 ± 8.2 s in frontal lobe seizures and 20.8 ± 7.4 s in temporal lobe seizures. When the duration of the figure 4 sign was examined by gender, it was found that the duration was longer in males, which was statistically significant. Conclusion In conclusion, it is essential to evaluate ictal EEG findings together with brain imaging while performing semiological localization and lateralization in epileptic patients.

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Predictive value of metabolic and perfusion changes outside the seizure onset zone for postoperative outcome in patients with refractory focal epilepsy

Cited by 4 publications

References 56 publications

Making the Case for Brain¹⁸F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Making the Case for Brain¹⁸F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Combined [18F]FDG-PET with MRI structural patterns in predicting post-surgical seizure outcomes in temporal lobe epilepsy patients

A different look on the importance of lateralization and localization of figure 4 symptoms in epilepsy

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Predictive value of metabolic and perfusion changes outside the seizure onset zone for postoperative outcome in patients with refractory focal epilepsy

Cited by 4 publications

References 56 publications

Making the Case for Brain18F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Making the Case for Brain18F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Combined [18F]FDG-PET with MRI structural patterns in predicting post-surgical seizure outcomes in temporal lobe epilepsy patients

A different look on the importance of lateralization and localization of figure 4 symptoms in epilepsy

Contact Info

Product

Resources

About

Making the Case for Brain¹⁸F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?

Making the Case for Brain¹⁸F-FDG PET Subtraction in Medically Refractory Epilepsy: A Novel, Useful Tool—Practical Points?