Presurgical Evaluation of Epileptogenic Focus in Temporal Lobe Epilepsy by 11 C - Flumazenil PET and 123 I - Iomazenil SPECT : A Case Report
نویسنده
چکیده
Meticulous neuroradiological evaluations, including 123I-iomazenil (IMZ) single photon emission computed tomography (SPECT) and 11C-flumazenil (FMZ) positron emission tomography (PET), preoperatively disclosed epileptogenic foci in a 16-year-old boy with temporal lobe epilepsy. Interictal scalp electroencephalography showed spikes in the left temporal region. Left hippocampal sclerosis was seen on magnetic resonance imaging. Hypoperfusion in the entire left temporal lobe was seen on 99mTc ethylcysteinate dimer (ECD) SPECT. Hypometabolism over most of the left temporal lobe was apparent on 18F-fluorodeoxyglucose (FDG) PET. An area of hypoperfusion dominating the left temporal lobe was identified on 123I-IMZ SPECT. A low-uptake area in the left temporal lobe was seen on 11C-FMZ PET. Anteromedial temporal lobectomy and multiple subpial transection with intraoperative electrocorticography resulted in satisfactory seizure outcomes. Use of 123I-IMZ SPECT and 11C-FMZ PET appeared to demonstrate the epilepsy focus more localised than 99mTc ECD SPECT and 18F-FDG PET.
منابع مشابه
Correct localization of epileptogenic focus with I-123 iomazenil cerebral benzodiazepine receptor imaging: a case report of temporal lobe epilepsy with discordant ictal cerebral blood flow SPECT.
A 26-year-old female with intractable epileptic seizures was studied with I-123 iomazenil cerebral benzodiazepine receptor, I-123 IMP inter-ictal and Tc-99m ECD ictal cerebral blood flow SPECT. The ictal cerebral blood flow SPECT indicated the location of the seizures to be in the left temporal lobe, where increased regional cerebral blood flow was noted in marked contrast to the inter-ictal SP...
متن کاملIs 11C-flumazenil PET superior to 18FDG PET and 123I-iomazenil SPECT in presurgical evaluation of temporal lobe epilepsy?
OBJECTIVE To determine the contribution of 18FDG PET, 11C-flumazenil PET, and 123I-iomazenil SPECT to the presurgical evaluation of patients with medically intractable complex partial seizures. METHODS Presurgical evaluation was performed in 23 patients, who were considered candidates for temporal lobe resective surgery (14 females and nine males with a median age of 34 (range 13 to 50) years...
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PET and SPECT are valuable clinical tools in the management of patients with medically resistant, partial epilepsy who are under evaluation for surgical treatment. The value of PET for localization of seizure activity has been fi rmly established for patients with temporal lobe epilepsy and extratemporal lobe epilepsy. It is a very useful test partly because it is non-invasive. The localizing v...
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