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Abstract Details

Ictal Cerebral Positron Emission Tomography (PET) in Partial Status Epilepticus
Epilepsy
P06 - (-)
162
BACKGROUND: The diagnosis of partial SE can be challenging. Clinically, it can mimic movement disorders, aphasia and amnesia of other origins, psychiatric disturbances or prolonged postictal states. It can present without any EEG abnormalities or with EEG patterns of undetermined ictal significance, such as periodic lateralized epileptiform discharges (PLEDs). A rapid diagnosis of status epilepticus is however crucial to initiate appropriate antiepileptic treatment and seek for underlying conditions. Among the imaging techniques used in epilepsy, single-photon emission tomography (SPECT) has a very short brain fixation time and is generally used to identify epileptogenic hyperperfused brain regions during seizures. In contrast, positron emission tomography (PET), which has a higher spatial definition but a longer uptake time, is generally used to delineate the interictal hypometabolic brain areas. However, in cases of prolonged ictal activity as it occurs in SE, the feasibility of PET is no longer limited by seizure duration and it can provide better spatial resolution than SPECT.
DESIGN/METHODS: Ictal 18F-FDG-PET was performed in eight patients in whom SE was finally diagnosed. All PET scans were conducted under EEG recording. Clinical, MRI and EEG data were reviewed.
RESULTS: In all cases, ictal 18F-FDG-PET results influenced aspects of patients' management. 18F-FDG-PET proved useful in three main instances 1) it contributed to the diagnosis of partial SE, when clinical elements were equivocal or the EEG did not show clear-cut epileptiform abnormalities; 2) it helped establish the etiology of partial SE, when clinical features, MRI and EEG were incongruent regarding the cause of SE and 3) it was useful in delineating the epileptic area in view of possible resective surgery.
CONCLUSIONS: Ictal 18F-FDG-PET represents a valuable diagnostic tool in selected patients with partial SE.
Authors/Disclosures

PRESENTER 		No disclosure on file
Stuart D. Cook, MD, FÂ鶹´«Ã½Ó³»­ (Rutgers) No disclosure on file
No disclosure on file
Andrea Rossetti No disclosure on file