Clinical utility of flumazenil-PET versus [18F]fluorodeoxyglucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients

Details

Serval ID
serval:BIB_86C275BC569C
Type
Article: article from journal or magazin.
Collection
Publications
Title
Clinical utility of flumazenil-PET versus [18F]fluorodeoxyglucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients
Journal
Brain
Author(s)
Ryvlin P., Bouvard S., Le Bars D., De Lamerie G., Gregoire M. C., Kahane P., Froment J. C., Mauguiere F.
ISSN
0006-8950 (Print)
ISSN-L
0006-8950
Publication state
Published
Issued date
11/1998
Volume
121 ( Pt 11)
Pages
2067-81
Language
english
Notes
Ryvlin, P
Bouvard, S
Le Bars, D
De Lamerie, G
Gregoire, M C
Kahane, P
Froment, J C
Mauguiere, F
eng
Comparative Study
Research Support, Non-U.S. Gov't
England
Brain. 1998 Nov;121 ( Pt 11):2067-81.
Abstract
We assessed the clinical utility of [11C]flumazenil-PET (FMZ-PET) prospectively in 100 epileptic patients undergoing a pre-surgical evaluation, and defined the specific contribution of this neuro-imaging technique with respect to those of MRI and [18F]fluorodeoxyglucose-PET (FDG-PET). All patients benefited from a long term video-EEG monitoring, whereas an intracranial EEG investigation was performed in 40 cases. Most of our patients (73%) demonstrated a FMZ-PET abnormality; this hit rate was significantly higher in temporal lobe epilepsy (94%) than in other types of epilepsy (50%) (P < 0.001). Most FMZ-PET findings coexisted with a MRI abnormality (81%), including hippocampal atrophy (35%) and focal hypometabolism on FDG-PET (89%). The area of decreased FMZ binding was often smaller than that of glucose hypometabolism (48%) or larger than that of the MRI abnormality (28%). FMZ-PET did not prove superior to FDG-PET in assessing the extent of the ictal onset zone, as defined by intracranial EEG recordings. However, it provided useful data which were complementary to those of MRI and FDG-PET in three situations: (i) in temporal lobe epilepsy associated with MRI signs of hippocampal sclerosis, FMZ-PET abnormalities delineated the site of seizure onset precisely, whenever they were coextensive with FDG-PET abnormalities; (ii) in bi-temporal epilepsy, FMZ-PET helped to confirm the bilateral origin of seizures by showing a specific pattern of decreased FMZ binding in both temporal lobes in 33% of cases; (iii) in patients with a unilateral cryptogenic frontal lobe epilepsy, FMZ-PET provided further evidence of the side and site of seizure onset in 55% of cases. Thus, FMZ-PET deserves to be included in the pre-surgical evaluation of these specific categories of epileptic patients, representing approximately half of the population considered for epilepsy surgery.
Keywords
Brain/diagnostic imaging/pathology/*physiopathology, Electroencephalography, Epilepsies, Partial/*diagnosis/physiopathology/surgery, Epilepsy, Frontal Lobe/diagnosis, Epilepsy, Temporal Lobe/diagnosis, *Flumazenil/pharmacokinetics, *Fluorodeoxyglucose F18/pharmacokinetics, Functional Laterality, GABA Modulators/pharmacokinetics, Humans, *Magnetic Resonance Imaging, Prospective Studies, *Radiopharmaceuticals/pharmacokinetics, *Tomography, Emission-Computed, Video Recording
Pubmed
Create date
29/11/2018 12:37
Last modification date
20/08/2019 14:46
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