Multimodality imaging for focus localization in pediatric pharmacoresistant epilepsy

Détails

ID Serval
serval:BIB_3390F486B9DD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Multimodality imaging for focus localization in pediatric pharmacoresistant epilepsy
Périodique
Epileptic Disorders
Auteur(s)
Kurian  M., Spinelli  L., Delavelle  J., Willi  J. P., Velazquez  M., Chaves  V., Habre  W., Meagher-Villemure  K., Roulet  E., Villeneuve  J. G., Seeck  M.
ISSN
1294-9361 (Print)
Statut éditorial
Publié
Date de publication
2007
Volume
9
Numéro
1
Pages
20-31
Notes
PT - Journal Article PT - Research Support, Non-U.S. Gov't
Résumé
Multiple structural and functional imaging modalities are available to localize the epileptogenic focus. In pre-surgical evaluation of children with pharmacoresistant epilepsy, investigations with the maximum yield should be considered in order to reduce the complexity of the workup. OBJECTIVE: To determine the extent to which PET, ictal/interictal SPECT and its co-registration with the patient's MRI contributes to correct localization of the epileptogenic focus, surgical intervention and to the post surgical outcome in paediatric patients. METHODS: The study population included children and adolescents with pharmacoresistant epilepsy (n = 50) who underwent preoperative evaluation, surgery and had postoperative follow-up for at least 12 months. Outcome was measured by postoperative seizure frequency using Engel's classification. RESULTS: Thirty-nine patients (78%) became completely seizure free after surgical intervention. The likelihood to benefit from surgical treatment was significantly higher if localization with more imaging modalities (MRI, PET, SPECT) were concordant with respect to the resected brain area (p < 0.01). Preoperative PET examination provided better localizing information in patients with extratemporal epilepsy and/or dysplastic lesions, whereas SPECT was found to be superior to PET in patients with temporal lobe epilepsy and/or tumors (p < 0.05). No significant difference was noted in the surgical outcome in younger or older age group, in children with or without special education needs. CONCLUSION: In paediatric epilepsy pre-surgical evaluation, the combined use of multiple functional imaging modalities for a precise localisation of the epileptogenic focus is worthwhile for both extratemporal and temporal lobe epilepsy, also when EEG and MRI alone are non-contributive, given the potential benefit of complete postoperative seizure control
Mots-clé
Adolescent/Age Factors/Child/Child,Preschool/Electroencephalography/Epilepsy/diagnosis/Pathology/surgery/Female/Humans/Infant/Magnetic Resonance Imaging/Male/Positron-Emission Tomography/Preoperative Care/Tomography,Emission-Computed,Single-Photon/Treatment Outcome/Video Recording
Pubmed
Web of science
Création de la notice
29/01/2008 19:36
Dernière modification de la notice
03/03/2018 15:48
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