EEG, PET, SPET AND MRI IN INTRACTABLE CHILDHOOD EPILEPSIES - POSSIBLESURGICAL CORRELATIONS

Magnetic resonance imaging (MRI), single photon emission tomography (S PET), and positron emission tomography (PET) using [18F]fluorodeoxyglu cose were used in combination with scalp and scalp-video EEGs in a gro up of 30 pediatric patients with drug resistant epilepsy (DRE) in orde r to identify patients who could benefit from neurosurgical approach. Seizures were classified according to the consensus criteria of The In ternational League Against Epilepsy. In three patients infantile spasm s (IS) were diagnosed; 13 subjects were affected by different types of generalized seizures, associated with complex partial seizures (CPS) in three. In the other 14 patients partial seizures, either simple (SP S) or complex, were present. A localized abnormality was demonstrated in one patient with IS and in three patients with generalized seizures . Of the group of 14 subjects with CPS, MRI and CT were normal in 7, b ut SPET or PET indicated focal hypoperfusion or hypometabolism concord ant with the localization of the EEG abnormalities. In 5 of the other 7 patients anatomical and functional imaging and EEG findings were con cordant for a localized abnormality. It can be concluded that function al imaging combined with scalp EEGs appears to be superior to the use of only CT and MRI for selecting children with epilepsy in whom a surg ical approach can be considered, in particular when CPS resistant to t herapy are present.