FDG-PET IN CHILDREN AND ADOLESCENTS WITH PARTIAL SEIZURES - ROLE IN EPILEPSY SURGERY EVALUATION

We used FDG-PET to measure interictal glucose metabolism in 16 childre n and adolescents (mean age 14.7 years) with complex partial seizures (CPS) (mean seizure onset age 5.0 years). Video-EEG localized the epil eptic foci. Glucose metabolism was determined in 14 paired anatomic ar eas using a standard template. PET hypometabolism was defined as great er than 15% asymmetry. Nine of the 13 (69%) patients with a unilateral EEG focus had regional hypometabolism ipsilateral to the epileptogeni c zone. Three subjects had bilateral EEG foci; all had nonfocal PET. M RI (15 patients) concurred with EEG and PET in two, and was normal in seven of nine with focal hypometabolism. One of seven patients with no rmal PET had a focal MRI abnormality. FDG-PET results are similar to t hose found in adults, but are present earlier in the natural history o f CPS (9.7 vs 22.2 years duration epilepsy) than previously reported. The presence of FDG-PET hypometabolism may be associated with a poor r esponse to drug treatment. PET can identify metabolic abnormalities as sociated with epileptic foci in children and adolescents and is useful in directing surgical intervention for the control of refractory comp lex partial epilepsy.