Persistent postictal hyperperfusion demonstrated with PET

Four patients with complex partial seizure disorder whose positron emission tomography (PET) scans show sustained hyperperfusion of the epileptiform f ocus 12-24 h after a seizure episode are presented. Three of these patients underwent same day Fluorine-18 (F-18) deoxyglucose (FDG) PET scans, which showed hypometabolism of the epileptic temporal lobe. In one patient who un derwent repeated blood flow and concurrent glucose metabolism scans 4 days after a seizure, hyperperfusion was not present and the FDG-PET demonstrate d hypometabolism. Persistent hyperperfusion was noted in six out of 65 case s studied. Four out of six patients who were followed clinically were prese nted in this report. The cause of the rare occurrence of persistent postict al or interictal hyperperfusion and the differences of postictal blood flow dynamics and glucose metabolism need to be clarified further with future s tudies. (C) 2000 Elsevier Science B.V. All rights reserved.