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Neuroimaging in Epilepsy$
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Harry Chugani, MD

Print publication date: 2010

Print ISBN-13: 9780195342765

Published to Oxford Scholarship Online: January 2011

DOI: 10.1093/acprof:oso/9780195342765.001.0001

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Positron Emission Tomography: Glucose Metabolism in Extratemporal Lobe Epilepsy

Positron Emission Tomography: Glucose Metabolism in Extratemporal Lobe Epilepsy

(p.141) Chapter 9 Positron Emission Tomography: Glucose Metabolism in Extratemporal Lobe Epilepsy
Neuroimaging in Epilepsy

Csaba Juhász

Harry T. Chugani

Oxford University Press

The interictal FDG PET often shows focal cortical hypometabolism in patients with extratemporal epilepsy and can correctly regionalize neocortical epileptic foci in more than 2/3 of the cases, even if MRI is non-localizing. In some cases, however, FDG PET overestimates the epileptogenic region, and hypometabolism may extend progressively to involve remote cortical and subcortical regions, thus establishing an epileptic network in chronic epilepsy. On the other hand, hypometabolism can occur adjacent to, rather than completely overlap with, ictal seizure onset zones. Therefore, FDG PET is best used for presurgical evaluation in combination with other clinical, electrophysiological and imaging data to guide intracranial grid placement and optimize tailored neocortical resection. When applied in this manner, the use of FDG PET can improve outcome of extratemporal lobe epilepsy surgery.

Keywords:   extratemporal, epilepsy, FDG-PET, hypometabolism, cortex, neocortical, subcortical, presurgical evaluation, surgery, surgical outcome

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