Hipometabolismo cerebral em pacientes com esclerose mesial temporal demonstrado pelo FDG-PET

Duarte, Paulo Schiavom; Zhuang, Hongming; King, David; Alavi, Abass

doi:10.1590/s0004-282x2000000500012

Arq. Neuro-Psiquiatr.

2000

DOI: 10.1590/s0004-282x2000000500012

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Hipometabolismo cerebral em pacientes com esclerose mesial temporal demonstrado pelo FDG-PET

Paulo Schiavom Duarte

Hongming Zhuang²,

David King

et al.

Abstract: These data indicated that hypometabolism extends beyond the epileptogenic focus in the temporal lobe in patients with complex partial seizure related to MTS. The metabolism in the medial portion of the temporal lobe is more correlated with the metabolism in the frontal lobe than with those of the others brain structures outside the temporal lobe. The pathophysiological mechanisms of hypometabolism remain controversial.

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Cited by 2 publications

References 26 publications

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PET Manifestation in Different Types of Pathology in Epilepsy

Talanow¹,

Ruggieri²,

Alexopoulos³

et al. 2009

Clinical Nuclear Medicine

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To investigate the metabolic behavior of different disease processes and pathology in epilepsy, fluorodeoxyglucose-positron emission tomography (FDG-PET) images of 280 patients with refractory epilepsy who had been surgically treated were retrospectively analyzed. The image findings were compared with the surgical pathology report. For all the pathology types reported, the major manifestations were regional hypometabolism. Of patients with sclerosis 92.1% (153/166) demonstrated FDG hypometabolism; 5.4% (9/166) were normometabolic and 2.4% (4/166) had increased FDG uptake (hypermetabolism). Of patients with malformation of cortical development, 84.5% (60/71) demonstrated hypometabolism, 8.4% (6/71) hypermetabolism, and 7% (5/71) showed normal metabolism. All of the neoplasms (24/24) and inflammatory processes (25/25) showed regional hypometabolism. The study suggests that although the major findings on FDG-PET in patients with refractory epilepsy are hypometabolic, attention should also be paid to patients with regional hypermetabolism, which might sufficiently localize the seizure origin. It might be worthwhile to repeat the study if no regions of hypometabolism are found and the electroencephalography suggests frequent spiking activity.

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PET Manifestation in Different Types of Pathology in Epilepsy

Talanow¹,

Ruggieri²,

Alexopoulos³

et al. 2009

Clinical Nuclear Medicine

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Avaliação pré-cirúrgica de epilepsia neocortical de lobo temporal com utilização de FDG-18F SPECT: relato de caso

Bilevicius

Etchebehere

Camargo

et al. 2006

J. epilepsy clin. neurophysiol.

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INTRODUÇÃO: Muitos portadores de epilepsias parciais não apresentam foco epileptogênico facilmente identificado na investigação com EEG de superfície e ressonância magnética (RM). Nestes casos o uso de técnicas de neuroimagem funcional como a tomografia por emissão de pósitrons (PET) interictal e a tomografia por emissão de fóton único (SPECT) ictal devem ser considerados, visando evitar a colocação de eletrodos profundos em alguns casos ou guiar o posicionamento destes em outros. O exame de PET, no entanto, não é disponível em grande parte dos centros de epilepsia, principalmente por seu alto custo. OBJETIVO: O nosso objetivo é demonstrar que a utilização de FDG-18F SPECT interictal pode ser uma boa alternativa ao uso do PET na localização do foco e planejamento cirúrgico. MATERIAIS E MÉTODOS: Relato de uma paciente com epilepsia parcial de lobo temporal neocortical, refratária a tratamento clínico, com RM normal e EEG ictal sem localização definida do foco epileptogênico. RESULTADOS: Após a extensa investigação pré cirúrgica sem resultados satisfatórios optou-se pela realização de exame de medicina nuclear FDG-18F SPECT interictal. O exame demonstrou hipometabolismo na região anterior das porções mesial e lateral do lobo temporal direito. A paciente foi, então, submetida à ressecção destas áreas e permanece com excelente controle de crises (Engel IB) 24 meses após a cirurgia. CONCLUSÃO: O FDG-18F SPECT pode tornar-se um substituto do PET nos locais onde esta tecnologia não é disponível.

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Hipometabolismo cerebral em pacientes com esclerose mesial temporal demonstrado pelo FDG-PET

Cited by 2 publications

References 26 publications

PET Manifestation in Different Types of Pathology in Epilepsy

PET Manifestation in Different Types of Pathology in Epilepsy

Avaliação pré-cirúrgica de epilepsia neocortical de lobo temporal com utilização de FDG-18F SPECT: relato de caso

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