Cerebral Perfusion Abnormalities in Therapy???resistant Epilepsy in Mentally Retarded Pediatric Patients

Hm, Abdel-Dayem; Mk, Nawaz; Mm, Hassoon; Abdel-Rahman, Mohamed; Oe, Olofsson

doi:10.1097/00003072-199108000-00005

Cited by 8 publications

(2 citation statements)

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“…Five hundred thirty-nine patients were reported in the literature with interictal SPECT results and EEG, with each of these determinations in sufficient detail to analyze sensitivity and specificity for predicting the lobe of epileptogenicity (Stefan et al, 1987(Stefan et al, , 1990Denays et al, 1988;Lee et al, 1988;Ryding et al, 1988;Gelfand et al, 1989;Lamanna et al, 1989;Rowe et al, 1989Rowe et al, , 1991Smith et al, 1989;Anderson et al, 1990;Cordes et al, 1990;Shen et al, 1990;Abdel-Dayem et al, 1991;Dietrich et al, 1991;Grunwald et al, 1991;Hajek et al, 1991;Launes et al, 1992;Markand et al, 1992;Newton et al, 1992b;Ryvlin et al, 1992;Verhoeff et al, 1992;Coubes et al, 1993). Two hundred ninety-one patients were localized by SPECT to the temporal lobe, 65 to extratemporal locations, and 183 were unlocalized, a discrepancy that may reflect merely the higher frequency of temporal lobe epilepsy in general or of temporal lobe epilepsy among patients refractory to medications who are most likely to undergo SPECT as part of presurgical evaluation ( Table 2).…”

Section: Sensitivity and Specificitymentioning

confidence: 99%

The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy

1994

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Functional and structural neuroimaging techniques are increasingly indispensable in the evaluation of epileptic patients for localization of the epileptic area as well as for understanding pathophysiology, propagation, and neurochemical correlates of chronic epilepsy. Although interictal single photon emission computed tomography (SPECT) imaging of cerebral blood flow is only moderately sensitive, ictal SPECT markedly improves yield. Positron emission tomography (PET) imaging of interictal cerebral metabolism is more sensitive than measurement of blood flow in temporal lobe epilepsy. Furthermore, PET has greater spatial resolution and versatility in that multiple tracers can image various aspects of cerebral function. Interpretation of all types of functional imaging studies is difficult and requires knowledge of time of most recent seizure activity and structural correlates. Only magnetic resonance imaging (MRI) can image the structural changes associated with the underlying epileptic process, and quantitative evidence of hippocampal volume loss has been highly correlated with seizure onset in medial temporal structures. Improved resolution and interpretation have made quantitative MRI more sensitive in temporal lobe epilepsy, as judged by pathology. When judged by electroencephalography (EEG), ictal SPECT and interictal PET have the highest sensitivity and specificity for temporal lobe epilepsy; these neuroimaging techniques have lower sensitivity and higher specificity for extratemporal EEG abnormalities. Regardless of the presence of structural abnormalities, functional imaging by PET or SPECT provides complementary information. Ideally these techniques should be used and interpreted together to improve the localization and understanding of epileptic brain.

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Section: Sensitivity and Specificitymentioning

confidence: 99%

The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy

1994

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“…There have also been reports on the role of paramagnetic contrast materials in MRI (Elster and Mirza, 1991) and on the correlations between MRI, surgical management (Altman, 1988;Jack et al, 1988;Brooks et al, 1990;Gzesh and Goldstein, 1990;Heinz et al, 1990;Sperling, 1990;Bronen et al, 1991;Dietrich et al, 1991), and histologic findings (Kusniecky et al, 1987;Maertens et al, 1987;Smith et al, 1988;Heinz et al, 1990;Bronen et al, 1991;Barkovich and Bent, 1992;Cascino et al, 1992). Functional neuroimaging with positron emission tomography (PET) (Latack et al, 1986;Levin et al, 1989;Gzesh and Goldstein, 1990) or single photon emission computed tomography (SPECT) (Cordes et al, 1990;Abdel-Dayem et al, 1991;Dietrich et al, 1991) have been emphasized in partial epilepsy, often with comparisons of these techniques with CT and MRI (Sperling et al, 1986;Theodore et al, 1986;Kramer, 1987;Abdel-Dayem et al, 1991;Ryvlin et al, 1992). MR spectroscopy (MRS) has been proposed to detect metabolic changes in the epileptic foci (Matthews et al, 1990).…”

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confidence: 99%

Imaging Studies in Partial Epilepsy in Children and Adolescents

et al. 1994

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We reviewed the results of imaging studies on 111 children and adolescents with partial epilepsy to determine which imaging procedure had the greatest sensitivity and specificity for partial epilepsy in this age range. All cases were classified as idiopathic, lesional, and cryptogenic epilepsy based on the 1989 International League Against Epilepsy Classification. All patients had magnetic resonance imaging (MRI) and 98 also had computed tomography (CT). Thirty patients with negative CT had MRI lesions that were most likely the cause of the epilepsy, and the initial diagnosis of cryptogenic partial epilepsy was changed to lesional partial epilepsy. We concluded that CT use is unwarrantedly common. MRI should be considered the procedure of first choice. CT has a complementary role, and functional neuroimaging should be encouraged.

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