Reduction of benzodiazepine receptor binding is related to the seizure onset zone in extratemporal focal cortical dysplasia |
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Authors: | Arnold S Berthele A Drzezga A Tölle T R Weis S Werhahn K J Henkel A Yousry T A Winkler P A Bartenstein P Noachtar S |
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Institution: | Department of Neurology, University of Munich, Germany. |
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Abstract: | PURPOSE: Comparison of regional reduction of GABA receptor binding and seizure onset zone in patients with extratemporal epilepsy due to focal cortical dysplasia. METHODS: Two patients with frontal lobe epilepsy who remained seizure free after partial frontal lobe resection were investigated with magnetic resonance imaging, positron emission tomography (PET) with 18F-fluoro-deoxy-glucose (FDG) and 11C-flumazenil, subdural EEG-video recordings, and postoperative benzodiazepine (BDZ)-receptor autoradiography. RESULTS: The area of reduced BDZ-receptor binding as documented by preoperative flumazenil-PET and postoperative BDZ-receptor autoradiography corresponded to the seizure onset zone and was smaller than the interictal hypometabolism documented by FDG-PET. CONCLUSION: Flumazenil-PET is a useful tool for localization of the epileptogenic zone in patients with extratemporal epilepsy caused by focal cortical dysplasia. Neuronal distribution of BDZ-receptor density confirms in vivo flumazenil-PET findings. The regional reduction of BDZ-receptor binding in focal cortical dysplasia seems to be confined to the seizure onset zone and not to the extent of dysplastic cortex. |
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Keywords: | Frontal lobe epilepsy Focal cortical dysplasia Positron emission tomography Benzodiazepine receptor |
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