Functional imaging in the work-up of childhood epilepsy |
| |
Authors: | L Hertz-Pannier C Chiron P Véra P F Van de Morteele A Kaminska M Bourgeois A Hollo D Ville C Cieuta O Dulac F Brunelle D LeBihan |
| |
Institution: | (1) Service Hospitalier Frederic Joliot, Department of Medical Research, CEA, Orsay, France, FR;(2) Pediatric Radiology Department (Radiopédiatrie), Hospital Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France e-mail: lucie.hertz-pannier@nck.ap-hop-paris.fr Tel.: +33-1-44495171 Fax: +33-1-44495170, FR;(3) Neuropediatric Department and INSERM Unit 29, Hospital Saint Vincent de Paul, Paris, France, VC;(4) Department of Nuclear Medicine, Rouen University Hospital and Henri Becquerel Center, Rouen, France, FR;(5) Pediatric Neurosurgery Department, Hospital Necker-Enfants Malades, Paris, France, FR |
| |
Abstract: | In children with medically intractable lesional epilepsy, surgery is deemed successful if the epileptogenic focus can be removed
while major neurological functions are spared. Current techniques rely on invasive intracranial recordings. The new developments
in functional imaging offer the possibility of localizing the epileptogenic focus noninvasively (PET/SPECT) and mapping cognitive
functions (fMRI). Ictal SPECT shows hyperperfusion in the focus and has proved to have better localizing value than interictal
PET or SPECT, which show focal hypometabolism or hypoperfusion. Ictal SPECT is useful for deciding on the placement of intracranial
electrodes in extratemporal epilepsies, particularly in young children. Functional MRI has proved highly accurate for localizing
motor and language networks, thus offering the possibilities of replacing the Wada test (language hemispheric lateralization)
and studying postlesional brain plasticity. Despite the difficulties of functional imaging in children owing to the limited
cooperation that can be expected, ethical constraints, and poor normative data, SPECT/PET and fMRI provide clinically useful
information for presurgical work-up of childhood epilepsies.
Received: 30 March 2000 |
| |
Keywords: | Functional imaging Ictal SPECT PET Functional MRI Children Epilepsy |
本文献已被 SpringerLink 等数据库收录! |
|