Clinical PET pp 103-113 | Cite as

Positron Emission Tomography in Partial Epilepsy

  • Bernard Sadzot
  • René M. C. Debets
  • Eric Salmon
  • Cornelius W. M. van Veelen
  • Guy Delfiore
  • Alexander C. van Huffelen
  • George Franck
Part of the Developments in Nuclear Medicine book series (DNUM, volume 28)


Uncontrolled partial epilepsy is an important medical problem. It can be surgically treated if the site of seizure onset, the epileptic focus, can be delimited and removed. Up to recently, accurate identification of the epileptogenic area relied solely upon sophisticated and time-consuming extra- and intracranial EEG recording techniques, even though EEG occasionnally may fail in providing the localization of the focus due to the rapid propagation of the electrical discharges.


Positron Emission Tomography Temporal Lobe Epilepsy Single Photon Emission Tomography Partial Epilepsy Complex Partial Seizure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Kuhl, D.E., Engel, J. Jr, Phelps, M.E., Selin, C. Epileptic patterns of local cerebral metabolism and perfusion in humans determined by emission computed tomography of 18FDG and 13NH3. Ann. Neurol. 1980; 8: 348–360.PubMedCrossRefGoogle Scholar
  2. 2.
    Abou-Khalil, B.W., Siegel, G.J., Sackellares, J.C., Gilman, S., Hichwa, R., Marshall, R. Positron emission tomography studies of cerebral glucose metabolism in chronic partial epilepsy. Ann. Neurol. 1987; 22: 480–486.PubMedCrossRefGoogle Scholar
  3. 3.
    DeLaPena, R., Perlman, S.B., Levine, R., Kanner, A.M., Jones, J.J., Pyzalski, R., Nickles, R.J. PET scan findings in patients with temporal lobe epilepsy of mesial temporal origin. J. Nucl. Med. 1992; 33: 1014.Google Scholar
  4. 4.
    Engel, J., Jr, Henry, T.R., Risinger, M.W., Mazziotta, J.C., Sutherling, W.W., Levesque, M.F., Phelps, M.E. Presurgical evaluation for partial epilepsy: relative contribution of chronic depth-electrode recordings versus FDG-PET and scalp-sphenoidal ictal EEG. Neurology 1990; 40: 1670–1677.PubMedGoogle Scholar
  5. 5.
    Engel, J., Jr, Kuhl, D.E., Phelps, M.E., Crandall, P.H. Comparative localization of epileptic foci in partial epilepsy by PCT and EEG. Ann. Neurol. 1982a; 12: 529–537.CrossRefGoogle Scholar
  6. 6.
    Engel, J., Jr, Kuhl, D.E., Phelps, M.E., Mazziotta, J.C. Interictal cerebral glucose metabolism in partial epilepsy and its relation to EEG changes. Ann. Neurol. 1982b; 12: 510–517.CrossRefGoogle Scholar
  7. 7.
    Ryvlin, P., Cinotti, L., Froment, J.C., Le Bars, D., Landais, P., Chaze, M., Galy, G., Lavenne, F., Serra, J.P., Mauguière, F. Metabolic patterns associated with nonspecific magnetic resonance imaging abnormalities in temporal lobe epilepsy. Brain 1991; 114: 2363–2383.PubMedCrossRefGoogle Scholar
  8. 8.
    Sackellares, J.C., Siegel, G.J., Abou-Khalil, B.W., Hood, T.W., Gilman, S., McKeever, P.E., Hichwa, R.D., Hutchins, G.D. Differences between lateral and mesial temporal metabolism interictally in epilepsy of mesial temporal origin. Neurology 1990; 40: 1420–1426.PubMedGoogle Scholar
  9. 9.
    Sadzot, B., Debets, R.M., Maquet, P., van Veelen, C.W., Salmon, E., van Emde Boas, W., Velis, D.N., van Huffelen, A.C., Franck, G. Regional brain glucose metabolism in patients with complex partial seizures investigated by intracranial EEG. Epilepsy Res. 1992; 12: 121–129.PubMedCrossRefGoogle Scholar
  10. 10.
    Theodore, W.H., Newmark, M.E., Sato, S., Brooks, R., Patronas, N., De La Paz, R., DiChiro, G., Kessler, R.M., Margolin, R., Manning, R.G., Channing, M., Porter, R.J. [18F]fluorodeoxyglucose positron emission tomography in refractory complex partial seizures. Ann. Neurol. 1983; 14: 429–437.PubMedCrossRefGoogle Scholar
  11. 11.
    Swartz, B.E., Tomiyasu, U., Delgado-Escueta, A.V., Mandelkern, M., Khonsari, A. Neuroimaging in temporal lobe epilepsy: test sensitivity and relationships to pathology and post-operative outcome. Epilepsia 1992; 33: 624–634.PubMedCrossRefGoogle Scholar
  12. 12.
    Hajek, M., Antonini, A., K.L. Leenders, Wieser, H.G. Mesiobasal versus lateral temporal lobe epilepsy: metabolic differences in the temporal lobe shown by interictal 18F-FDG positron emission tomography. Neurology 1993; 43: 79–86.PubMedGoogle Scholar
  13. 13.
    Henry, T.R., Sutherling, W.W., Engel, J. Jr, Risinger, M.W., Levesque, M.F., Mazziotta, J.C., Phelps, M.E. Interictal cerebral metabolism in partial epilepsics of ncocortical origin. Epilepsy Res. 1991; 10: 174–182.PubMedCrossRefGoogle Scholar
  14. 14.
    Radtke, R.A., Coleman, R.E., Hanson, M.W., Walczak, T.S., Lewis, D.V., McNamara, J.O. Positron emission tomography in extratemporal epilepsy. Neurology 1989; 39 (Suppl. 1): 301.Google Scholar
  15. 15.
    Swartz, B.E., Halgren, E., Delgado-Escueta, A.V., Mandelkern, M., Gee, M., Quinones, N., Bland, W.H., Repchan, J. Neuroimaging in patients with seizures of probable frontal lobe origin. Epilepsia 1989; 30: 547–558.PubMedCrossRefGoogle Scholar
  16. 16.
    Franceschi, M., Messa, C., Ferini-Strambi, L., Lucignani, G., Canal, N., Lenzi, G.L., Fazio, F. SPECT imaging of cerebral perfusion in patients with non-refractory temporal lobe epilepsy. Acta Neurol. Scand. 1993; 87: 268–74.PubMedCrossRefGoogle Scholar
  17. 17.
    Newton, M.R., Berkovic, S.F., Austin, M.C., Rowe, C.C., McKay, W.J., Bladin, P.F. Postictal switch in blood flow distribution and temporal lobe seizures.. J. Neurol. Neurosurg. Psychiat. 1992; 55: 891–894.PubMedCrossRefGoogle Scholar
  18. 18.
    Rowe, C.C., Berkovic, S.F., Sia, S.T.B., Austin, M., McKay, W.J., Klanius, R.M., Bladin, P.F. Localization of epileptic foci with postictal single photon emission computed tomography. Ann. Neurol. 1989; 26: 660–668.PubMedCrossRefGoogle Scholar
  19. 19.
    Ryvlin, Ph., Philippon, B., Cinotti, L., Froment, J.C., Le Bars, D., Maugiuère, F. Functional neuroimaging strategy in temporal lobe epilepsy: a comparative study of 18FDG-PET and 99mTc-HMPAO-SPECT. Ann. Neurol. 1992; 31: 650–656.PubMedCrossRefGoogle Scholar
  20. 20.
    Rowe, C.C., Berkovic, S.F., Austin, M.C., Saling, M., Kalnins, R.M., McKay, W.J., Bladin, P.F. Visual and quantitative analysis of interictal SPECT with technetium99m-HMPAO in temporal lobe epilepsy. J. Nucl. Med. 1991; 32: 1688–1991.Google Scholar
  21. 21.
    Stefan, H., Pawlik, G., Böcher-Schwarz, H.G., Biersack, H.J., Burr, W., Penin, H., Heiss, W.D. Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal and ictal EEG, CT, MRI, SPECT and PET. J. Neurol. 1987; 234: 377–384.PubMedCrossRefGoogle Scholar
  22. 22.
    Duncan, R., Patterson, J., Roberts, R., Hadley, D.M., Bone I. Ictal/postictal SPECT in the pre-surgical localisation of complex partial seizures.. J. Neurol. Neurosurg. Psychiat. 1993; 56: 141–148.PubMedCrossRefGoogle Scholar
  23. 23.
    Cordes, M., Henkes, H., Ferstl, F., Schmitz, B., Hierholzer, J., Schmidt, D., Felix, R. Evaluation of focal epilepsy: a SPECT scanning comparison of 123-I-iomazenil versus HM-PAO. Am. J. Neuroradiol. 1992; 13: 249–253.PubMedGoogle Scholar
  24. 24.
    van Huffelen, A.C., van Isselt, J.W., van Veelen, C.W., van Rijk, P.P., van Bentum, A.M., Dive, D., Maquet, P., Franck, G., Velis, D.N., van Emde Boas, W., Debets, R.M. Identification of the side of epileptic focus with 1231-lomazenil SPECT. A comparison with 18FDG-PET and ictal EEG findings in patients with medically intractable complex partial seizures. Acta Neurochir. 1990; Supplcmcntum 50: 95–99.Google Scholar
  25. 25.
    Müller-Gärtner, H.W., Mayberg, H.S., Fisher, R.S., Lesser, R.P., Wilson, A.A., Raven, H.T., Dannals, R.F., Wagner, H.N. Jr., Uematsu, S., Frost, J.J. Decreased hippocampal muscarinic cholinergic receptor binding measured by 123 1iododexetimide and single-photon emission computed tomography in epilepsy. Ann. Neurol. 1993; 34: 235–238.PubMedCrossRefGoogle Scholar
  26. 26.
    Bemardi, S., Trimble, M.R., Frackowiak, R.S.J., Wise, R.J.S., Jones, T. An interictal study of partial epilepsy using positron emission tomography and the oxygen-15 inhalation technique. J. Neurol. Neurosurg. Psychiat. 1983; 46: 473–477.CrossRefGoogle Scholar
  27. 27.
    Franck, G., Sadzot, B., Salmon, E., Depresseux, J.C., Grisar, T., Peters, J.M., Quaglia, L., Delfiore, G., Lamotte, D., Regional blood flow and metabolic rates in human focal epilepsy and status epilepticus. In: “Advances in Neurology: Basic Mechanisms of the Epilepsies”, Vol 44, edited by A.V. Delgado-Escueta, Ward, A.A., Jr., D.M. Woodbury, and R.J. Porter. Raven Press, New York 1986;pp:935–948.Google Scholar
  28. 28.
    Leiderman, D.B., Balish, M., Sato, S., Kufta, C., Reeves, P., Gaillard, W.D., Theodore, W.H. Comparison of PET measurements of cerebral blood flow and glucose metabolism for the localization of human epileptic foci. Epilepsy Res. 1992; 13: 153–157.PubMedCrossRefGoogle Scholar
  29. 29.
    Frost, J.J., Mayberg, H.S., Fisher, R.S., Douglass, K.H., Dannals, R.F., Links, J.M., Wilson, A.A., Ravert, H.T., Rosenbaum, A.E., Snyder, S.H., Wagner, H.N., Jr. Mu-opiate receptors measured by positron emission tomography are increased in temporal lobe epilepsy. Ann. Neurol. 1988; 23: 231–237.PubMedCrossRefGoogle Scholar
  30. 30.
    Mayberg, H.S., Sadzot, B., Cidis Meltzer, C.C., Fisher, R.S., Lesser, R.P., Dannals, R.F., Lever, J.R., Wilson, A.A., Ravert, H. T., Wagner, H.N., Jr, Bryan, R.N., Cromwell, C.C., Frost, J.J. Quantification of mu and non-mu opiate receptors in temporal lobe epilepsy using positron emission tomography. Ann. Neurol. 1991; 30: 3–11.PubMedCrossRefGoogle Scholar
  31. 31.
    Theodore, W.H., Carson, R.E., Andreasen, P., Zametkin, A., Blasberg, R., Leiderman, D.B., Rice, K., Newman, A., Channing, M., Dunn, B., Simpson, N., Herscovitch, P. PET imaging of opiate receptor binding in human epilepsy using [18F]cyclofoxy. Epilepsy Res. 1992; 13: 129–139.PubMedCrossRefGoogle Scholar
  32. 32.
    Persson, A., Ehrin, E., Eriksson, L., Farde, L., Hedström, C-G., Litton, J.-E., Mindus, P., Sedvall, G. Imaging of [11C]-labelled Ro 15–1788 binding to benzodiazepine receptors in the human brain by positron emission tomography. J. Psychiat. Res. 1985; 19: 609–622.PubMedCrossRefGoogle Scholar
  33. 33.
    Samson, Y., Hantraye, P., Baron, J.C., Soussaline, F., Comar, D., Mazière, M. Kinetics and displacement of [11C]Ro 15–1788, a benzodiazepine antagonist, studied in human brain in vivo by positron emission tomography. Eur. J. Pharmacol. 1985; 110: 247–251.PubMedCrossRefGoogle Scholar
  34. 34.
    Savic, I., Persson, A., Roland, P., Pauli, S., Sedvall, G., Widen, L. In vivo demonstration of reduced benzodiazepine receptor binding in human epileptic foci. Lancet 1988; 2: 863–866.PubMedCrossRefGoogle Scholar
  35. 35.
    Henry, T.R., Frey, K.A., Sackellares, J.C., Gilman, S., Koeppe, R.A., Brunberg, J.A., Ross, D.A., Berent, S., Young, A.B., Kuhl, D. In vivo cerebral metabolism and central benzodiazepine-receptor binding in temporal lobe epilepsy. Neurology 1993; 43: 1998–2006.PubMedGoogle Scholar
  36. 36.
    Sadzot, B., Debets, R.M., Delfiore, G., van Huffelen, C.W., van Veelen, A.C., Degueldre, C, Comar, D., Franck, G. Decrease of 11C-flumazenil binding is more localized than glucose hypometabolism in patients with TLE studied by PET. Neurology 1994; 44 (Suppl. 2): A351 - A352.Google Scholar
  37. 37.
    Savic, I., Ingvar, M., Stone-Elander, S. Comparison of [11C]flumazenil and [18F]FDG as PET markers of epileptic foci. J. Neurol. Neurosurg. Psychiat. 1993; 56: 615–621.PubMedCrossRefGoogle Scholar
  38. 38.
    Syapin, P.J., Skolnick, P. Characterization of benzodiazepine binding sites in cultured cells of neuronal origin. J. Neurochem. 1979; 32: 1047–1051.PubMedCrossRefGoogle Scholar
  39. 39.
    Zavala, F., Lenfant, M. Benzodiazepines and PK 11195 exert immunomodulating activities by binding on a specific receptor on macrophage. Ann. NY Acad. Sci. 1987; 496: 240–249.PubMedCrossRefGoogle Scholar
  40. 40.
    Benavides, J., Cornu, P., Dennis, T., Dubois, A., Hauw, J.J., MacKenzie, Sazdovitch, V., Scatton, B., Imaging of human brain lesions with an omega 3 site radioligand. Ann. Neurol. 1988; 24: 708–712.PubMedCrossRefGoogle Scholar
  41. 41.
    Junck, L., Olson, J.M., Ciliax, B.J., Koeppe, R.A., Watkins, G.L., Jewett, D.M., McKeever, P.E., Wieland, D.M., Kilbourn, M.R., Starosta-Rubinstein, S., Mancini, W.R., Kuhl, D.E., Greenberg, H.S., Young, A.B. PET imaging of human gliomas with ligands for the peripheral benzodiazepine binding site. Ann. Neurol. 1989;26:752–758.PubMedCrossRefGoogle Scholar
  42. 42.
    Kumlien, E., Hilton-Brown, P., Spännare, B., Gillberg, P.G. In vitro quantitative autoradiography of [3H]-L-deprenyl and [3H]-PK 11195 binding sites in human epileptic hippocampus. Epilepsia 1992; 33: 610–617.PubMedCrossRefGoogle Scholar
  43. 43.
    Knoll, J., Magyar, K. Some puzzling effects of monoamine oxydase inhibitors. Adv. Biochem. Psychopharmacol. 1972; 5: 393–408.Google Scholar
  44. 44.
    Nakamura, S., Kawamata, T., Akiguchi, I., Kameyama, M., Nakamura, N., Kimura, H. Expression of monoamine oxidase B activity in astrocytes of senile plaques. Acta Neuropathol. 1990; 80: 419–425.PubMedCrossRefGoogle Scholar
  45. 45.
    Fowler, J.S., Wolf, A.P., MacGregor, R.R., et al. Mechanistic positron emission tomography studies: demonstration of a deuterium effect in the monoamine oxidase-catalyzed binding of 11C-L-deprenyl in living baboon brain. J. Neurochem. 1988; 51: 1524–1534.PubMedCrossRefGoogle Scholar
  46. 46.
    Kumlien, E., Bergström, M., Lilja, A., Andersson, J., Szekeres, V., Westerberg, C-E., Westerberg, G., Antoni, G., Langström, B. Positron emission tomography with 11 Cdeuterium-deprenyl in temporal lobe epilepsy. Epilepsia 1994;In press:.Google Scholar
  47. 47.
    Sadzot, B., Debets, R.M.C., Maquet, P., Comar, C., Franck, G. PET data interpretation: visual inspection and semi-quantification/quantification. Acta Neurol. Scand. 1994; 89: 175–178.Google Scholar
  48. 48.
    Sperling, M.R., O’Connor, M.J., Saykin, A.J., Phillips, C.A., Morrel, M.J., Bridgman, P.A., French, J.A., Gonatas, N. A non invasive protocol for anterior temporal lobectomy. Neurology 1992; 42: 416–422.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Bernard Sadzot
  • René M. C. Debets
  • Eric Salmon
  • Cornelius W. M. van Veelen
  • Guy Delfiore
  • Alexander C. van Huffelen
  • George Franck

There are no affiliations available

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