Predictive factors of ictal SPECT findings in paediatric patients with focal cortical dysplasia

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• 作者：Martin Kudr (1)
  Pavel Krsek (1)
  Bruno Maton (2)
  Stephen Malone (2)
  Alena Jahodova (1)
  Petr Jezdik (1)
  Vladimir Komarek (1)
  Ian Miller (2)
  Prasanna Jayakar (2)
  Trevor Resnick (2) (3)
  Michael Duchowny (2) (3) (4)
  
• 关键词：Ictal SPECT ; focal cortical dysplasia ; epilepsy surgery
• 刊名：Epileptic Disorders
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：15
• 期：4
• 页码：383-391
• 全文大小：163 KB
• 作者单位：Martin Kudr (1)
  Pavel Krsek (1)
  Bruno Maton (2)
  Stephen Malone (2)
  Alena Jahodova (1)
  Petr Jezdik (1)
  Vladimir Komarek (1)
  Ian Miller (2)
  Prasanna Jayakar (2)
  Trevor Resnick (2) (3)
  Michael Duchowny (2) (3) (4)
  
  1. Department of Paediatric Neurology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
  2. Department of Neurology and Comprehensive Epilepsy Program, Brain Institute, Miami Children’s Hospital, Miami, Florida, USA
  3. Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
  4. Department of Neurology, Brain Institute Miami, Children’s Hospital, University of Miami Miller School of Medicine, 3200 SW 60th Court, Miami, Florida, USA
  
• ISSN：1950-6945

文摘

Aims To identify variables that influence the extent of ictal single-photon emission computed tomography (SPECT) findings in paediatric patients with focal cortical dysplasia (FCD). Methods We visually evaluated 98 ictal SPECT studies from 67 children treated surgically for intractable epilepsy caused by FCD. SPECT findings were classified as “non-localised- “well-localised- and “extensive-and compared with parameters of injected seizures (seizure type and duration, injection time, and scalp EEG ictal pattern), presence of structural pathology on MRI, type of surgery performed after SPECT study, and histological findings. Results A shorter injection time and duration of injected seizure was associated with more localised SPECT hyperperfusion. SPECT findings were not significantly influenced by type of injected seizure. Widespread ictal scalp EEG patterns were associated with extensive SPECT findings. Larger zones of hyperperfusion were more common in patients with lesional MRI and patients undergoing multilobar resections. SPECT studies demonstrating good localisation were more common in patients with mild malformations of cortical development. Conclusion Early ictal SPECT radiotracer injection is crucial for successful localisation of the epileptogenic zone. Seizure duration, type of scalp EEG findings, and presence of structural pathology on MRI may influence the extent of ictal SPECT hyperperfusion, which was associated with certain types of epilepsy surgery aswell as histopathological findings.