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Intractable Seizure Disorder
Andrew T. Trout, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Definitions

          • Seizure: Clinical manifestation of aberrant neuronal electrical discharge(s) in brain
          • Epilepsy: ≥ 2 unprovoked, afebrile seizures or diagnosis of epilepsy syndrome

        IMAGING

        • General Features

          • F-18 FDG PET Findings

            • C-11 Flumazenil Findings

              • Other PET Agent Findings

                • PET/MR Findings

                  • Nuclear Medicine Findings

                    • MR Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Mayoral M et al: Seizure-onset zone localization by statistical parametric mapping in visually normal (18) F-FDG PET studies. Epilepsia. 57(8):1236-44, 2016
                                    2. Kumar A et al: The role of radionuclide imaging in epilepsy, part 2: epilepsy syndromes. J Nucl Med. 54(11):1924-30, 2013
                                    3. Kumar A et al: The role of radionuclide imaging in epilepsy, Part 1: Sporadic temporal and extratemporal lobe epilepsy. J Nucl Med. 54(10):1775-81, 2013
                                    4. Miyata H et al: Surgical pathology of epilepsy-associated non-neoplastic cerebral lesions: a brief introduction with special reference to hippocampal sclerosis and focal cortical dysplasia. Neuropathology. 33(4):442-58, 2013
                                    5. Sidhu R et al: Pediatric seizures. Pediatr Rev. 34(8):333-41; 342, 2013
                                    6. Blümcke I et al: The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 52(1):158-74. 2011
                                    7. Kim S et al: SPECT Imaging of Epilepsy: An Overview and Comparison with F-18 FDG PET. Int J Mol Imaging. 2011:813028, 2011
                                    8. Struck AF et al: Surgical decision making in temporal lobe epilepsy: a comparison of [(18)F]FDG-PET, MRI, and EEG. Epilepsy Behav. 22(2):293-7, 2011
                                    9. Kumar A et al: Objective detection of epileptic foci by 18F-FDG PET in children undergoing epilepsy surgery. J Nucl Med. 51(12):1901-7, 2010
                                    10. la Fougère C et al: PET and SPECT in epilepsy: a critical review. Epilepsy Behav. 15(1):50-5, 2009
                                    11. Rastogi S et al: Neuroimaging in pediatric epilepsy: a multimodality approach. Radiographics. 28(4):1079-95, 2008
                                    12. Salamon N et al: FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy. Neurology. 71(20):1594-601, 2008
                                    13. Won HJ et al: Comparison of MR imaging with PET and ictal SPECT in 118 patients with intractable epilepsy. AJNR Am J Neuroradiol. 20(4):593-9, 1999
                                    14. Spencer SS: The relative contributions of MRI, SPECT, and PET imaging in epilepsy. Epilepsia. 35 Suppl 6:S72-89, 1994
                                    15. Friston KJ et al: Comparing functional (PET) images: the assessment of significant change. J Cereb Blood Flow Metab. 11(4):690-9, 1991
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          TERMINOLOGY

                                          • Definitions

                                            • Seizure: Clinical manifestation of aberrant neuronal electrical discharge(s) in brain
                                            • Epilepsy: ≥ 2 unprovoked, afebrile seizures or diagnosis of epilepsy syndrome

                                          IMAGING

                                          • General Features

                                            • F-18 FDG PET Findings

                                              • C-11 Flumazenil Findings

                                                • Other PET Agent Findings

                                                  • PET/MR Findings

                                                    • Nuclear Medicine Findings

                                                      • MR Findings

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Mayoral M et al: Seizure-onset zone localization by statistical parametric mapping in visually normal (18) F-FDG PET studies. Epilepsia. 57(8):1236-44, 2016
                                                                      2. Kumar A et al: The role of radionuclide imaging in epilepsy, part 2: epilepsy syndromes. J Nucl Med. 54(11):1924-30, 2013
                                                                      3. Kumar A et al: The role of radionuclide imaging in epilepsy, Part 1: Sporadic temporal and extratemporal lobe epilepsy. J Nucl Med. 54(10):1775-81, 2013
                                                                      4. Miyata H et al: Surgical pathology of epilepsy-associated non-neoplastic cerebral lesions: a brief introduction with special reference to hippocampal sclerosis and focal cortical dysplasia. Neuropathology. 33(4):442-58, 2013
                                                                      5. Sidhu R et al: Pediatric seizures. Pediatr Rev. 34(8):333-41; 342, 2013
                                                                      6. Blümcke I et al: The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 52(1):158-74. 2011
                                                                      7. Kim S et al: SPECT Imaging of Epilepsy: An Overview and Comparison with F-18 FDG PET. Int J Mol Imaging. 2011:813028, 2011
                                                                      8. Struck AF et al: Surgical decision making in temporal lobe epilepsy: a comparison of [(18)F]FDG-PET, MRI, and EEG. Epilepsy Behav. 22(2):293-7, 2011
                                                                      9. Kumar A et al: Objective detection of epileptic foci by 18F-FDG PET in children undergoing epilepsy surgery. J Nucl Med. 51(12):1901-7, 2010
                                                                      10. la Fougère C et al: PET and SPECT in epilepsy: a critical review. Epilepsy Behav. 15(1):50-5, 2009
                                                                      11. Rastogi S et al: Neuroimaging in pediatric epilepsy: a multimodality approach. Radiographics. 28(4):1079-95, 2008
                                                                      12. Salamon N et al: FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy. Neurology. 71(20):1594-601, 2008
                                                                      13. Won HJ et al: Comparison of MR imaging with PET and ictal SPECT in 118 patients with intractable epilepsy. AJNR Am J Neuroradiol. 20(4):593-9, 1999
                                                                      14. Spencer SS: The relative contributions of MRI, SPECT, and PET imaging in epilepsy. Epilepsia. 35 Suppl 6:S72-89, 1994
                                                                      15. Friston KJ et al: Comparing functional (PET) images: the assessment of significant change. J Cereb Blood Flow Metab. 11(4):690-9, 1991