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Open Access 01-11-2015 | CLINICAL ARTICLE - FUNCTIONAL

Seizure outcomes in relation to the extent of resection of the perifocal fluorodeoxyglucose and flumazenil PET abnormalities in anteromedial temporal lobectomy

Authors: Milo Stanišić, Christopher Coello, Jugoslav Ivanović, Arild Egge, Torsten Danfors, John Hald, Einar Heminghyt, Marjan Makki Mikkelsen, Bård Kronen Krossnes, Are Hugo Pripp, Pål Gunnar Larsson

Published in: Acta Neurochirurgica | Issue 11/2015

Abstract

Background

The area of predominant perifocal [¹⁸F]fluorodeoxyglucose (¹⁸F-FDG) hypometabolism and reduced [¹¹C]flumazenil (¹¹C-FMZ) -binding on PET scans is currently considered to contain the epileptogenic zone and corresponds anatomically to the area localizing epileptogenicity in patients with temporal lobe epilepsy (TLE). The question is whether the volume of the perifocal pre-operative PET abnormalities, the extent of their resection, and the volume of the non-resected abnormalities affects the post-operative seizure outcome.

Methods

The sample group consisted of 32 patients with mesial temporal sclerosis who underwent anteromedial temporal lobe resection for refractory TLE. All patients had pathologic perifocal findings on both of the PET modalities as well as on the whole-brain MRI. The volumetric data of the PET and MRI abnormalities within the resected temporal lobe were estimated by automated quantitative voxel-based analysis. The obtained volumetric data were investigated in relation to the outcome subgroups of patients (Engel classification) determined at the 2-year post-operative follow-up.

Results

The mean volume of the pre-operative perifocal ¹⁸F-FDG- and ¹¹C-FMZ PET abnormalities in the volumes of interest (VOI) of the epileptogenic temporal lobe, the mean resected volume of these PET abnormalities, the mean volume of the non-resected PET abnormalities, and the mean MRI-derived resected volume were not significantly related to the outcome subgroups and had a low prediction for individual freedom from seizures.

Conclusions

The extent of pre-surgical perifocal PET abnormalities, the extent of their resection, and the extent of non-resected abnormalities were not useful predictors of individual freedom from seizures in patients with TLE.

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Title: Seizure outcomes in relation to the extent of resection of the perifocal fluorodeoxyglucose and flumazenil PET abnormalities in anteromedial temporal lobectomy
Authors: Milo Stanišić
Christopher Coello
Jugoslav Ivanović
Arild Egge
Torsten Danfors
John Hald
Einar Heminghyt
Marjan Makki Mikkelsen
Bård Kronen Krossnes
Are Hugo Pripp
Pål Gunnar Larsson
Publication date: 01-11-2015
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2015
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-015-2578-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Seizure outcomes in relation to the extent of resection of the perifocal fluorodeoxyglucose and flumazenil PET abnormalities in anteromedial temporal lobectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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