Artículos de revistas
Ictal technetium-99 m ethyl cysteinate dimer single-photon emission tomographic findings in epileptic patients with polymicrogyria syndromes: A Subtraction of ictal-interictal SPECT coregistered to MRI study
Fecha
2008Registro en:
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, v.35, n.6, p.1159-1170, 2008
1619-7070
10.1007/s00259-007-0655-3
Autor
WICHERT-ANA, Lauro
AZEVEDO-MARQUES, Paulo Mazzoncini de
OLIVEIRA, Lucas Ferrari
FERNANDES, Regina Maria Franca
VELASCO, Tonicarlo Rodrigues
SANTOS, Antonio Carlos
ARAUJO, David
KATO, Mery
BIANCHIN, Marino Muxfeldt
SAKAMOTO, Americo Ceiki
Institución
Resumen
Purpose To describe the ictal technetium-99 m-ECD SPECT findings in polymicrogyria syndromes (PMG) during epileptic seizures. Methods We investigated 17 patients with PMG syndromes during presurgical workup, which included long-term video-electroencephalographic (EEG) monitoring, neurological and psychiatry assessments, invasive EEG, and the subtraction of ictal-interictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM). Results The analysis of the PMG cortex, using SISCOM, revealed intense hyperperfusion in the polymicrogyric lesion during epileptic seizures in all patients. Interestingly, other localizing investigations showed heterogeneous findings. Twelve patients underwent epilepsy surgery, three achieved seizure-freedom, five have worthwhile improvement, and four patients remained unchanged. Conclusions Our study strongly suggests the involvement of PMG in seizure generation or early propagation. Both conventional ictal single-photon emission computed tomography (SPECT) and SISCOM appeared as the single contributive exam to suggest the localization of the epileptogenic zone. Despite the limited number of resective epilepsy surgery in our study (n=9), we found a strong prognostic role of SISCOM in predicting surgical outcome. This result may be of great value on surgical decision-making of whether or not the whole or part of the PMG lesion should be surgically resected.