Alterations in local cerebral metabolic rates for glucose (LCMRGlc) in childhood epilepsies as determined with FDG and PET
The authors investigated LCMRGlc in Lennox-Gastant Syndrome (LGS) (n=15), infantile spasm (IS) (n=14) and Sturge-Weber Syndrome (SWS) (n=5). In children with LGS, 3 distinct metabolic patterns are seen interically: 1) unilateral focal hypometabolism in frontal or temporal lobes, 2) unilateral diffuse hypometabolism, and 3) bilateral diffuse hypometabolism. Therapeutic implications of this classification are: surgical resection in focal (i.e., as for partial epilepsy), corpus callosotomy in diffuse unilateral, and elimination of surgery for those with bilateral diffuse hypometabolism. Babies with idiopathic IS showed symmetrical hypometabolism of lenticular nuclei and midbrain/brain stem compared to cortex and is characterized by slightly better prognosis. In contrast, babies with symtomatic IS had additional CMRGlc disturbances such as bilateral assymetric and multi focal hypometabolism in infant with neurofibromatosis; right parieto-occipital hypometabolims in infant with tuberous sclerosis; intense hypermetabolism of hypothalamus (34.5 vs 3.18 ..mu..moles/-min/100g in other regions) in another where x-ray CT showed only obstructive hydrocephalus. Findings support classical notion of subcortical involvement in this disorder. In SWS, PET showed marked hypometabolism in affected hemisphere in older children, while a 9 month old showed increased LCMRGlc unilaterally (40-50 vs 28-44 ..mu.. moles/min/100g contralateral) with cross cerebellar hypermetabolism (48-50 vs 27-31 ..mu.. moles/min/100g) with no behavioral or EEG evidence of seizure during study. PET studies of LCMRGlc appear sensitive and useful in classifying heterogeneous syndromes into subtypes regarding differential therapy and prognosis, and provide more comprehensive identification of sites of disturbance for investigating mechanisms of these disorders.
- Research Organization:
- UCLA School of Medicine, Los Angeles, CA
- OSTI ID:
- 7032108
- Report Number(s):
- CONF-850611-; TRN: 87-010647
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
BRAIN
METABOLISM
POSITRON COMPUTED TOMOGRAPHY
EPILEPSY
GLUCOSE
CEREBRUM
CLASSIFICATION
CONGENITAL DISEASES
INFANTS
PATHOLOGICAL CHANGES
THERAPY
AGE GROUPS
ALDEHYDES
BODY
CARBOHYDRATES
CENTRAL NERVOUS SYSTEM
CHILDREN
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
EMISSION COMPUTED TOMOGRAPHY
HEXOSES
MONOSACCHARIDES
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
ORGANIC COMPOUNDS
ORGANS
SACCHARIDES
TOMOGRAPHY
550601* - Medicine- Unsealed Radionuclides in Diagnostics
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