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Title: Epilepsy

Abstract

As surgical treatments for adult and pediatric forms of epilepsy have become more refined, methods for noninvasive localization of epileptogenic foci have become increasingly important. Detection of focal brain metabolic or flow abnormalities is now well recognized as an essential step in the presurgical evaluation of many patients with epilepsy. Positron emission tomography (PET) scanning is most beneficial when used in the context of the total clinical evaluation of patients, including scalp EEG, invasive EEG, neuropsychologic testing, etc. Metabolic PET studies also give insight into pathophysiologic mechanisms of epilepsy. The dynamic nature of the interictal hypometabolism observed with 18(F)FDG in some patients suggests that excitatory or inhibitory neurotransmitters and their receptors may be involved. An exciting current application of PET scanning is the use of tracers for neurotransmitter receptors in the study of epilepsy patients. Mu and non-mu opiate receptors have been extensively studied and are beginning to give new insights into this disorder. Increased labeling of mu receptors in temporal neocortex using 11C-carfentanil has been demonstrated and, in some patients, supplements the clinical localization information from 18(F)FDG studies. Increased mu opiate receptor number or affinity is thought to play a role in anticonvulsant mechanisms. Specificity of increased mu receptorsmore » is supported by the absence of significant changes in non-mu opiate receptors. Other brain receptors are also of interest for future studies, particularly those for excitatory neurotransmitters. Combined studies of flow, metabolism, and neuroreceptors may elucidate the factors responsible for initiation and termination of seizures, thus improving patient treatment.95 references.« less

Authors:
;  [1]
  1. (Johns Hopkins Univ., Baltimore, MD (USA))
Publication Date:
OSTI Identifier:
5800837
Alternate Identifier(s):
OSTI ID: 5800837
Resource Type:
Journal Article
Journal Name:
Journal of Nuclear Medicine; (USA)
Additional Journal Information:
Journal Volume: 32:4; Journal ID: ISSN 0161-5505
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; POSITRON COMPUTED TOMOGRAPHY; EPILEPSY; DIAGNOSIS; CARBON 11; ENDORPHINS; FLUORINE 18; GLUCOSE; METABOLISM; PATIENTS; RECEPTORS; REVIEWS; ALDEHYDES; AUTONOMIC NERVOUS SYSTEM AGENTS; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; BODY; CARBOHYDRATES; CARBON ISOTOPES; CENTRAL NERVOUS SYSTEM; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DISEASES; DOCUMENT TYPES; DRUGS; EMISSION COMPUTED TOMOGRAPHY; EVEN-ODD NUCLEI; FLUORINE ISOTOPES; HEXOSES; HOURS LIVING RADIOISOTOPES; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LIGHT NUCLEI; MEMBRANE PROTEINS; MINUTES LIVING RADIOISOTOPES; MONOSACCHARIDES; NERVOUS SYSTEM; NERVOUS SYSTEM DISEASES; NEUROREGULATORS; NUCLEI; ODD-ODD NUCLEI; ORGANIC COMPOUNDS; ORGANS; PROTEINS; RADIOISOTOPES; SACCHARIDES; TOMOGRAPHY 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics

Citation Formats

Fisher, R.S., and Frost, J.J. Epilepsy. United States: N. p., 1991. Web.
Fisher, R.S., & Frost, J.J. Epilepsy. United States.
Fisher, R.S., and Frost, J.J. Mon . "Epilepsy". United States.
@article{osti_5800837,
title = {Epilepsy},
author = {Fisher, R.S. and Frost, J.J.},
abstractNote = {As surgical treatments for adult and pediatric forms of epilepsy have become more refined, methods for noninvasive localization of epileptogenic foci have become increasingly important. Detection of focal brain metabolic or flow abnormalities is now well recognized as an essential step in the presurgical evaluation of many patients with epilepsy. Positron emission tomography (PET) scanning is most beneficial when used in the context of the total clinical evaluation of patients, including scalp EEG, invasive EEG, neuropsychologic testing, etc. Metabolic PET studies also give insight into pathophysiologic mechanisms of epilepsy. The dynamic nature of the interictal hypometabolism observed with 18(F)FDG in some patients suggests that excitatory or inhibitory neurotransmitters and their receptors may be involved. An exciting current application of PET scanning is the use of tracers for neurotransmitter receptors in the study of epilepsy patients. Mu and non-mu opiate receptors have been extensively studied and are beginning to give new insights into this disorder. Increased labeling of mu receptors in temporal neocortex using 11C-carfentanil has been demonstrated and, in some patients, supplements the clinical localization information from 18(F)FDG studies. Increased mu opiate receptor number or affinity is thought to play a role in anticonvulsant mechanisms. Specificity of increased mu receptors is supported by the absence of significant changes in non-mu opiate receptors. Other brain receptors are also of interest for future studies, particularly those for excitatory neurotransmitters. Combined studies of flow, metabolism, and neuroreceptors may elucidate the factors responsible for initiation and termination of seizures, thus improving patient treatment.95 references.},
doi = {},
journal = {Journal of Nuclear Medicine; (USA)},
issn = {0161-5505},
number = ,
volume = 32:4,
place = {United States},
year = {1991},
month = {4}
}