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Nuclear Medicine Neuroimaging and Electromagnetic Source Localization in Nonlesional Drug-Resistant Focal Epilepsy

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PET and SPECT in Neurology

Abstract

Surgery is recognized worldwide as a rational option for drug-resistant epilepsy; however, it requires accurate localization of the epileptogenic zone (EZ). Magnetic resonance imaging (MRI) has dramatically changed presurgical evaluation in epilepsy. Nevertheless, MRI-negative cases still account for up to 25 % of all patients exposed to presurgical evaluation. Moreover, the absence of an MRI lesion renders accurate seizure focus localization more difficult and usually corresponds to a poorer outcome in epilepsy surgery, both for temporal and extratemporal epilepsies. Single perfusion photon emission computed tomography (SPECT) and 18F-FDG positron emission tomography (18F-FDG PET) have significantly changed presurgical epilepsy evaluation in nonlesional cases. Source analysis based on electrophysiological information, using either electroencephalography (EEG) or magnetoencephalography (MEG), has as much potential as SPECT and PET in the presurgical evaluation of epilepsy patients. In this chapter we aim to review the value of nuclear medicine neuroimaging and how the addition of source analysis based on electrophysiological information (EEG/MEG) improves EZ localization in drug-resistant nonlesional focal epilepsy, with a significant positive impact on surgery outcome.

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Abbreviations

BESA:

Dipole brain electric source analysis

CT:

Computed tomography

DTI:

Diffusion tensor imaging

EEG:

Electroencephalography

EZ:

Epileptogenic zone

FCD:

Focal cortical dysplasia

iEEG:

Intracranial electroencephalography

LORETA:

Low-resolution electromagnetic tomography

MEG:

Magnetoencephalography

MRI:

Magnetic resonance imaging

SPM:

Statistical parametric mapping

TLE:

Temporal lobe epilepsy

VARETA:

Brain distributed variable resolution electromagnetic tomography

V-EEG:

Video-EEG

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Acknowledgments

We thank Odalys Morales Chacón and Eloisa Le Riverend Morales for their English assistance. We would also like to thank Maria Luisa Rodriguez and Abel Sanchez for their useful cooperation.

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Authors and Affiliations

  1. Clinical Neurophysiology Service, Center for Neurological Restoration (CIREN), Ave 25 15805 e/158 y 160, Playa, Havana, 11300, Cuba

    Lilia Maria Morales Chacón & Otto Trapaga Quincoses

  2. Department of Nuclear Medicine, Center for Neurological Restoration (CIREN), Ave 25 15805 e/158 y 160, Playa, Havana, 11300, Cuba

    Lilia Maria Morales Chacón & Carlos A. Sánchez-Catasús

  3. Department of Nuclear Medicine, Cuban Neuroscience Center, Ave 25 15202 esq. 158, Playa, Havana, 11300, Cuba

    Carlos A. Sánchez-Catasús

  4. Neuroinmunology Department, Center for Neurological Restoration (CIREN), Ave 25 15805 e/158 y 160, Playa, Havana, 11300, Cuba

    Lourdes Lorigados Pedre

  5. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713GZ, The Netherlands

    Rudi A. J. O. Dierckx

  6. Department of Radiology and Nuclear Medicine, Ghent University, De Pintelaan 185 K12, Ghent, 9000, Belgium

    Rudi A. J. O. Dierckx

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  1. Lilia Maria Morales Chacón
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Correspondence to Carlos A. Sánchez-Catasús .

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  1. Dept. of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F.J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Neurology, University Medical Center Groningen, Groningen, The Netherlands

    Klaus L. Leenders

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Morales Chacón, L.M., Sánchez-Catasús, C.A., Quincoses, O.T., Pedre, L.L., Dierckx, R.A.J.O. (2014). Nuclear Medicine Neuroimaging and Electromagnetic Source Localization in Nonlesional Drug-Resistant Focal Epilepsy. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., Leenders, K. (eds) PET and SPECT in Neurology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54307-4_40

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