A review of interictal cerebral blood flow in the evaluation of patients for epilepsy surgery.
The literature on cerebral blood flow (CBF) studies in patients with epilepsy is critically reviewed. Two methods are specifically addressed, radioactive xenon delivered through inhalation or vascularly, and single photon emission computed tomography (SPECT) using various tracers. Both regional and global blood flow were used in these studies to assess focal and generalized seizures. Electroencephalogram (EEG) foci were determined by various techniques, including interictal and ictal recordings from scalp or intracranial electrodes. All studies reported a positive concordance between EEG foci and CBF. However, there was a high incidence of false positive and false negative results. The methodology of almost all of the studies was inadequate to assess accurately the sensitivity and specificity of CBF to localize the seizure focus. Even when conservative estimates were made, the sensitivity and specificity of CBF was too low to be used as a diagnostic test for epilepsy, and inadequate to localize the EEG focus in the evaluation of patients for epilepsy surgery.
University of Pittsburgh Epilepsy Center, Department of Neurology, School of Medicine PA.
R M
RM
Dasheiff
D001921:Brain / Q000000981:diagnostic imaging / Q000601:surgery*; D002560:Cerebrovascular Circulation; D004569:Electroencephalography / Q000592:standards; D004827:Epilepsy / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes