Epilepsy duration, febrile seizures, and cerebral glucose metabolism.
OBJECTIVE
Studies using magnetic resonance imaging have shown that reduced hippocampal volume is associated with a history of febrile seizures, the duration of epilepsy, and the number of generalized tonic-clonic seizures. It is uncertain whether these factors have the same influence on functional as on structural measures of the integrity of the epileptogenic zone.


METHODS
We used positron emission tomography (PET) with fluorine 18 2-deoxyglucose to study 91 patients with temporal lobe seizure foci localized by ictal video-EEG. PET was performed in the awake interictal resting state with ears plugged and eyes patched. We recorded surface EEG during injection (5 mCi) and the 30-min uptake period. We used a standard template to analyze PET scans.


RESULTS
A significant negative relation was found between the duration of epilepsy and hippocampal glucose metabolism ipsilateral to the epileptic focus. Patients with a history of either any febrile seizures, or complex, or prolonged febrile seizures, did not have greater hypometabolism ipsilateral to the epileptic focus than did patients without a febrile seizure history. We found no effect of generalized tonic-clonic seizure history.


CONCLUSIONS
Longer epilepsy duration is associated with greater hypometabolism, suggesting that epilepsy is a progressive disease.
Theodore
William H
WH
NIH, Clinical Epilepsy Section, Bethesda, Maryland 20892, USA. theodorw@ninds.nih.gov
Kelley
Kathey
K
Toczek
Maria T
MT
Gaillard
William D
WD
D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000378:metabolism* / Q000473:pathology; D004827:Epilepsy / Q000175:diagnosis / Q000378:metabolism; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019275:Radiopharmaceuticals; D003294:Seizures, Febrile / Q000175:diagnosis* / Q000378:metabolism*; D012720:Severity of Illness Index; D013997:Time Factors; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose