title: Quantitative analysis of simultaneous EEG features during PET studies for childhood partial epilepsy.
abstract: OBJECTIVE
  To demonstrate the significance of simultaneous electroencephalography (EEG) recording during 2-deoxy-2-[(18)F] fluoro-D-glucose (FDG)-positron emission tomography (PET) in childhood partial epilepsy.
  
  
  METHODS
  We included 46 children with partial epilepsy who underwent simultaneous EEG during PET. We compared the epileptogenic area of several EEG features including epileptiform discharges, focal polymorphic slow waves, and electrographic seizures, with the abnormal metabolic region on PET. We also compared the epileptogenic area of simultaneous EEG and PET with findings on magnetic resonance imaging (MRI) and video/EEG, as well as the histopathological diagnosis of the resected cortical area, in eight patients who underwent surgical resection of the epileptogenic area.
  
  
  RESULTS
  Hypometabolic regions on interictal PET were concordant with epileptogenic areas of epileptiform discharges and focal polymorphic slow waves, according to their frequency and/or severity, with odds ratios of 1.35 and 1.81, respectively (p<0.05). Hypermetabolic PET was also concordant with epileptogenic areas of ictal events longer than 20 seconds during the period of FDG uptake. Among the eight patients who underwent surgical resection, six patients, including two with non-lesional MRI, had concordant EEG and PET findings, were confirmed pathologically, and became seizure-free after surgery.
  
  
  CONCLUSIONS
  Simultaneous EEG is useful in identifying epileptogenic areas due to a high concordance with abnormal PET metabolic areas. Moreover, simultaneous EEG may also prevent false lateralization of PET from postictal and mixed metabolism during ictal events, as well as abnormal hypermetabolism, during frequent interictal epileptiform discharges.
authors.affiliation: Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Hur
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Jong Doo
authors.initials: JD
authors.lastname: Lee
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Yun
authors.forename: Heung Dong
authors.initials: HD
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D002648:Child; D004569:Electroencephalography / Q000379:methods*; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D016896:Treatment Outcome
keywords: Positron-emission tomography; electroencephalography; epilepsy
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