The dynamics of metabolic change following seizures as measured by positron emission tomography with fludeoxyglucose F 18
D. B. Leiderman, P. Albert, M. Balish, E. Bromfield and W. H. Theodore
Epilepsy Research Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md.
OBJECTIVE: To examine the time course of alterations in glucose metabolism
in relation to the interval from the last seizure, focus laterality,
seizure frequency, and seizure type. DESIGN: Metabolic study with the use
of positron emission tomography with fludeoxyglucose F 18. Blinded scan
evaluation with use of a standard template. Multivariate regression
analysis of positron emission tomographic data. SETTING: National
Institutes of Health Clinical Center, Bethesda, Md. PATIENTS: Thirty-two
adults with intractable partial epilepsy and lateralized seizure onset
documented by video-electroencephalographic monitoring. MAIN OUTCOME
MEASURE: Normalized metabolic rate for glucose ipsilateral and
contralateral to the epileptic focus. RESULTS: The most dramatic changes
occurred in inferior temporal regions; the midtemporal region was affected
as well. Effects lasting 48 hours were found after both simple and complex
partial seizures. The time course was different for the two types of
seizures. The inferior temporal metabolic rate ipsilateral to the focus
increased compared with the interictal rate during the 24-hour period
following simple partial seizures; a nadir occurred in the second 24 hours.
The rate then rose to an intermediate level after 48 hours. The relative to
an intermediate level after 48 hours. The relative regional increase in
ipsilateral metabolism following complex partial seizures persisted for 48
hours before falling. CONCLUSION: The brain may take longer than 24 hours
after a partial seizure to return to its baseline state.
