Relationship Between Brain Glucose Metabolism Positron Emission Tomography (PET) and Electroencephalography (EEG) in Children With Continuous Spike-and-Wave Activity During Slow-Wave Sleep
Restricted accessOtherFirst published online August, 2005
Relationship Between Brain Glucose Metabolism Positron Emission Tomography (PET) and Electroencephalography (EEG) in Children With Continuous Spike-and-Wave Activity During Slow-Wave Sleep
We studied the relationship between brain glucose metabolism patterns and objectively measured interictal epileptiform abnormalities in six children with intractable epilepsy and continuous spike-and-wave activity during slow-wave sleep. Five of the six patients showed lateralized positron emission tomographic (PET) findings, with the hemisphere showing a relative increase in glucose metabolism concordant with the presumed origin of the generalized interictal spike activity delineated by quantitative electroencephalographic (EEG) analysis. One of these five patients achieved seizure freedom following cortical resection involving the areas of unilateral multifocal hypermetabolism, and another patient has been approved for cortical resection. The results in the present study add further support to the hypothesis that the general ized spike-waves in most cases of continuous spike-and-wave activity during slow-wave sleep are the result of secondary bilateral synchrony. Resective surgery can be effective in selected patients with uncontrolled seizures associated with continuous spike-and-wave activity during slow-wave sleep provided that there is concordance between focal abnormalities on PET and EEG. (J Child Neurol 2005;20:682—690).
Get full access to this article
View all access options for this article.
References
1.
Patry G., Lyagoubi S., Tassinari CA: Subclinical electrical status epilepticus induced by sleep in children. A clinical and electroencephalographic study of six cases. Arch Neurol1971; 24:242—252.
2.
Tassinari CA, Terzano G., Capocchi G., et al: Epileptic seizures during sleep in children, in Penry JK (ed): Epilepsy. The 8th International Symposium. New York, Raven Press , 1977, 345—354.
3.
Maquet P., Hirsch E., Dive D., et al: Cerebral glucose utilization during sleep in Landau-Kleffner syndrome: A PET study. Epilepsia1990;31:778—783.
4.
Park YD, Hoffman JM, Radtke RA, et al: Focal cerebral metabolic abnormality in a patient with continuous spike waves during slow-wave sleep. J Child Neurol1994;9:139—143.
5.
Rintahaka PJ , Chugani HT, Sankar R.: Landau-Kleffner syndrome with continuous spike and wave during slow wave sleep. J Child Neurol1995;10:127—133.
6.
Gaggero R., Caputo M., Fiorio P., et al: SPECT and epilepsy with continuous spike waves during slow-wave sleep. Childs Nerv Syst1995;11:154—160.
7.
Maquet P., Hirsch E., Metz-Lutz MN, et al: Regional cerebral glucose metabolism in children with deterioration of one or more cognitive functions and continuous spike-and-wave discharges during sleep. Brain1995;118:1497—1520.
8.
da Silva EA, Chugani DC, Muzik O., Chugani HT: Landau-Kleffner syndrome: Metabolic abnormalities in temporal lobe are a common feature. J Child Neurol1997;12:489—495.
9.
de Saint-Martin A., Petiau C., Massa R., et al: Idiopathic rolandic epilepsy with interictal facial myoclonia and oromotor deficit: A longitudinal EEG and PET study. Epilepsia1999;40:614—620.
10.
Morikawa T., Seino M., Watanabe M.: Long term outcome of ESES, in Beaumanoir A , Bureau M, Deonna T, et al (eds): Continuous Spikes and Waves During Slow Sleep, Electrical Status Epilepticus During Slow Wave Sleep: Acquired Epileptic Aphasia and Related Conditions. London, John Libbey, 1995, 27—36.
11.
Kobayashi K. , Nishibayashi N., Ohtsuka Y., et al: Epilepsy with electrical status epilepticus during slow sleep and secondary bilateral synchrony. Epilepsia1994;35:1097—1103.
12.
Farnarier G., Kouna P., Genton P.: Amplitude EEG mapping in three cases of CSWS, in Beaumanoir A, Bureau M, Deonna T, et al (eds): Continuous Spike and Wave During Slow Sleep, Electrical Status Epilepticus During Slow Wave Sleep: Acquired Epileptic Aphasia and Related Conditions. London , John Libbey, 1995, 91—98.
13.
Tassinari CA , Rubboli G., Volpi L., et al: Encephalopathy with electrical status epilepticus during slow sleep or ESES syndrome including the acquired aphasia . Clin Neurophysiol2000;111: S94—S102.
14.
Bergstrom M. , Litton J., Eriksson L., et al: Determination of object contour from projections for attenuation correction in cranial positron emission tomography . J Comput Assist Tomogr1982;6:365—372.
15.
Muzik O., Chugani DC, Juhász C., et al: Statistical parametric mapping: Assessment of application in children. Neuroimage2000;12:538—549.
16.
Friston KJ, Holmes AP, Worsley JP, et al: Statistical parametric maps in functional imaging: A general linear approach. Hum Brain Map1995;2:189—210.
17.
Jain AK: Fundamentals of Digital Image Processing. London, Prentice-Hall, 1991.
18.
Manzano GM, Ragazzo PC, Tavares SM, Marino R. Jr: Anterior zygomatic electrodes: A special electrode for the study of temporal lobe epilepsy. Appl Neurophysiol1986;49:213—217.
19.
Otsubo H., Shirasawa A., Chitoku S., et al: Computerized brain-surface voltage topographic mapping for localization of intracranial spikes from electrocorticography. Technical note. J Neurosurg2001;94:1005—1009.
20.
Asano E., Muzik O., Shah A., et al: Quantitative interictal subdural EEG analyses in children with neocortical epilepsy. Epilepsia2003;44:425—434.
21.
Muzik O., da Silva EA, Juhász C., et al: Intracranial EEG versus flumazenil and glucose PET in children with extratemporal lobe epilepsy. Neurology2000;54:171—179.
22.
Asano E., Benedek K., Shah A., et al: Is intraoperative electrocorticography reliable in children with intractable neocortical epilepsy?Epilepsia2004;45:1091—1099.
23.
Bureau M.: Continuous spikes and waves during slow sleep (CSWS): Definition of this syndrome , in Beaumanoir MBA, Deonna T, Mira L, Tassinari CA (eds): Continuous Spikes and Waves During Slow Sleep, Electrical Status Epilepticus During Slow Sleep: Acquired Epileptic Aphasia and Related Conditions. London , John Libbey, 1995, 17—26.
24.
Galanopoulou AS, Bojko A., Lado F., Moshe SL: The spectrum of neuropsychiatric abnormalities associated with electrical status epilepticus in sleep. Brain Dev2000;22:279—295.
25.
Smith MC, Hoeppner TJ: Epileptic encephalopathy of late childhood: Landau-Kleffner syndrome and syndrome of continuous spikes and waves during slow wave sleep. J Clin Neurophysiol2003;20:462—472.
26.
Tassinari CA, Bureau M., Dravet C., et al: Epilepsy with continuous spike and waves during slow sleep: Otherwise described as ESES (epilepsy with electrical status epilepticus during slow wave sleep), in Roger J, Dravet C, Bureau M, et al (eds): Epileptic Syndromes in Infancy, Childhood and Adolescence . London, John Libbey Eurotext, 1985, 195—204.
27.
Tassinari CA, Bureau M., Dravet C., et al: Epilepsies with continuous spikes and waves during slow sleep—Otherwise described as ESES (epilepsy with electrical status epilepticus during slow sleep), in Roger J, Bureau M, Dravet C, Dreifuss FE, Perret A, Wolf P (eds): Epileptic Syndromes in Infancy, Childhood and Adolescence, 2nd ed. London, John Libbey Eurotext, 1992 , 245—256.
28.
Tyner FS, Knott JR, Mayer WE: Fundamentals of EEG Technology. Volume 1: Basic Concepts and Methods. New York, Raven Press, 1983.
29.
Theodore WH, Bairamian D., Newmark ME, et al: Effect of phenytoin on human cerebral metabolism. J Cereb Blood Flow Metab1986;6:315—320.
30.
Theodore WH , DiChiro G., Margolin R., et al: Barbiturates reduce human cerebral glucose metabolism. Neurology1986;36:60—64.
31.
Theodore WH , Bromfield E., Onorati L.: The effect of carbamazepine on cerebral glucose metabolism. Ann Neurol1989;25:516—526.
32.
Foster NL, VanDerSpek AF, Aldrich MS, et al: The effect of diazepam sedation on cerebral glucose metabolism in Alzheimer's disease as measured using positron emission tomography. J Cereb Blood Flow Metab1987;7:415—420.
33.
Leiderman DB , Balish M., Bromfield EB, Theodore WH: Effect of valproate on human cerebral glucose metabolism. Epilepsia1991;42:417—422.
34.
Gotman J., Marciani MG: Electroencephalographic spiking activity, drug levels, and seizure occurrence in epileptic patients. Ann Neurol1985;17:597—603.
35.
Commission on Classification and Terminology of the International League Against Epilepsy: Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia1989;30:389—399.
36.
de Tiege X. , Goldman S., Laureys S., et al: Regional cerebral glucose metabolism in epilepsies with continuous spikes and waves during sleep. Neurology2004;63:853—857.
37.
Chugani HT, Shewmon DA, Khanna S., Phelps ME: Interictal and postictal focal hypermetabolism on positron emission tomography . Pediatr Neurol1993; 9: 10—15.
38.
Bittar RG, Andermann F., Olivier A., et al: Interictal spikes increase cerebral glucose metabolism and blood flow: A PET study. Epilepsia1999;40:170—178.
39.
Lewis DV, O' Connor MJ, Schuette WH: Oxidative metabolism during recurrent seizure in the penicillin-treated hippocampus . Electroencephalogr Clin Neurophysiol1974 ;36:347—356.
40.
Bruehl C., Witte OW: Cellular activity underlying altered brain metabolism during focal epileptic activity. Ann Neurol1995;38:414—420.
41.
Kreisman NR , Sick TJ, Bruley DF: Local oxygen tension and its relationship to unit activity during penicillin interictal discharges in the bullfrog hippocampus . Electroencephalogr Clin Neurophysiol1979 ;46:619—633.
42.
Cole AJ, Andermann F., Taylor L., et al: The Landau-Kleffner syndrome of acquired epileptic aphasia: Unusual clinical outcome, surgical experience, and absence of encephalitis . Neurology1988;38:31—38.
43.
Morrell F., Whisler WW, Bleck TP: Multiple subpial transection: A new approach to the surgical treatment of focal epilepsy. J Neurosurg1989;70:231—239.
44.
Morrell F., Whisler WW, Smith MC, et al: Landau-Kleffner syndrome: Treatment with subpial intracortical transection. Brain1995;118:1529—1546.
45.
Sawhney IM, Robertson IJ, Polkey CE, et al: Multiple subpial transection: A review of 21 cases. J Neurol Neurosurg Psychiatry1995;58:344—349.
46.
Grote CL, Van Slyke P, Hoeppner Jab: Language outcome following multiple subpial transection for Landau-Kleffner syndrome. Brain1999;122:561—566.
47.
Irwin K., Birch V., Less J., et al: Multiple subpial transection in Landau-Kleffner syndrome. Dev Med Child Neurol2001;43:248—252.
