What has positron emission tomography told us about the epileptogenic zone?

• Published in: Revue neurologique 2009-10, Vol.165 (10), p.739-741
• Main Author: Hammers, A.
• Format: Article
• Language: English
• Subjects: Alpha-methyl-tryptophan; Alpha-méthyl-tryptophane; Anticonvulsants - therapeutic use; Biological and medical sciences; Brain Chemistry - drug effects; Brain Chemistry - physiology; Diprenorphine; Diprénorphine; Epilepsy - diagnostic imaging; Epilepsy - drug therapy; Epilepsy - physiopathology; Epileptogenic zone; FDG; Flumazenil; Flumazénil; Glucose - metabolism; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Investigative techniques, diagnostic techniques (general aspects); Ligands; Medical sciences; Nervous system; Nervous system (semeiology, syndromes); Neurology; PET; Positron-Emission Tomography; Radionuclide investigations; Receptors, Drug - drug effects; Seizures - diagnostic imaging; Seizures - drug therapy; TEP; Zone épileptogène
• ISSN: 0035-3787
• DOI: 10.1016/j.neurol.2009.07.012

There is no one ligand for visualising “the epileptogenic zone”. Several PET ligands, however, can help by noninvasively or minimally invasively refining hypotheses regarding its location. Their relative merits depend not only on local availability and expertise, but also on epilepsy syndrome and overall diagnostic category. FDG, flumazenil (FMZ), alpha-methyl-tryptophan (AMT), the 5-HT1A ligands, and diprenorphine are discussed. Il n’existe pas de ligand unique permettant de visualiser « la zone épileptogène ». En revanche, plusieurs ligands peuvent être utiles pour affiner de façon peu ou non-invasive des hypothèses quant à sa localisation. Leurs avantages respectifs dépendent non seulement de leur disponibilité et des expertises locales, mais aussi du syndrome en question et de la catégorie diagnostique globale de l’épilepsie. Le FDG, le flumazénil, l’alpha-méthyl-tryptophane, les ligands 5-HT1A et la diprénorphine sont discutés.