The role of interictal 18F-FDG PET in epilepsy surgery

Objective: To evaluate the value of the 18F-FDG PET localizing epileptic for surgical treatment. Methods: 30 patients with medically intractable epilepsy received the examination of EEG, MRI, 18F-FDG PET, and underwent one of the three surgical therapies (open skull operation, X-knife, stereotactic operation) according to the results of examination. Results: Twenty-two of the patients had temporal, 6 had extra-temporal and 2 had frontal-temporal epileptic foci. According to the results of the noninvasive work-up, 16 patients were referred for open skull operation, 10 patients for X-knife and 4 patients for stereotactic operation. After treatment, for only 2 patients, the frequency of seizures remained as before, the remaining patients were all complete or almost seizure free. Conclusions: In a considerable number of patients with medically intractable, particularly temporal epileptic foci, the selection of various surgical therapies can be based on the results of 18F-FDG PET examination. It can advance the curative effect on seizure episodes and avoid the risk of invasive work-up