Imaging inflammation in a patient with epilepsy due to focal cortical dysplasia.
| Publication Type | Case Report |
| Authors | Butler T, Ichise M, Teich A, Gerard E, Osborne J, French J, Devinsky O, Kuzniecky R, Gilliam F, Pervez F, Provenzano F, Goldsmith S, Vallabhajosula S, Stern E, Silbersweig D |
| Journal | J Neuroimaging |
| Volume | 23 |
| Issue | 1 |
| Pagination | 129-31 |
| Date Published | 01/11/2011 |
| ISSN | 1552-6569 |
| Keywords | Encephalitis, Epilepsy, Isoquinolines, Malformations of Cortical Development, Positron-Emission Tomography |
| Abstract | BACKGROUND AND PURPOSE: Evidence from animal models and examination of human epilepsy surgery specimens indicates that inflammation plays an important role in epilepsy. Positron emission tomography (PET) using [C11]PK11195, a marker of activated microglia, provides a means to visualize neuroinflammation in vivo in humans. We hypothesize that in patients with active epilepsy, [C11]PK11195 PET (PK-PET) may be able to identify areas of focally increased inflammation corresponding to the seizure onset zone. METHODS: A young woman with intractable epilepsy underwent PK-PET as part of an approved research study. PK-PET results were compared with results from other clinical studies. RESULTS: PK-PET revealed an area of focally increased radiotracer uptake in the right frontal lobe corresponding to this patient's seizure focus as identified by ictal and interictal 18F-fluorodeoxyglucose (FDG)-PET and EEG. Routine brain magnetic resonance imaging (MRI) was initially considered normal, though high-resolution studies showed possible subtle dysplasia of the right frontal lobe. The patient underwent a right frontal lobe resection, and pathological evaluation showed focal cortical dysplasia with activated microglia. CONCLUSIONS: PK-PET can identify neuroinflammation associated with subtle focal cortical dysplasia, and may therefore have a clinical role in guiding epilepsy surgery for patients with difficult-to-localize seizure foci. |
| DOI | 10.1111/j.1552-6569.2010.00572.x |
| PubMed ID | 21223436 |
| PubMed Central ID | PMC5303618 |