Epilepsy

R. S. Fisher, J. J. Frost

Research output: Contribution to journalArticle

Abstract

As surgical treatments for adult and pediatric forms of epilepsy have become more refined, methods for noninvasive localization of epileptogenic foci have become increasingly important. Detection of focal brain metabolic or flow abnormalities is now well recognized as an essential step in the presurgical evaluation of many patients with epilepsy. Positron emission tomography (PET) scanning is most beneficial when used in the context of the total clinical evaluation of patients, including scalp EEG, invasive EEG, neuropsychologic testing, etc. Metabolic PET studies also give insight into pathophysiologic mechanisms of epilepsy. The dynamic nature of the interictal hypometabolism observed with 18[F]FDG in some patients suggests that excitatory or inhibitory neurotransmitters and their receptors may be involved. An exciting current application of PET scanning is the use of tracers for neurotransmitter receptors in the study of epilepsy patients. Mu and non-mu opiate receptors have been extensively studied and are beginning to give new insights into this disorder. Increased labeling of mu receptors in temporal neocortex using 11C-carfentanil has been demonstrated and, in some patients, supplements the clinical localization information from 18[F]FDG studies. Increased mu opiate receptor number or affinity is thought to play a role in anticonvulsant mechanisms. Specificity of increased mu receptors is supported by the absence of significant changes in non-mu opiate receptors. Other brain receptors are also of interest for future studies, particularly those for excitatory neurotransmitters. Combined studies of flow, metabolism, and neuroreceptors may elucidate the factors responsible for initiation and termination of seizures, thus improving patient treatment.

Original languageEnglish (US)
Pages (from-to)651-659
Number of pages9
JournalJournal of Nuclear Medicine
Volume32
Issue number4
StatePublished - 1991

Fingerprint

Epilepsy
mu Opioid Receptor
Opioid Receptors
Positron-Emission Tomography
Neurotransmitter Receptor
carfentanil
Electroencephalography
Peptide Initiation Factors
Neocortex
Brain
Sensory Receptor Cells
Scalp
Anticonvulsants
Neurotransmitter Agents
Seizures
Pediatrics
Therapeutics

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Fisher, R. S., & Frost, J. J. (1991). Epilepsy. Journal of Nuclear Medicine, 32(4), 651-659.

Epilepsy. / Fisher, R. S.; Frost, J. J.

In: Journal of Nuclear Medicine, Vol. 32, No. 4, 1991, p. 651-659.

Research output: Contribution to journalArticle

Fisher, RS & Frost, JJ 1991, 'Epilepsy', Journal of Nuclear Medicine, vol. 32, no. 4, pp. 651-659.
Fisher RS, Frost JJ. Epilepsy. Journal of Nuclear Medicine. 1991;32(4):651-659.
Fisher, R. S. ; Frost, J. J. / Epilepsy. In: Journal of Nuclear Medicine. 1991 ; Vol. 32, No. 4. pp. 651-659.
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