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From the Departments of Neurology (Drs. Engel and Nuwer), Anatomy (Dr. Engel), Radiological Sciences (Drs. Kuhl and Phelps), and Surgery (Neurosurgery) (Dr. Rausch), the Laboratory of Nuclear Medicine (Drs. Engel, Kuhl, and Phelps), the Division of Biophysics (Dr. Phelps), the Brain Research Institute (Dr. Engel), and the Reed Neurological Research Center (Drs. Nuwer, Rausch, and Engel) UCLA School of Medicine, Los Angeles, CA.
Intericta1 and ictal fluorodeoxyglucose scans were obtained with positron CT from four patients with spontaneous recurrent partial seizures, one with epilepsia partialis continua, and one with a single partial seizure induced by electrical stimulation of the hippocampus. Ictal metabolic patterns were different for each patient studied. Focal and generalized increased and decreased metabolism were observed. Ictal hypermetabolism may exceed six times the interictal rate and could represent activation of excitatory or inhibitory synapses in the epileptogenic region and its projection fields. Hypometabolism seen on ictal scans most likely reflects postictal depression and may indicate projection fields of inhibited neurons. No quantitative relationship between alterations in metabolism and EEG or behavioral measurements of ictal events could be demonstrated.
Address correspondence and reprint requests to Dr. Engel, Reed Neurological Research Center, UCLA School of Medicine, Los Angeles, CA 90024.
Supported by Department of Energy contract No. DE-AM03-76-SF00012 and by US Public Health Service grants Nos. 7R01-GM-24839, 1P01-NS-15654, and 2P50-NS-02808.
Presented in part at the thirty-third annual meeting of the American Academy of Neurology, Toronto, April 1981.
Accepted for publication August 13, 1982
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