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Clinical Epilepsy Section, Medical Neurology Branch (Drs. Theodore and Porter), the Neuroradiology and Computed Tomography Section, Surgical Neurology Branch (Drs. Brooks, Patronas, Mansi, Bairamian, and DiChiro), and the Epilepsy Branch (Dr. Sato). NINCDS: and the Nuclear Medicine Department, Clinical Center (Dr. Margolin), NIH. Bethesda, MD.
We used 1BF-fluorodeoxyglucose (FDG) positron emission tomography (PET) to study nine patients with clinical absence or generalized seizures. One patient had only absence seizures, two had only generalized tonic-clonic seizures, and six had both seizure types. Interictal scans in eight failed to reveal focal or lateralized hypometabolism. No apparent abnormalities were noted. Two patients had PET scans after isotope injection during hyperventilation-induced generalized spike-wave discharges. Diffusely increased metabolic rates were found in one compared with an interictal scan, and in another compared with control values. Another patient had FDG injected during absence status: EEG showed generalized spike-wave discharges (during which she was unresponsive) intermixed with slow activity accompanied by confusion. Metabolic rates were decreased, compared with the interictal scan, throughout both cortical and subcortical structures. Interictal PET did not detect specific anatomic regions responsible for absence seizure onset in any patient, but the results of the ictal scans did suggest that pathophysiologic differences exist between absence status and single absence attacks.
Address correspondence and reprint requests to Dr. Theodore, Clinical Epilepsy Section, NIH 10/5N244, Bethesda, MD 20205.
Presented in part at the thirty-fifth Annual Meeting of the American Academy of Neurology, San Diego, C.A. April 1983.
Accepted for publication September 5, 1984.
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