Functional imaging in the work-up of childhood epilepsy.
Identifieur interne : 000F45 ( France/Analysis ); précédent : 000F44; suivant : 000F46Functional imaging in the work-up of childhood epilepsy.
Auteurs : L. Hertz-Pannier ; C. Chiron ; P. Véra [France] ; P. F. Van De Morteele ; A. Kaminska [France] ; M. Bourgeois [France] ; A. Hollo ; D. Ville ; C. Cieuta ; O. Dulac [France] ; F. Brunelle [France] ; D. Le Bihan [France]Source :
Abstract
In children with medically intractable lesional epilepsy, surgery is deemed successful if the epileptogenic focus can be removed while major neurological functions are spared. Current techniques rely on invasive intracranial recordings. The new developments in functional imaging offer the possibility of localizing the epileptogenic focus noninvasively (PET/SPECT) and mapping cognitive functions (fMRI). Ictal SPECT shows hyperperfusion in the focus and has proved to have better localizing value than interictal PET or SPECT, which show focal hypometabolism or hypoperfusion. Ictal SPECT is useful for deciding on the placement of intracranial electrodes in extratemporal epilepsies, particularly in young children. Functional MRI has proved highly accurate for localizing motor and language networks, thus offering the possibilities of replacing the Wada test (language hemispheric lateralization) and studying postlesional brain plasticity. Despite the difficulties of functional imaging in children owing to the limited cooperation that can be expected, ethical constraints, and poor normative data, SPECT/PET and fMRI provide clinically useful information for presurgical work-up of childhood epilepsies.
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Dulac</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-97540" status="VALID"><orgName>Service de neurologie pédiatrique</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-300068" type="direct"></relation><relation active="#struct-300127" type="direct"></relation><relation active="#struct-301664" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300068" type="direct"><org type="institution" xml:id="struct-300068" status="VALID"> <orgName>Assistance publique - Hôpitaux de Paris (AP-HP)</orgName> <desc> <address> <country key="FR"></country> </address> </desc></org></tutelle><tutelle active="#struct-300127" type="direct"><org type="institution" xml:id="struct-300127" status="VALID"><orgName>Hôpital Necker - Enfants Malades</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle active="#struct-301664" type="direct"><org type="institution" xml:id="struct-301664" status="VALID"> <idno type="IdRef">026404788</idno> <idno type="ISNI">0000 0001 2188 0914 </idno> <orgName>Université Paris Descartes - Paris 5</orgName> <orgName type="acronym">UPD5</orgName> <desc> <address> <addrLine>12, rue de l'École de Médecine - 75270 Paris cedex 06</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.parisdescartes.fr/</ref> </desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Brunelle, F" sort="Brunelle, F" uniqKey="Brunelle F" first="F." last="Brunelle">F. Brunelle</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-41309" status="VALID"><orgName>Service de radiologie pédiatrique</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-300068" type="direct"></relation><relation active="#struct-300127" type="direct"></relation><relation active="#struct-301664" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-300068" type="direct"><org type="institution" xml:id="struct-300068" status="VALID"> <orgName>Assistance publique - Hôpitaux de Paris (AP-HP)</orgName> <desc> <address> <country key="FR"></country> </address> </desc></org></tutelle><tutelle active="#struct-300127" type="direct"><org type="institution" xml:id="struct-300127" status="VALID"><orgName>Hôpital Necker - Enfants Malades</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle><tutelle active="#struct-301664" type="direct"><org type="institution" xml:id="struct-301664" status="VALID"> <idno type="IdRef">026404788</idno> <idno type="ISNI">0000 0001 2188 0914 </idno> <orgName>Université Paris Descartes - Paris 5</orgName> <orgName type="acronym">UPD5</orgName> <desc> <address> <addrLine>12, rue de l'École de Médecine - 75270 Paris cedex 06</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.parisdescartes.fr/</ref> </desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Le Bihan, D" sort="Le Bihan, D" uniqKey="Le Bihan D" first="D." last="Le Bihan">D. Le Bihan</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-40417" status="VALID"><orgName>Service NEUROSPIN</orgName><orgName type="acronym">NEUROSPIN</orgName><desc><address><country key="FR"></country></address><ref type="url">http://www-dsv.cea.fr/neurospin</ref></desc><listRelation><relation name="DSV/I2BM" active="#struct-300016" type="direct"></relation></listRelation><tutelles><tutelle name="DSV/I2BM" active="#struct-300016" type="direct"><org type="institution" xml:id="struct-300016" status="VALID"><orgName>Commissariat à l'énergie atomique et aux énergies alternatives</orgName><orgName type="acronym">CEA</orgName><desc><address><addrLine>Centre de SaclayCentre de GrenobleCentre de Cadaracheetc</addrLine><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author></analytic></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In children with medically intractable lesional epilepsy, surgery is deemed successful if the epileptogenic focus can be removed while major neurological functions are spared. Current techniques rely on invasive intracranial recordings. The new developments in functional imaging offer the possibility of localizing the epileptogenic focus noninvasively (PET/SPECT) and mapping cognitive functions (fMRI). Ictal SPECT shows hyperperfusion in the focus and has proved to have better localizing value than interictal PET or SPECT, which show focal hypometabolism or hypoperfusion. Ictal SPECT is useful for deciding on the placement of intracranial electrodes in extratemporal epilepsies, particularly in young children. Functional MRI has proved highly accurate for localizing motor and language networks, thus offering the possibilities of replacing the Wada test (language hemispheric lateralization) and studying postlesional brain plasticity. Despite the difficulties of functional imaging in children owing to the limited cooperation that can be expected, ethical constraints, and poor normative data, SPECT/PET and fMRI provide clinically useful information for presurgical work-up of childhood epilepsies.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Haute-Normandie</li><li>Région Normandie</li></region><settlement><li>Le Havre</li><li>Rouen</li></settlement><orgName><li>Université de Rouen</li><li>Université du Havre</li></orgName></list><tree><noCountry><name sortKey="Chiron, C" sort="Chiron, C" uniqKey="Chiron C" first="C." last="Chiron">C. Chiron</name><name sortKey="Cieuta, C" sort="Cieuta, C" uniqKey="Cieuta C" first="C." last="Cieuta">C. Cieuta</name><name sortKey="Hertz Pannier, L" sort="Hertz Pannier, L" uniqKey="Hertz Pannier L" first="L." last="Hertz-Pannier">L. Hertz-Pannier</name><name sortKey="Hollo, A" sort="Hollo, A" uniqKey="Hollo A" first="A." last="Hollo">A. Hollo</name><name sortKey="Van De Morteele, P F" sort="Van De Morteele, P F" uniqKey="Van De Morteele P" first="P. F." last="Van De Morteele">P. F. Van De Morteele</name><name sortKey="Ville, D" sort="Ville, D" uniqKey="Ville D" first="D." last="Ville">D. Ville</name></noCountry><country name="France"><region name="Région Normandie"><name sortKey="Vera, P" sort="Vera, P" uniqKey="Vera P" first="P." last="Véra">P. Véra</name></region><name sortKey="Bourgeois, M" sort="Bourgeois, M" uniqKey="Bourgeois M" first="M." last="Bourgeois">M. Bourgeois</name><name sortKey="Brunelle, F" sort="Brunelle, F" uniqKey="Brunelle F" first="F." last="Brunelle">F. Brunelle</name><name sortKey="Dulac, O" sort="Dulac, O" uniqKey="Dulac O" first="O." last="Dulac">O. Dulac</name><name sortKey="Kaminska, A" sort="Kaminska, A" uniqKey="Kaminska A" first="A." last="Kaminska">A. Kaminska</name><name sortKey="Le Bihan, D" sort="Le Bihan, D" uniqKey="Le Bihan D" first="D." last="Le Bihan">D. 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