PET/CT and Epilepsy Diagnosis and treatment

Seizures are the results of abnormal activity of a cluster of brain cells. During a seizure these brain cells become very metabolically very active, as opposed to being very inactive between seizures.

How symptoms of a seizure presents differs depending on which part of the brain is involved. If surgery is considered as a treatment option, accurate identification of the location of the brain tissue involved is critical to a good outcome of surgery, as identifying the source of the seizure activity may lead to effective surgical removal of this tissue, enabling the seizures to be stopped completely or at least, reduced.

PET/CT is good for accurately locating seizure sites. Using an imaging drug that is like glucose the PET part of a PET/CT scan can show how the tissues in the brain are functioning. Areas of less function use less energy, where as areas with increased metabolic activity use more energy. The PET scan shows those differences in functional activity using the imaging drug (FDG) as during a seizure, the area responsible for the seizure will show as an area of increased glucose use.

Between seizures, PET shows a reduced need for glucose from the previous active areas. Coupling accurate location from CT scans with the PET scans can lead the surgeons to the specific problem sites and mark them out for removal.

PET/CT is a very useful test for identifying the source of seizure activity in the brain because it is a non-invasively procedure that can identify the metabolic focus for possible surgical removal.