Introduction: Epilepsy is a disorder of the central nervous system characterized by recurrent seizures unprovoked by an acute systemic or neurologic insult. According to the World Health Organization (WHO) this neurological disorder is affecting about 0.5-1.0% of the population of the World. New, modern radiological studies are of great importance in the diagnosis of pathogenesis and clinical manifestation of epilepsy. The PET / CT study in epileptic assays has never been performed in Lithuania. This case demonstrates one of the first PET/CT scans of the brains in Lithuania for patient with epilepsy.
The aim: To report the case of epilepsy patient who undergone PET/CT scan of the brain before neurosurgical operation.
Case: Patient Z. B. is a 28-year-old female with a history of epileptic seizures since she was seven. Despite medical treatment she continued to have seizures and surgical treatment was recommended. Before the first surgery epileptogenic focus was evaluated using magnetic resonance imaging (MRI), electroencephalography (EEG) and clinical data. However, after the intervention she still experienced multiple seizures every day. Later she underwent positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG PET) which showed that the lesion of the brain was bigger compared with lesion showed by MRI.
Outcome: After second surgery patient remained seizure free.
Conclusion: Our case demonstrates that 18F-FDG PET is a useful diagnostic tool to evaluate epileptogenic focus in patients with refractory epilepsy.
Keywords: 18F-FDG PET, MRI, EEG, refractory epilepsy.