Reduction of benzodiazepine receptor binding is related to the seizure onset zone in extratemporal focal cortical dysplasia

Stephan Arnold; Achim Berthele; Alexander Drzezga; Thomas R. Tölle; Serge Weis; Konrad J. Werhahn; Anja Henkel; Tarek A. Yousry; Peter A. Winkler; Peter Bartenstein; Soheyl Noachtar

doi:10.1111/j.1528-1157.2000.tb00248.x

Reduction of benzodiazepine receptor binding is related to the seizure onset zone in extratemporal focal cortical dysplasia

Stephan Arnold, Achim Berthele, Alexander Drzezga, Thomas R. Tölle, Serge Weis, Konrad J. Werhahn, Anja Henkel, Tarek A. Yousry, Peter A. Winkler, Peter Bartenstein, Soheyl Noachtar

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Abstract

Purpose: Comparison of regional reduction of GABA receptor binding and seizure onset zone in patients with extratemporal epilepsy due to focal cortical dysplasia. Methods: Two patients with frontal lobe epilepsy who remained seizure free after partial frontal lobe resection were investigated with magnetic resonance imaging, positron emission tomography (PET) with ¹⁸F-fluoro-deoxy-glucose (FDG) and ¹¹C-flumazenil, subdural EEG-video recordings, and postoperative benzodiazepine (BDZ)-receptor autoradiography. Results: The area of reduced BDZ-receptor binding as documented by preoperative flumazenil-PET and postoperative BDZ-receptor autoradiography corresponded to the seizure on- set zone and was smaller than the interictal hypometabolism documented by FDG-PET. Conclusion: Flumazenil-PET is a useful tool for localization of the epileptogenic zone in patients with extratemporal epilepsy caused by focal cortical dysplasia. Neuronal distribution of BDZ-receptor density confirms in vivo flumazenil-PET findings. The regional reduction of BDZ-receptor binding in focal cortical dysplasia seems to be confined to the seizure onset zone and not to the extent of dysplastic cortex.

Original language	English
Pages (from-to)	818-824
Number of pages	7
Journal	Epilepsia
Volume	41
Issue number	7
DOIs	https://doi.org/10.1111/j.1528-1157.2000.tb00248.x
State	Published - 2000

Keywords

Benzodiazepine receptor
Focal cortical dysplasia
Frontal lobe epilepsy
Positron emission tomography

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10.1111/j.1528-1157.2000.tb00248.x

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title = "Reduction of benzodiazepine receptor binding is related to the seizure onset zone in extratemporal focal cortical dysplasia",

abstract = "Purpose: Comparison of regional reduction of GABA receptor binding and seizure onset zone in patients with extratemporal epilepsy due to focal cortical dysplasia. Methods: Two patients with frontal lobe epilepsy who remained seizure free after partial frontal lobe resection were investigated with magnetic resonance imaging, positron emission tomography (PET) with 18F-fluoro-deoxy-glucose (FDG) and 11C-flumazenil, subdural EEG-video recordings, and postoperative benzodiazepine (BDZ)-receptor autoradiography. Results: The area of reduced BDZ-receptor binding as documented by preoperative flumazenil-PET and postoperative BDZ-receptor autoradiography corresponded to the seizure on- set zone and was smaller than the interictal hypometabolism documented by FDG-PET. Conclusion: Flumazenil-PET is a useful tool for localization of the epileptogenic zone in patients with extratemporal epilepsy caused by focal cortical dysplasia. Neuronal distribution of BDZ-receptor density confirms in vivo flumazenil-PET findings. The regional reduction of BDZ-receptor binding in focal cortical dysplasia seems to be confined to the seizure onset zone and not to the extent of dysplastic cortex.",

keywords = "Benzodiazepine receptor, Focal cortical dysplasia, Frontal lobe epilepsy, Positron emission tomography",

author = "Stephan Arnold and Achim Berthele and Alexander Drzezga and T{\"o}lle, {Thomas R.} and Serge Weis and Werhahn, {Konrad J.} and Anja Henkel and Yousry, {Tarek A.} and Winkler, {Peter A.} and Peter Bartenstein and Soheyl Noachtar",

year = "2000",

doi = "10.1111/j.1528-1157.2000.tb00248.x",

language = "English",

volume = "41",

pages = "818--824",

journal = "Epilepsia",

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TY - JOUR

T1 - Reduction of benzodiazepine receptor binding is related to the seizure onset zone in extratemporal focal cortical dysplasia

AU - Arnold, Stephan

AU - Berthele, Achim

AU - Drzezga, Alexander

AU - Tölle, Thomas R.

AU - Weis, Serge

AU - Werhahn, Konrad J.

AU - Henkel, Anja

AU - Yousry, Tarek A.

AU - Winkler, Peter A.

AU - Bartenstein, Peter

AU - Noachtar, Soheyl

PY - 2000

Y1 - 2000

N2 - Purpose: Comparison of regional reduction of GABA receptor binding and seizure onset zone in patients with extratemporal epilepsy due to focal cortical dysplasia. Methods: Two patients with frontal lobe epilepsy who remained seizure free after partial frontal lobe resection were investigated with magnetic resonance imaging, positron emission tomography (PET) with 18F-fluoro-deoxy-glucose (FDG) and 11C-flumazenil, subdural EEG-video recordings, and postoperative benzodiazepine (BDZ)-receptor autoradiography. Results: The area of reduced BDZ-receptor binding as documented by preoperative flumazenil-PET and postoperative BDZ-receptor autoradiography corresponded to the seizure on- set zone and was smaller than the interictal hypometabolism documented by FDG-PET. Conclusion: Flumazenil-PET is a useful tool for localization of the epileptogenic zone in patients with extratemporal epilepsy caused by focal cortical dysplasia. Neuronal distribution of BDZ-receptor density confirms in vivo flumazenil-PET findings. The regional reduction of BDZ-receptor binding in focal cortical dysplasia seems to be confined to the seizure onset zone and not to the extent of dysplastic cortex.

AB - Purpose: Comparison of regional reduction of GABA receptor binding and seizure onset zone in patients with extratemporal epilepsy due to focal cortical dysplasia. Methods: Two patients with frontal lobe epilepsy who remained seizure free after partial frontal lobe resection were investigated with magnetic resonance imaging, positron emission tomography (PET) with 18F-fluoro-deoxy-glucose (FDG) and 11C-flumazenil, subdural EEG-video recordings, and postoperative benzodiazepine (BDZ)-receptor autoradiography. Results: The area of reduced BDZ-receptor binding as documented by preoperative flumazenil-PET and postoperative BDZ-receptor autoradiography corresponded to the seizure on- set zone and was smaller than the interictal hypometabolism documented by FDG-PET. Conclusion: Flumazenil-PET is a useful tool for localization of the epileptogenic zone in patients with extratemporal epilepsy caused by focal cortical dysplasia. Neuronal distribution of BDZ-receptor density confirms in vivo flumazenil-PET findings. The regional reduction of BDZ-receptor binding in focal cortical dysplasia seems to be confined to the seizure onset zone and not to the extent of dysplastic cortex.

KW - Benzodiazepine receptor

KW - Focal cortical dysplasia

KW - Frontal lobe epilepsy

KW - Positron emission tomography

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Reduction of benzodiazepine receptor binding is related to the seizure onset zone in extratemporal focal cortical dysplasia

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