08:35am Tuesday 12 December 2017

PET Scans Provide Insight into Fever-Induced Epilepsy in Children

Reston, Va. — Sudden, catastrophic childhood epilepsy is a parent’s worst nightmare, especially in the case of fever-induced refractory epileptic encephalopathy in school-age children (FIRES). While not much is known about the condition, new research published in the January issue of The Journal of Nuclear Medicine shows that positron emission tomography (PET) scans can offer an evaluation of cognitive dysfunction of FIRES, its evolution and further prognosis.

FIRES, a recently named condition, occurs in previously healthy children who, after a brief fever, experience acute seizures that are resistant to medication and last for several weeks. After the seizures stop, children are left with severe cognitive dysfunction, mainly involving language, memory and behavior. 

The study, “18F-FDG PET Reveals Frontotemporal Dysfunction in Children with Fever-Induced Refractory Epileptic Encephalopathy,” was conducted with eight patients diagnosed with FIRES. The patients were given a neuropsychologic evaluation, a brain MRI and an 18F-FDG PET scan. Severe cognitive dysfunction was noted, and while the MRI tests showed no abnormalities for the patients, the PET scans reported significant cognitive impairment. 

Researchers compared the FIRES patients with a pseudo-control group of epilepsy patients with normal MRI and PET scan results. Using statistical parametric mapping, an objective approach to analyzing brain activity, the study exposed that the brain dysfunction was related to the epilepsy in the FIRES patients.

“The fact that the dysfunctional network is superimposed over the epileptic network is a strong argument that FIRES is the cause of cognitive deterioration in these previously normal children. Moreover, localizing such a dysfunction may help to specify the re-adaptation more accurately,”said Catherine Chiron, M.D., Ph.D., pediatric epileptologist and head of the Research Program on Epilepsy at Hospital Necker – Enfants Malades in Paris and one of the authors of the study.

She continued, “These findings may open the way for using 18F-FDG PET more extensively and more accurately in pediatric imaging, as this methodology allows us to investigate not only unilateral but also bilateral diseases, and to interpret PET images in an objective and sensitive manner.”

Much remains unknown about FIRES; however, with the further understanding of the condition achieved through this research, physicians can recommend better intervention, ultimately leading to improved patient outcomes.

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Authors of the scientific article,“18F-FDG PET Reveals Frontotemporal Dysfunction in Children with Fever-Induced Refractory Epileptic Encephalopathy” include: Michel Mazzuca, Olivier Dulac and Catherine Chiron, Inserm, U663 – University Paris Descartes, and APHP, Neuropediatric Department, Hospital Necker – Enfants Malades, Paris, France; Isabelle Jambaque, Lucie Hertz-Pannier, Viviane Bouilleret, Frederique Archambaud and Sebastian Rodrigo, Inserm, U663 – University Paris Descartes, Paris, France and Verne Caviness, Department of Neurology, Massachusetts General Hospital, Boston, Mass.

Please visit the SNM Newsroom to view the PDF of the study. To schedule an interview with the researchers, please contact Susan Martonik at (703) 652-6773 or smartonik@snm.org. Current and past issues of The Journal of Nuclear Medicine can be found online at http://jnm.snmjournals.org.

About SNM—Advancing Molecular Imaging and Therapy

SNM is an international scientific and medical organization dedicated to raising public awareness about what molecular imaging is and how it can help provide patients with the best health care possible. SNM members specialize in molecular imaging, a vital element of today’s medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated.

SNM’s more than 17,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit http://www.snm.org.


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