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CC BY 4.0 · World J Nucl Med 2023; 22(03): 174-182
DOI: 10.1055/s-0042-1757284
Original Article

Neurocognitive Profile and 18F-Fluorodeoxyglucose Positron Emission Tomography Brain Imaging Correlation in Children with Electrical Status Epilepticus during Sleep

Madhur K. Srivastava 
1   Department of Nuclear Medicine, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Afshan J. Shaik
2   Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Sireesha Yareeda
2   Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Kavitha Nallapareddy
1   Department of Nuclear Medicine, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Lokesh Lingappa
3   Department of Pediatric Neurology, Rainbow Children Hospital, Banjara Hills, Hyderabad, Telangana, India
,
Pallavi Moturi
2   Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Padmaja Gaddamonugu
2   Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Rukmini M. Kandadai
2   Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
,
Rupam Borgohain
2   Department of Neurology, Nizam's Institute of Medical Sciences (NIMS), Panjagutta, Hyderabad, Telangana, India
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Abstract

Objective Electrical status epilepticus in sleep (ESES) is defined by near-continuous epileptiform discharges during sleep along with cognitive, behavioral, and/or imaging abnormalities. We studied the neurocognitive profile and their correlation with 18F fluorodeoxyglucose positron emission tomography (FDG PET) brain abnormalities in children with ESES.

Methods Fourteen children with ESES with normal magnetic resonance imaging (MRI) from March to December 2019 were included. The intelligence quotient (IQ) and child behavior checklist (CBCL) scores were estimated using validated scales, and FDG PET brain was done at the same point of time to look for cerebral metabolic defects which was compared with a control group.

Results Fourteen patients with a mean age of 8.2 ± 2.7 years were analyzed. The average duration of epilepsy was 6 ± 2.8 years. The mean IQ was 72.4 ± 18.2 and mean CBCL score was 37.3 ± 11.8. There was negative correlation between IQ and CBCL (r = −0.55, p < 0.001). The duration of epilepsy also showed negative correlation with IQ (r = −4.75, p < 0.001). FDG PET scan showed predominant thalamic hypometabolism in 12 of 14 patients (85.7%) on visual analysis with multiple other hypometabolic cortical and subcortical regions in the brain. The quantitative analysis showed significant difference in metabolism of basal ganglion when compared with control group. The total number of hypometabolic regions seen in the brain showed moderate positive correlation with CBCL score but no significant correlation with the IQ of cases.

Conclusion This study demonstrates functional impairment of cerebral cortical, basal ganglia, and thalamic hypometabolism in a cohort of ESES patients with normal structural MRI brain study. There was a moderate correlation of extent and pattern of cerebral hypometabolism with the neuropsychological status of the child and duration of epilepsy.

Keywords

absolute asymmetry index - CBCL - CSWS - ESES - 18F FDG PET-CT - thalamic hypometabolism - Weschler's scale


Publication History

Article published online:
27 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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