Epilepsy and cerebellar hypometabolism

✍ Scribed by Dikran Bairamian; Giovanni Di Chiro; William H. Theodore

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 411 KB
• Volume: 20
• Category: Article
• ISSN: 0364-5134
• DOI: 10.1002/ana.410200519

✦ Synopsis

A 17-year-old female with the diagnosis of a right parietal mass had a positron emission tomographic (PET) scan of the brain using ( 'EF)-2-deoxyglucose (FDG) to determine the metabolic activity of the lesion. She had a long history of epileptic seizures treated with a combination of phenytoin and primidone.

The PET-FDG scan showed the right parietal mass to be hypometabolic and operation verified an oligoastrocytoma, Grade 11. The PET scan also revealed striking symmetrical hypometabolism of both cerebellar hemispheres (Figure ). We have never observed this finding in any of our more than five hundred patients, most of them cases of tumor, epilepsy, or dementia, studied by PET-FDG.

The explanation for the cerebellar hypometabolism in our patient, who failed to show cerebellar symptoms or signs on clinical examination, remains obscure. Phenytoin or primidone toxicity, seizure-related hypoxia, and an unusual remote tumoral effect different from the more common unilateral crossed cerebellar diaschisis El), all represent possibilities to be considered. We are not satisfied, however, that any of these factors represent the definite causative mechanism of the cerebellar hypometabolism in this young woman.

We have initiated a study to assess cerebellar metabolism in a large series of patients with partial seizures. In the mean-Massive reduction of glucose utilization in both cerebellar hemispheres.