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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Epilepsy
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1521842
The clinical features and 18 F-FDG-PET analysis of absence status epilepsy
Provisionally accepted- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Objective: To summarize the clinical features and 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) patterns of absence status epilepsy (ASE).Methods: In our study, three patients with ASE were presented, and a comprehensive review of the relevant literature was conducted to elucidate the clinical features and PET results of patients with ASE.Results: Seventeen cases of ASE from 7 articles were identified. A total of 20 cases were included in this study, including 9 males (9/20) and 11 females (11/20). The average age at onset was 28.1±15.07 years.Patients with ASE typically present with prolonged episodes of confusion and unresponsiveness. Some patients also present with generalized tonic clonic seizure (GTCS). The episodic frequency was relatively low, ranging from once per year to once per month, and the duration of each episode varied from 30 minutes to 3 weeks. The episodes of five patients coincided with menstruation, and one patient experienced episodes triggered by sleep deprivation and emotional disturbance. Ictal electroencephalogram (EEG) revealed generalized spike-wave (SW) activity at 2-4 Hz, and brain magnetic resonance imaging (MRI) revealed normal findings. Two patients underwent ictal 18 F-FDG-PET, which revealed hypermetabolism in the bilateral thalamus and cerebellar vermis, along with hypometabolism in the bilateral frontal and parietal cortices and cerebellar hemispheres. The three patients in this study underwent interictal 18 F-FDG-PET, which revealed decreased metabolic activity in the temporal, parietal, and occipital cortices and cerebellum. Furthermore, the patients' thalamic area and standard uptake value (SUVavg) were lower than those of healthy individuals.Seventeen cases (17/20) became seizure-free after treatment with valproate (VPA) and lamotrigine (LTG).Interpretation: ASE can be considered a specific syndrome of genetic generalized epilepsies (GGEs). Interictal brain PET imaging may reveal relative hypometabolism in posterior regions, along with decreased thalamic area and metabolic activity, potentially indicating the key role of posterior regions in sustaining wakefulness. Most patients responded well to VPA and LTG.
Keywords: Absence status epilepsy, FDG-PET, posterior regions, Clinical features, Metabolism
Received: 03 Nov 2024; Accepted: 21 Mar 2025.
Copyright: © 2025 Zuo, Lv, Shao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Rui-Juan Lv, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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