18F-FDG PET/CT in pachygyria during evaluation for seizure disorder

Document Type : Case Report


Department of Nuclear Medicine and PET-CT, Army Hospital Research and Referral, New Delhi, India


Pachygyria or incomplete lissencephaly is a developmental condition due to abnormal migration of neurons. The association of seizures in this condition warrants investigation like electroencephalogram (EEG) and magnetic resonance imaging (MRI). 18F-flurodeoxyglucose positron emission topography computed topography (18F-FDG PET/CT) has a potential role in commenting of wide distribution of abnormal metabolism in affected brain parenchyma as well as hypermetabolic epileptogenic focus during ictal phase. Scan during interictal phase will give an idea of affected regions in brain in the form of hypometabolic areas. Although treatment is long-term antiepileptic drugs however if the epileptogenic foci are localized to same region then surgical interventions like hemispherectomies are the options. We present a case in which 18F-FDG PET/CT proved beneficial in pachygyria with seizure disorder.


Main Subjects

  1. Barkovich AJ, Kuzniecky RI, Jackson GD, Guerrini R, Dobyns WB. A developmental and genetic classification for malformations of cortical development. Neurology. 2005 Dec 27;65(12):1873-87.
  2. Gleeson JG. Lissencephaly. National Organization for Rare Disorders (NORD). 2009; https://rarediseases.info.nih.gov/diseases. Accessed 06/23/2017.
  3.  Kang O, Gaillard F. Lissencephaly-pachygyria spectrum. https://radiopaedia.org/articles/lissencephaly-pachygyria-spectrum-2. Acessed 06/23/2017.
  4. Verloes A, Elmaleh M, Gonzales M, Laquerrière A, Gressens P. Genetic and clinical aspects of   lissencephaly. Rev Neurol (Paris). 2007 May;163(5):533-47.
  5. Pachygyria. The Cortical Foundation. http://cortfoundation.org/cms/pachygyria/. Accessed 06/23/2017.
  6. Prevalence of rare diseases: Orphanet Report Series, Bibliographic data. http://www.orpha.net/orphacom/cahiers/docs/GB/Prevalence_of_rare_diseases. Accessed 06/23/2017.
  7. Kurul S, Cakmakçi H, Dirik E. Agyria-pachygyria complex: MR findings and correlation with clinical features. Pediatr Neurol. 2004 Jan;30(1):16-23.
  8. Neuronal Migration Disorders Information Page. National Institute of Neurological Disorders and Stroke (NINDS). http://www.ninds.nih.gov/health_and_medical/disorders/neuronal_migration.htm. Accessed Accessed 06/23/2017.
  9. Kumar A, Govil T, Chugani H..Role of FDG PET in the evaluation of cortical function in children with agenesis of corpus callosum. J Nucl Med. 2016;57(Suppl 2):1851.
  10. Bo-Kai H, Yum-Kung C. Epileptogenic pachygyria demonstrating on FDG PET. Clin Nucl Med. 2012 Jan;37(1):e4-6.