The evolution of cerebral glucose metabolism after partial seizure onset was studied in 38 children using PET scans over 3.0 +/- 1.3 years (and within a year after a third unprovoked partial seizure) by researchers at the Clinical Epilepsy Section, NINDS, and Children’s National Medical Center, Washington, DC. Twenty-eight patients with an initial normal PET were significantly more likely to have good seizure control than the 10 with initial abnormal scan. Those that developed an abnormal PET had longer history of epilepsy before the first PET but not greater seizure frequency. Patients with shorter time between seizures and higher seizure frequency had a greater risk of abnormal PET. Six of 7 patients with persistently abnormal PET had poor seizure control. History of febrile seizures did not affect PET findings. MRI was strongly predictive of initial PET results, but did not correlate with fluctuating hypometabolism. The combination of MRI and initial PET was strongly predictive of clinical course. 
COMMENT. Initial, but not serial, MRI and FDG-PET combined may be useful in predicting prognosis of partial epilepsy in children.