Correlation of Severity of FDG‐PET Hypometabolism and Interictal Regional Delta Slowing in Temporal Lobe Epilepsy

• Published in: Epilepsia (Copenhagen) Vol. 46; no. 4; pp. 573 - 576
• Main Authors: Altay, Ebru Erbayat, Fessler, A. James, Gallagher, Martin, Attarian, Hrayr P., Dehdashti, Farrokh, Vahle, Victoria J., Ojemann, Jeffrey, Dowling, Joshua L., Gilliam, Frank G.
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148 , USA and 9600 Garsington Road , Oxford , OX4 2XG , England Blackwell Science Inc 01.04.2005; Blackwell
• Subjects: Adult; Aged; Anticonvulsants. Antiepileptics. Antiparkinson agents; Biological and medical sciences; Brain Mapping; Delta Rhythm - statistics & numerical data; EEG delta slowing; Electroencephalography - statistics & numerical data; Epilepsy, Temporal Lobe - diagnosis; Epilepsy, Temporal Lobe - diagnostic imaging; Epilepsy, Temporal Lobe - physiopathology; Female; Fluorodeoxyglucose F18 - metabolism; Functional Laterality - physiology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Magnetic Resonance Imaging; Male; Malformations of the nervous system; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Neuropharmacology; PET hypometabolism; Pharmacology. Drug treatments; Positron-Emission Tomography; Retrospective Studies; Severity of Illness Index; Temporal Lobe - diagnostic imaging; Temporal Lobe - metabolism; Temporal Lobe - physiopathology; Temporal lobe epilepsy; Videotape Recording; Radionuclide study; Nervous system diseases; Epilepsy; Electrophysiology; Complex partial epilepsy; Electroencephalography; Cerebral disorder; PET hypometabolism-EEG delta slowing-Temporal lobe epilepsy; Central nervous system disease; Temporal lobe epilepsy; Positron emission tomography; Positron; Emission tomography
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.0013-9580.2005.08204.x

Purpose: We investigated the association of severity of hypometabolism detected by positron emission tomography (PET) with [18F]fluorodeoxyglucose (FDG) and persistence of interictal EEG focal slowing in patients with refractory temporal lobe epilepsy. Methods: Eighty temporal lobes of 40 consecutive patients with intractable temporal lobe epilepsy (mean age, 43.5 years) were studied. All patients underwent video‐EEG monitoring, magnetic resonance imaging (MRI), and FDG‐PET. Patients with either normal MRI or with unilateral mesial temporal sclerosis, but no other structural abnormality, were included. Interictal EEG delta slowing was graded as none, infrequent (one episode or less/hour), intermediate (more than one episode/hour), or continuous. PET hypometabolism was graded as none, mild, moderate, or severe. Results: The severity of temporal lobe hypometabolism with PET was significantly correlated with the amount of delta activity in the interictal EEG, independent of MRI findings (Spearman r = 0.46; p < 0.0005). Conclusions: This observation suggests related underlying pathophysiologic mechanisms for metabolic and electrical dysfunction in temporal lobe epilepsy.