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False Lateralization of Temporal Lobe Epilepsy with FDG Positron Emission Tomography
Author(s) -
Sperling Michael R.,
Alavi Abass,
Reivich Martin,
French Jacqueline A.,
O'Connor Michael J.
Publication year - 1995
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1995.tb01052.x
Subject(s) - hypermetabolism , temporal lobe , ictal , positron emission tomography , lateralization of brain function , epilepsy , psychology , neuroscience , asymptomatic , medicine , amygdala , temporal cortex
Summary: We report 2 patients in whom visual interpretation of interictal positron emission tomography (PET) with [ 18 F]fluorodeoxyglucose (FDG) suggested false lateralization of an epileptic focus. PET scans were interpreted as showing diffuse left temporal lobe hypometabolism in 1 patient and lateral temporal hypometabolism in the other. However, seizures began in the right mesial temporal lobe in both patients, and both responded favorably to right temporal lobectomy. In 1 patient, the intra‐cranial EEG showed continuous asymptomatic subclinical seizure activity emanating from the right amygdala. These limbic discharges probably caused unrecognized right temporal lobe hypermetabolism. In the other case, quantitative analysis of metabolic rates showed conflicting mesial and lateral metabolic indexes. Frequent mesial interictal discharges might have increased lateral temporal metabolism. We conclude that asymptomatic epileptiform activity may alter temporal lobe metabolism and that quantitative PET analysis helps clarify contradictory visual PET interpretations.