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Status Gelasticus after Temporal Lobectomy: Ictal FDG‐PET Findings and the Question of Dual Pathology Involving Hypothalamic Hamartomas
Author(s) -
Palmini Andre,
Van Paesschen Wim,
Dupont Patrick,
Van Laere Koen,
Van Driel Guido
Publication year - 2005
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.1528-1167.2005.52804.x
Subject(s) - ictal , hypothalamic hamartoma , gelastic seizure , temporal lobe , hypermetabolism , medicine , positron emission tomography , lesion , context (archaeology) , hamartoma , epilepsy , fluorodeoxyglucose , radiology , pathology , psychology , precocious puberty , psychiatry , paleontology , biology , hormone
Summary: Purpose: To present the first ictal fluorodeoxyglucose–positron emission tomography (FDG‐PET) evidence of the hypothalamic origin of gelastic seizures in a patient with a hypothalamic hamartoma (HH) and to raise the issue of true dual pathology related to this entity. Methods: Ictal FDG‐PET was acquired during an episode of status gelasticus with preserved consciousness, in a patient previously operated on for complex partial seizures (CPSs) due to a temporal lobe epileptogenic cyst. Results: Ictal hypermetabolism was localized to the region of the HH during the status gelasticus. CPSs had been completely eliminated after temporal lobe surgery. Conclusions: Ictal FDG‐PET independently confirmed that gelastic seizures in patients with HH do originate in the diencephalic lesion. An HH may coexist with another epileptogenic lesion, in a context of dual pathology.