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FDG‐PET and MRI in temporal lobe epilepsy: relationship to febrile seizures, hippocampal sclerosis and outcome
Author(s) -
Salanova V.,
Markand O.,
Worth R.,
Smith R.,
Wellman H.,
Hutchins G.,
Park H.,
Ghetti B.,
Azzarelli B.
Publication year - 1998
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1998.tb00628.x
Subject(s) - hippocampal sclerosis , temporal lobe , epilepsy , magnetic resonance imaging , medicine , positron emission tomography , status epilepticus , atrophy , nuclear medicine , radiology , pathology , psychiatry
Objective – To correlate the volumetric head magnetic resonance imaging (MRI) and fluorodeoxyglucose‐positron emission tomography (FDG‐PET) scan findings with the history, intracarotid amobarbital procedure, pathology, and outcome in patients with medically refractory temporal lobe epilepsy. Material and methods – Thirty‐eight patients with temporal lobe epilepsy treated surgically following a comprehensive presurgical evaluation. Follow‐up ranged from 12 to 44 months. Results – Volumetric MRI showed ipsilateral hippocampal atrophy in 29 (76%), and PET scan showed ipsilateral temporal hypometabolism (PET‐TH) in 31 (81.5%) of patients. Eighty‐three percent of those patients with hippocampal sclerosis on MRI (MRI‐HS) had ipsilateral PET‐TH. Sixty‐six percent of patients with MRI‐HS had a history of prolonged febrile convulsions or a childhood febrile illness accompanied by convulsions, and 77% of patients with MRI‐HS had pathologically proven hippocampal sclerosis (HS). Ninety percent became seizure free or had rare seizures. Conclusion – FDG‐PET scans and head MRIs were complementary; 95% of patients had either MRI‐HS or temporal hypometabolism. MRI‐HS correlated with a history of febrile seizures and pathologically demonstrated hippocampal sclerosis. Ninety‐three percent of patients had focal functional deficits on the epileptogenic side. Concordance between PET temporal hypometabolism and MRI‐HS correlated with better outcome.