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Cerebral activation during speech discrimination in temporal lobe epilepsy
E B Bromfield1, C L Ludlow, S Sedory
1Clinical Epilepsy Section, National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD.
Epilepsy Research
|May 1, 1991
Summary
Positron emission tomography (PET) using 18-fluoro-2-deoxyglucose may improve epilepsy diagnosis. Task-based scans revealed increased temporal lobe hypometabolism in patients with complex partial seizures, aiding localization.
Area of Science:
- Neuroscience
- Medical Imaging
- Epilepsy Research
Background:
- Complex partial seizures are challenging to localize.
- Metabolic imaging like FDG-PET is used in epilepsy but task-based activation is less explored.
Purpose of the Study:
- To investigate if an auditory discrimination task enhances the diagnostic yield of FDG-PET in patients with uncontrolled complex partial seizures.
- To compare task-related metabolic changes in patients and controls.
Main Methods:
- Positron emission tomography (PET) with 18-fluoro-2-deoxyglucose (FDG) was performed on 8 patients with complex partial seizures and 8 age-matched controls.
- Scans were conducted both at rest and during an auditory order discrimination task involving speech syllables.
- An additional 18 normal subjects were scanned at rest for comparison.
Main Results:
- No consistent task-related changes were observed in control subjects.
- In 3 patients with left temporal epileptogenic foci, left inferior temporal lobe hypometabolism was more pronounced during the activated scan compared to the resting scan.
- Task activation appeared to augment the detection of hypometabolism in the epileptogenic zone.
Conclusions:
- Task-based FDG-PET scanning may increase the diagnostic accuracy for localizing epileptogenic foci in epilepsy.
- Auditory discrimination tasks could be a valuable tool to enhance metabolic imaging in epilepsy evaluation.