Thermography mapping patterns in temporal lobe epilepsy surgery

Area of Science:

• Neurosurgery
• Epileptology
• Medical Imaging

Background:

• Epileptogenic tissue often appears macroscopically normal, complicating surgical decisions regarding tissue resection versus preservation.
• Infrared thermography mapping (IrTM) offers a potential method to assess brain metabolism intraoperatively.

Purpose of the Study:

• To evaluate the utility of IrTM in identifying epileptogenic zones during epilepsy surgery.
• To correlate IrTM findings with electrocorticography and neuropathology.

Main Methods:

• IrTM was performed on 12 temporal lobe epilepsy surgery patients.
• IrTM data were correlated with electrocorticography and neuropathology results.

Main Results:

• Irritative zones (IZ) exhibited lower temperatures (mean ΔT 3.40°C) compared to normal cortex.
• Coldest zones precisely matched IZ in 90% of cortical dysplasia (CD) cases.
• A radial heating pattern was observed in CD cases, absent in neoplasia cases. Hippocampal hypothermia correlated with maximal irritative activity.
• Temperature difference (ΔT) showed an inverse relationship with epilepsy duration.

Conclusions:

• IrTM is a promising tool for detecting hypothermic IZ in CD cases.
• The inverse relationship between ΔT and epilepsy chronicity may influence brain thermic patterns.