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Complex partial seizures: cerebral structure and cerebral function.

W H Theodore, M D Holmes, R H Dorwart

    Epilepsia
    |September 1, 1986
    PubMed
    Summary
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    Structural brain lesions do not always predict the extent of dysfunction in complex partial seizures. Metabolic and electrophysiologic abnormalities can be more widespread than visible structural changes, impacting epilepsy treatment strategies.

    Area of Science:

    • Neurology
    • Neuroimaging
    • Epilepsy Research

    Background:

    • Complex partial seizures are often associated with focal cerebral lesions.
    • Understanding the relationship between structural abnormalities and functional deficits is crucial for effective management.

    Purpose of the Study:

    • To investigate the correlation between structural cerebral lesions and functional/electrophysiological abnormalities in patients with complex partial seizures.
    • To determine if structural lesions accurately predict the extent of brain dysfunction.

    Main Methods:

    • Utilized computed tomography (CT) and magnetic resonance imaging (MRI) for structural assessment.
    • Employed electroencephalography (EEG) for electrophysiological evaluation.
    • Conducted positron emission tomography (PET) with [18F]-2-deoxyglucose to assess cerebral metabolism.

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    Main Results:

    • Epileptiform discharges on EEG were often widespread and bilateral, irrespective of lesion laterality.
    • Interictal PET revealed hypometabolism extending beyond structural lesions in several cases.
    • Metabolic dysfunction sometimes involved the ipsilateral temporal lobe even with extratemporal lesions.

    Conclusions:

    • Structural lesions in patients with partial seizures may not fully represent the extent of cerebral dysfunction.
    • Patterns of metabolic and electrophysiologic dysfunction can be more diffuse than structural changes suggest.
    • This highlights the need for comprehensive neuroimaging and functional assessments in epilepsy.