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Contralateral temporal hypometabolism on positron emission tomography in temporal lobe epilepsy
L Nagarajan1, N Schaul, D Eidelberg
1Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, NY 10021, USA.
Introduction:
No detailed case studies report lateralised hypometabolism on positron emission tomography (PET) contralateral to the epileptogenic focus in temporal lobe epilepsy (TLE).
Material And Methods:
We performed 18F fluorodeoxyglucose (FDG) PET in two intractable TLE patients.
Results:
One had right temporal interictal spikes on electroencephalography (EEG) and a right medial temporal lobe lesion on magnetic resonance imaging (MRI). FDG-PET showed decreased uptake in the left temporal lobe. Right temporal ictal onset, with bilateral interictal epileptiform activity, occurred on intracranial EEG. He is seizure free after right temporal lobectomy and ganglioglioma resection. The second had right temporal lobe interictal and ictal EEG activity. MRI demonstrated right anteriomedial temporal increased T2 signal. Neuropsychology revealed bilateral cognitive dysfunction. FDG-PET showed left anterior temporal and lateral frontal hypometabolism. He is seizure free after right temporal lobectomy.
Conclusion:
These findings suggest that regional uptake asymmetry on FDG-PET may be give misleading lateralising information in TLE.