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Ipsilateral thalamic hypoperfusion on interictal SPECT in temporal lobe epilepsy
1Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
Summary
Ipsilateral thalamic hypoperfusion is common in temporal lobe epilepsy (TLE) patients undergoing interictal brain SPECT. This finding can help lateralize seizure foci, aiding diagnosis in TLE.
Area of Science:
- Neurology
- Nuclear Medicine
- Epilepsy Research
Background:
- Interictal brain SPECT is a valuable tool for localizing seizure foci.
- Ipsilateral thalamic hypoperfusion has been observed in temporal lobe epilepsy (TLE) patients.
Purpose of the Study:
- To determine the prevalence of ipsilateral thalamic hypoperfusion in TLE patients.
- To assess the utility of this finding for lateralizing epileptic foci using interictal SPECT.
Main Methods:
- 46 refractory TLE patients underwent interictal brain SPECT using 99mTc-ECD.
- Evaluated perfusion impairments in temporal lobes and thalami.
- Seizure focus localization confirmed with EEG, MRI, and clinical outcomes.
Main Results:
- 26% (12/46) of TLE patients showed concomitant temporal lobe and ipsilateral thalamic hypoperfusion.
- Hypoperfusion patterns included left TLE with left thalamus (7 patients) and right TLE with right thalamus (5 patients).
- Additional findings included ipsilateral basal ganglia hypoperfusion (10 patients) and contralateral cerebellar hypoperfusion (4 patients).
Conclusions:
- Ipsilateral thalamic hypoperfusion is a frequent finding in TLE.
- Corticothalamic diaschisis is a potential mechanism.
- This finding can assist in lateralizing seizure foci on interictal SPECT.