Abstracts

RATIONALE: There is increasing evidence to suggest that the metabolic and neuropsychologic abnormailites observed among patients with complex partial seizures of temporal lobe origin (CPS/TL)extends beyond the hippocampus and ipsilateral temporal lobe. The purpose of this study was to identify the presence and extent of quantitative MRI volumetric loss observed in extratemporal regions of patients with CPS/TL and to examine its association to basic clinical seizure correlates (e.g, age of onset, duration, presence of initial precipitating insults). METHODS: Quantitative volumetric imaging was conducted on 35 patients with CPS/TL and 22 health controls using a semi-automated MR volumetrics program (Univeristy of Iowa BRAINS software). Extratemporal regions of interest included gray and white matter volumes for left and right frontal,temporal, parietal, occipital, and cerebellar regions, as well as total intracranial volume. RESULTS: CPS/TL patients exhibited a 8-10% decrease in MRI volumes compared with normals)in all extratemporal regions of interest. Early age of recurrent seizure onset appeared to be a critical correlate of volumetric loss in CPS/TL patients. CONCLUSIONS: These data indicate the presence of significant extratemp oral atrophy extending outside the primary temporal lobe/hippocampal region. The degree to which these extratemporal volumetric findings represent the effects of the timing and contextual history of initial seizures, the consequences of prolonged intractable epilepsy, or a combination of such factors will be presented.