Abstracts

FDG-PET HYPOMETABOLISM IS ASSOCIATED WITH GOOD SURGICAL OUTCOME IN TEMPORAL LOBE EPILEPSY WITH NORMAL MRI

Abstract number : 1.221
Submission category :
Year : 2003
Submission ID : 3965
Source : www.aesnet.org
Presentation date : 12/6/2003 12:00:00 AM
Published date : Dec 1, 2003, 06:00 AM

Authors :
Ebru E. Altay, James A. Fessler, Victoria P. Vahle, Hrayr P. Attarian, Frank G. Gilliam Neurology, Washington University, St. Louis, MO; Neurology, Washington University, St. Louis, MO; Neurology, Washington University, St. Louis, MO; Neurology, Washingto

Although mesial temporal sclerosis is a good predictor for surgical outcome in patients with temporal lobe epilepsy, there is no well known predeterminant for a group of patients with normal MRI findings but mesial temporal lobe seizures.
We studied 19 consecutive patients who had normal MRI but mesial temporal lobe seizures defined by clinical and EEG findings from scalp and/or intracranial video/EEG monitoring. FDG-PET scans were performed for each patient as a part of standard phase 1 evaluation for epilepsy surgery. The presence of interictal regional delta slowing was also determined from the scalp recordings. All patients had subsequent epilepsy surgery and have been followed up for a minimum of six months. Data were stored in SPSS database and analysed by using the Chi-Square statistics.
The presence or the severity of PET hypometabolism ipsilateral to the resection side was significantly correlated with good surgical outcome with absence of seizures for at least six months (p[lt]0.05). Twelve of fourteen patients who were seizure free after surgery had ipsilateral PET hypometabolism. Of five patients with continued seizures, one patient had ipsilateral hypometabolism on the PET. However, the presence of interictal regional delta slowing ipsilateral to the surgery side did not reveal a significant correlation.
The presence and the severity of PET hypometabolism is closely correlated with good surgical outcome in mesial TLE patients with normal MRI findings. This observation may indicate that PET hypometabolism can be an independent predictor for surgical outcome in patients with mesial temporal lobe epilepsy.