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Correlation of Clinical and Metabolic Features

Mark D. Holmes, MD; Kathy Kelly, MA; William H. Theodore, MD

Arch Neurol. 1988;45(11):1191-1193.

Abstract
• We compared metabolic patterns on 18F-2-deoxyglucose positron emission tomography (PET) with closed circuit television and simultaneous electroencephalographic ictal recordings of complex partial seizures in 48 patients. Closed circuit television and electroencephalographic data and PET scans were scored by "blinded" raters. Of the 48 patients, 26 had unilateral temporal; three, frontal; ten, ipsilateral frontotemporal; one, frontoparietal; and five, temporoparietal hypometabolism; and three had widespread hypometabolism affecting frontal, temporal, and parietal lobes. Patients with frontal hypometabolism alone had shorter ictal and postictal durations, but involvement of multiple regions was associated with prolonged seizures. Auras were more likely to be present in patients with temporal hypometabolism alone, but an initial motionless stare did not distinguish this group. However, other metabolic patterns did not predict specific ictal clinical features. Vocalizations (formed or unformed) were not more closely associated with frontal involvement. When hypometabolism is multilobar, it may be difficult to use PET to distinguish between complex partial seizures of frontal and temporal origin.

Author Affiliations
From the Clinical Epilepsy Section, National Institute of Neurological and Communicative Disorders and Stroke, Division of Intramural Research, National Institutes of Health, Bethesda, Md.

Footnotes
Accepted for publication June 2, 1988.

Reprint requests to Clinical Epilepsy Section, National Institutes of Health, Bldg 10, Room 5N-248, Bethesda, MD 20892 (Dr Theodore).

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