This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on Web of Science (5)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Epilepsy  • Neuropathology  • Nutritional and Metabolic Disorders  • Metabolism  • Radiologic Imaging  • PET/ SPECT Imaging  • Alert me on articles by topic  Social Bookmarking   What's this?

Eun Yeon Joo, MD; Eun Kyung Lee, MD; Woo Suk Tae, MD; Seung Bong Hong, MD, PhD

Arch Neurol. 2004;61:1074-1078.

Background  Patients with mesial temporal lobe epilepsy (TLE) often show bilateral temporal hypometabolism (BTH), but the nature of this finding has not been well established.

Objective  To compare the clinical characteristics between unitemporal hypometabolism (UTH) and BTH patients in mesial TLE.

Design  Cross-sectional study.

Setting  Epilepsy center at university hospital in Seoul, Korea.

Patients  We enrolled 95 patients with mesial TLE, 87 of whom had subsequently undergone surgery. Seizures, interictal and ictal electroencephalography (EEG), brain magnetic resonance imaging, Wada test, and neuropsychological test results were reviewed. ¹⁸F-fluorodeoxyglucose positron emission tomography scans were interpreted visually. Patients were divided into 2 groups: UTH and BTH.

Results  There were 59 UTH patients and 36 BTH patients. Semiologic analysis showed that UTH patients had higher frequencies of aura and unilateral dystonic posturing, whereas BTH patients had higher frequencies of a nonlateralized bilateral ictal EEG pattern and bilateral interictal spikes. Moreover, BTH patients had more frequent symmetric Wada memory scores and white matter changes in the bilateral temporal lobes on brain magnetic resonance imaging than UTH patients. All UTH patients with bilateral TLE on scalp EEG showed unilateral seizure onset on intracranial EEG.

Conclusions  The characteristic clinical findings of mesial TLE with BTH were a more frequent nonlateralized ictal EEG pattern, bitemporal interictal spikes, symmetric Wada memory score, and the anterior temporal white matter changes, and less frequent aura and unilateral dystonic posturing. Surgical outcomes were similar and good in both groups, although surgery could not be performed in 8 BTH patients (22%).

From the Department of Neurology, Samsung Medical Center and Center for Clinical Research, SBRI, Sungkyunkwan University School of Medicine, Seoul, Korea. The authors have no relevant financial interest in this article.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?