J Korean Epilepsy Soc.  2004 Jun;8(1):41-46.

The Clinical Findings of Unitemporal and Bitemporal Glucose Hypometabolism in Mesial Temporal Lobe Epilepsy

• Joo EY
• Hong SB

Abstract

PURPOSE
To identify clinical characteristics in patients with unitemporal hypometabolism (UTH) or bitemporal hypometabolism (BTH) in mesial temporal lobe epilepsy (TLE). METHODS: We enrolled 95 patients with mesial TLE, 87 of whom subsequently had a surgery. Seizures, interictal and ictal EEG, brain MRI, Wada test, and neuropsychological test results were reviewed. (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) scans were visually interpreted. Patients were divided into two groups, UTH and BTH. RESULTS: There were 59 UTH patients and 36 BTH patients. Semiology showed that UTH had higher frequencies of aura and unilateral dystonic posturing than BTH, whereas BTH had higher frequencies of a non-lateralized bilateral ictal EEG pattern and of bilateral interictal spikes than UTH. Moreover, BTH had symmetric Wada memory scores more frequently than UTH, and white matter changes of the bilateral temporal lobes in brain MRI were more frequent in BTH than UTH. All UTH patients with bilateral TLE in scalp EEG showed unilateral seizure onset in intracranial EEG. CONCLUSION: The characteristic clinical findings of mesial TLE patients with BTH were more frequent non-lateralized ictal EEG pattern, bitemporal interictal spikes, symmetric Wada memory score, the presence of 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 (22.2%) BTH patients.

Keyword

Positron emission tomography; Bitemporal hypometabolism; Temporal lobe epilepsy; EEG; Wada test; White matter change of temporal lobe

MeSH Terms

Brain
Electroencephalography
Epilepsy
Epilepsy, Temporal Lobe*
Glucose*
Humans
Magnetic Resonance Imaging
Memory
Neuropsychological Tests
Positron-Emission Tomography
Scalp
Seizures
Temporal Lobe*
Glucose