Comparison of the intracarotid amobarbital procedure and interictal cerebral 18-fluorodeoxyglucose positron emission tomography scans in refractory temporal lobe epilepsy.
The relationship between interictal focal hypometabolism determined by 18-fluorodeoxyglucose positron emission tomography (FDG-PET) scans and memory function with the intracarotid amobarbital procedure (IAP) was evaluated in 23 patients with temporal lobe epilepsy. All patients underwent prolonged EEG/video monitoring. The epileptogenic focus was defined by interictal epileptiform discharges and ictal onsets. All 23 patients had recorded seizures arising exclusively from one temporal lobe. PET showed temporal lobe hypometabolism ipsilateral to the epileptogenic focus in 86% (20 of 23) of patients; IAP showed impaired memory of the hemisphere of seizure onset in 65% (15 of 23). Sixty-five percent (13 of 20) of patients with focal hypometabolism had ipsilateral memory impairment. Memory impairment contralateral to the hypometabolic zone was not observed. Ninety-five percent (22 of 23) of patients demonstrated functional impairment by either PET or IAP (or both) on the epileptogenic side.
Salanova
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Department of Neurology, Cleveland Clinic Foundation, Ohio 44195-5227.
Morris
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Rehm
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Wyllie
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Dinner
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Lüders
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Gilmore-Pollak
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D000328:Adult; D000654:Amobarbital / Q000008:administration & dosage; D002343:Carotid Artery, Internal; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D008875:Middle Aged; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000378:metabolism; D014055:Tomography, Emission-Computed; D014743:Videotape Recording
D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D000654:Amobarbital; D005947:Glucose