Correlation of severity of FDG-PET hypometabolism and interictal regional delta slowing in temporal lobe epilepsy.
OBJECTIVE
We investigated the association of severity of hypometabolism detected by positron emission tomography (PET) with [(18)F]fluorodeoxyglucose (FDG) and persistence of interictal EEG focal slowing in patients with refractory temporal lobe epilepsy.


METHODS
Eighty temporal lobes of 40 consecutive patients with intractable temporal lobe epilepsy (mean age, 43.5 years) were studied. All patients underwent video-EEG monitoring, magnetic resonance imaging (MRI), and FDG-PET. Patients with either normal MRI or with unilateral mesial temporal sclerosis, but no other structural abnormality, were included. Interictal EEG delta slowing was graded as none, infrequent (one episode or less/hour), intermediate (more than one episode/hour), or continuous. PET hypometabolism was graded as none, mild, moderate, or severe.


RESULTS
The severity of temporal lobe hypometabolism with PET was significantly correlated with the amount of delta activity in the interictal EEG, independent of MRI findings (Spearman r = 0.46; p < 0.0005).


CONCLUSIONS
This observation suggests related underlying pathophysiologic mechanisms for metabolic and electrical dysfunction in temporal lobe epilepsy.
Erbayat Altay
Ebru
E
Department of Neurology, Washington University in St Louis, School of Medicine, St Louis, Missouri 63110, USA.
Fessler
A James
AJ
Gallagher
Martin
M
Attarian
Hrayr P
HP
Dehdashti
Farrokh
F
Vahle
Victoria J
VJ
Ojemann
Jeffrey
J
Dowling
Joshua L
JL
Gilliam
Frank G
FG
D000328:Adult; D000368:Aged; D001931:Brain Mapping; D003700:Delta Rhythm / Q000706:statistics & numerical data*; D004569:Electroencephalography / Q000706:statistics & numerical data; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000503:physiopathology; D014743:Videotape Recording
D019788:Fluorodeoxyglucose F18