Composite SISCOM perfusion patterns in right and left temporal seizures.
OBJECTIVE
To compare composite subtraction ictal single-photon emission computed tomography coregistered to magnetic resonance imaging (also known as SISCOM) patterns between right and left medial temporal-onset seizures to document neuroanatomical involvement in perfusion patterns.


METHODS
A retrospective comparative survey.


METHODS
Epilepsy monitoring unit in a tertiary care referral center.


METHODS
Subjects with temporal lobe epilepsy (TLE) who underwent ictal single-photon emission computed tomography studies.


METHODS
Comparison of ictal perfusion pattern changes in subjects with right and left temporal seizures.


RESULTS
Composite subtraction ictal single-photon emission computed tomography coregistered to magnetic resonance images showed similar regions of hyperperfusion change in the ipsilateral anteromedial temporal-corpus striatum-insula region in both groups. In the midbrain reticular formation, there was a significant difference in hyperperfusion between the left and right TLE groups. In addition, the right, but not the left, TLE group shows contralateral hypoperfusion of the temporoparietal junction.


CONCLUSIONS
While anteromedial temporal-corpus striatum-insula perfusion patterns are similar, there are brainstem and hemispheric perfusion pattern differences in right and left TLE seizures, confirming pathophysiological differences between the groups. These findings help define neuronal network involvement in TLE seizures, and may explain the differences in clinical symptoms of right and left TLE seizures.
Hogan
R Edward
RE
Departments of Neurology, Saint Louis University, St Louis, MO, USA. hogane@neuro.wustl.edu
Kaiboriboon
Kitti
K
Bertrand
Mary E
ME
Rao
Venkat
V
Acharya
Jayant
J
D000328:Adult; D001921:Brain / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D002560:Cerebrovascular Circulation; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*