Dynamic perfusion patterns in temporal lobe epilepsy.
OBJECTIVE
To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE).


METHODS
We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates.


RESULTS
The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum.


CONCLUSIONS
The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms.
Dupont
Patrick
P
Nuclear Medicine, Medical Imaging Center and Neurology, KU Leuven/UZ Gasthuisberg, Leuven, Belgium.
Zaknun
John J
JJ
Maes
Alex
A
Tepmongkol
Supatporn
S
Vasquez
Silvia
S
Bal
C S
CS
Van Paesschen
Wim
W
Carpintiero
Silvina
S
Locharernkul
Chaichon
C
Dondi
Maurizio
M
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D010477:Perfusion; D012640:Seizures / Q000175:diagnosis / Q000000981:diagnostic imaging; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*