title: Metabolic changes in occipital lobe epilepsy with automatisms.
abstract: OBJECTIVE
  Some studies suggest that the pattern of glucose hypometabolism relates not only to the ictal-onset zone but also reflects seizure propagation. We investigated metabolic changes in patients with occipital lobe epilepsy (OLE) that may reflect propagation of ictal discharge during seizures with automatisms.
  
  
  METHODS
  Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG-PET) between 1994 and 2004 were divided into two groups (with and without automatisms during seizure). Significant regions of hypometabolism were identified by comparing (18)F-FDG-PET results from each group with 16 healthy controls by using statistical parametric mapping.
  
  
  RESULTS
  Significant hypometabolism was confined largely to the epileptogenic occipital lobe in the patient group without automatisms. In patients with automatisms, glucose hypometabolism extended from the epileptogenic occipital lobe into the ipsilateral temporal lobe.
  
  
  CONCLUSIONS
  We identified a distinctive hypometabolic pattern that was specific for OLE patients with automatisms during a seizure. This finding supports the postulate that seizure propagation is a cause of glucose hypometabolism beyond the region of seizure onset.
authors.affiliation: Sydney Medical School, University of Sydney , Sydney, NSW , Australia ; Department of Neurology, Westmead Hospital , Westmead, NSW , Australia.
authors.forename: Chong H
authors.initials: CH
authors.lastname: Wong
authors.affiliation: Sydney Medical School, University of Sydney , Sydney, NSW , Australia ; Department of PET and Nuclear Medicine, Royal Prince Alfred Hospital , Camperdown, NSW , Australia.
authors.forename: Armin
authors.initials: A
authors.lastname: Mohamed
authors.affiliation: Department of PET and Nuclear Medicine, Royal Prince Alfred Hospital , Camperdown, NSW , Australia ; School of Information Technologies, University of Sydney , Sydney, NSW , Australia.
authors.forename: Lingfeng
authors.initials: L
authors.lastname: Wen
authors.affiliation: Department of PET and Nuclear Medicine, Royal Prince Alfred Hospital , Camperdown, NSW , Australia ; School of Information Technologies, University of Sydney , Sydney, NSW , Australia.
authors.forename: Stefan
authors.initials: S
authors.lastname: Eberl
authors.affiliation: Department of Neurology, Westmead Hospital , Westmead, NSW , Australia ; Institute of Neurological Sciences, Prince of Wales Hospital , Randwick, NSW , Australia.
authors.forename: Ernest
authors.initials: E
authors.lastname: Somerville
authors.affiliation: Sydney Medical School, University of Sydney , Sydney, NSW , Australia ; Department of PET and Nuclear Medicine, Royal Prince Alfred Hospital , Camperdown, NSW , Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Fulham
authors.affiliation: Sydney Medical School, University of Sydney , Sydney, NSW , Australia ; Department of Neurology, Westmead Hospital , Westmead, NSW , Australia.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Bleasel
keywords: automatisms; automotor seizure; epilepsies; epilepsy; fluorodeoxyglucose; focal; occipital lobe; positron-emission tomography
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