High-resolution (2.6-mm) PET in partial complex epilepsy associated with mesial temporal sclerosis

Abstract

Eleven patients with medically refractory partial seizures underwent positron emission tomography (PET) with a 600-crystal tomograph and fluorine-18 fluorodeoxyglucose. All patients had been selected for temporal lobe resection, and the side of the epileptogenic focus had been demonstrated with electroencephalography (EEG). Only patients in whom structural lesions had been excluded with magnetic resonance (MR) imaging were studied. Ten of 11 patients were found to have temporal cortical hypometabolism on the same side as the focal abnormality that was demonstrated with EEG. In two patients, PET showed hypometabolism in the mesial temporal cortex only. There were no incorrectly lateralizing PET results. MR imaging showed an abnormality in the corresponding temporal lobe in seven patients. In one patient, both PET and MR images were normal. All patients underwent anterior temporal resection, and histologic examination of resected tissue showed mesial temporal sclerosis in all cases.