THALAMIC GLUCOSE-METABOLISM IN TEMPORAL-LOBE EPILEPSY MEASURED WITH 18F-FDG POSITRON-EMISSION-TOMOGRAPHY (PET)

Thalamic glucose metabolism has been studied in 24 patients suffering from temporal lobe epilepsy (TLE) using interictal F-18-fluorodeoxyglu cose (FDG) positron emission tomography (PET). A total of 17 patients had a unilateral TL seizure onset, 11 of these patients had a mesial t emporal lobe epilepsy syndrome (MTLE), with mesial gliosis and a mesia l TL seizure origin. Three patients had a lateral TL seizure origin, a nd 3 patients had mesial TL tumors. Bilateral TLE was assumed in 7 pat ients. Only in the patient group with MTLE (n = 11), the ipsilateral t halamic glucose uptake showed a statistically significant lower value when compared to the thalamus of the contralateral side (Wilcoxon pair ed sign test, P = 0.012). There was a more pronounced hypometabolism i n right TLE compared to left TLE. A 'hypersynchronous seizure onset pa ttern' in ictal EEG was only seen in 6 (26%) patients (1 patient with bilateral, 5 with unilateral TLE). No correlation existed between the thalamic, temporal glucose metabolism and the 'hypersynchronous seizur e onset pattern'. (C) 1997 Elsevier Science B.V.