Al. Rabinowicz et al., CHANGES IN REGIONAL CEREBRAL BLOOD-FLOW BEYOND THE TEMPORAL-LOBE IN UNILATERAL TEMPORAL-LOBE EPILEPSY, Epilepsia, 38(9), 1997, pp. 1011-1014
Purpose: Single photon emission computed tomography (SPECT) is widely
used to evaluate functional abnormalities during the epileptic event.
Changes in regional cerebral blood flow (rCBF) are well defined in pat
ients with temporal lobe epilepsy (TLE) undergoing surgical resection.
Nonetheless, the interpretation of ictal abnormalities in CBF beyond
the temporal lobes has not been carefully addressed. Methods: We asses
sed 4 patients with pathologically proven unilateral TLE who had signi
ficant ipsilateral frontal hypoperfusion in ictal studies with no othe
r abnormalities but chronic epilepsy accounting for such findings. Pat
ients were assessed as candidates for surgery by interictal EEG, neuro
psychological studies, brain magnetic resonance imaging, scalp electro
de video-EEG monitoring, and ictal SPECT. Results: Characteristic hype
rperfusion was evident over the temporal lobe ipsilateral to the EEG f
ocus, with significant hypoperfusion over the frontal region in 3 pati
ents. In patient 4, frontal hypoperfusion was not statistically signif
icant. Conclusions: SPECT demonstrated relative rCBF changes beyond th
e epileptogenic zone in unilateral TLE. Our findings provide further i
nsight into the pathophysiological changes underlying this condition.