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FIG 2. Nonconcordance among MR imaging, ictal SPECT, and PET in a 31-year-old woman with right temporal lobe epilepsy.
A, Oblique coronal turbo spin-echo T2-weighted MR image (5000/100/3) shows atrophy and slight hyperintensity of left hippocampus (arrow).
B, Ictal SPECT scan shows slight hyperperfusion in right temporal lobe (arrows). Radioactivity ratio between right temporal cortex/left temporal cortex was 1.2:1.
C, FDG-PET scan shows slight hypometabolism in right temporal lobe (arrows). Radioactivity ratio between right temporal cortex/left temporal cortex was 0.5:1.
Invasive EEG (subdural grids) study showed the epileptogenic focus in the right temporal lobe. After right anterior temporal lobectomy, pathologic diagnosis was hippocampal sclerosis combined with microscopic cortical dysplasia. Engel's outcome at 1-year follow up was class II.
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