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FIG 3. False-negative MR findings in a 30-year-old man with left complex partial seizures. Ictal activity was shown in left temporal area on video/EEG.
A, Oblique coronal fast spin-echo T2-weighted MR image (4000/120/4) shows no abnormalities.
B, Ictal SPECT scan shows hyperperfusion in left temporal lobe (arrows). Radioactivity ratio between right temporal cortex/left temporal cortex was 1:2.4.
C, FDG-PET scan shows hypometabolism in left temporal lobe (arrows). Radioactivity ratio between right temporal cortex/left temporal cortex was 1:0.7.
Invasive EEG showed ictal activity in left temporal lobe. After left anterior temporal lobectomy, pathologic diagnosis was hippocampal sclerosis of a mild degree associated with mild cortical dysplasia. Engel's outcome was class II.
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