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Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal and ictal EEG, CT, MRI, SPECT and PET

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Summary

Ten patients suffering from drug-resistant complex partial seizures, with EEG abnormalities in the temporal region, were studied by means of non-invasive electrophysiological techniques (video-monitored, 16-channel, prolonged surface and sphenoidal EEG) as well as by imaging techniques (CT, MRI, SPECT and PET). Analysis of interictal and ictal EEG indicated the localization of epileptic activity in one side in eight cases. CT demonstrated focal abnormalities in three, SPECT in five unequivocally (in another four questionably, with the same lateralization as indicated by PET), MRI in eight, and PET in all cases. While only EEG provided specific diagnostic information, the focus definition was consistently good on PET images, poor on CT scans, and generally good but less consistent on MRI.

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References

  1. Bergström M, Litton J, Eriksson L, Bohm C, Blomquist G (1982) Determination of object contour from projections for attenuation correction in cranial positron emission tomography. J Comput Assist Tomogr 6:365–372

    Article  PubMed  Google Scholar 

  2. Bergström M, Eriksson L, Bohm C, Blomquist G, Litton J (1983) Correction for scattered radiation in a ring detector positron camera by intergral transformation of the projections. J Comput Assist Tomogr 7:42–50

    Article  PubMed  Google Scholar 

  3. Biersack HJ, Kreiten K, Meyer H, Reske SN, Knopp R, Reichmann K, Winkler C (1984) SPECT des Hirns mit 123-Jod-Isopropyl-Amphetamin. Untersuchungen mit einer rotierenden Gammakamera. In: Schmidt HEA, Adam WE (eds) Nuclear medicine imaging of metabolism and organ function. Schattauer, Stuttgart New York, pp 41–44

    Google Scholar 

  4. Biersack HJ, Reichmann K, Stefan H, Kuhnen C, Neirinckx R, Tyrell D, Penin H, Winkler C (1986) Brain SPECT with 99m-Tclabeled hexamethyl propylene amine oxime (HMO-PAO): results in epilepsy. In: Höfer R, Bergman H (eds) Gasteiner International Symposium 1986: Radioaktive Isotope in Klinik und Forschung. Egermann, Wien, pp 33–38

    Google Scholar 

  5. Chatrian GE, Lettich E, Nelson PL (1985) Ten percent electrode system for topographic studies of spontaneous and evoked EEG activities. Am J EEG Technol 25:83–92

    Google Scholar 

  6. Delgado-Escueta AV, Nashold B, Freedman M (1979) Videotaping epileptic attacks during stereoelectroencephalography. Neurology 29:473–489

    Article  CAS  PubMed  Google Scholar 

  7. Delgado-Escueta AV, Bascal FE, Treiman DM (1982) Complex partial seizures on closed-circuit television and EEG: a study of 691 attacks in 79 patients. Ann Neurol 11:292–300

    Article  Google Scholar 

  8. Engel J Jr (1983) Metabolic patterns of human epilepsy: clinical observations and possible physiological correlates. In: Baldy-Moulinier M, Ingvar DH, Meldrum BS (eds) Cerebral blood flow, metabolism and epilepsy. Libbey, London Paris, pp 6–18

    Google Scholar 

  9. Engel J Jr, Kuhl DE, Phelps ME, Crandall PH (1982) Comparative localization of epileptic foci in partial epilepsy by PCT and EEG. Ann Neurol 12:529–537

    Article  PubMed  Google Scholar 

  10. Engel J Jr, Crandall PH, Rausch R (1983) Surgical treatment of the partial epilepsies. In: Rosenberg RN, Grossman RG, Schochet S, Heinz ER, Willis WD (eds) The clinical neurosciences, vol 2. Churchill Livingstone, New York, II-1349-II-1380

    Google Scholar 

  11. Eriksson L, Bohm C, Kesselberg M, Blomquist G, Litton J, Widén L, Bergström M, Ericson K, Greitz T (1982) A four ring positron camera system for emission tomography of the brain. IEEE Trans Nucl Sci 29:539–543

    Article  Google Scholar 

  12. Gloor P (1975) Contributions of electroencephalography and electrocorticography to the neurosurgical treatment of the epilepsies. Adv Neurol 8:59–106

    CAS  PubMed  Google Scholar 

  13. Gloor P (1977) Application of voltage conductor principles to montage design. Am J EEG Technol 1:5–20

    Google Scholar 

  14. Heiss WD, Pawlik G, Herholz K, Wagner R, Göldner H, Wienhard K (1984) Regional kinetic constants and cerebral metabolic rate for glucose in normal human volunteers determined by dynamic positron emission tomography of (18F)-2-fluoro-2-deoxy-D-Glucose. J Cereb Blood Flow Metab 4:212–223

    Article  CAS  PubMed  Google Scholar 

  15. Herholz K, Pawlik G, Wienhard K, Heiss WD (1985) Computer assisted mapping in quantitative analysis of cerebral positron emission tomograms. J Comput Assist Tomogr 9:154–161

    Article  CAS  PubMed  Google Scholar 

  16. Ives JR, Gloor P (1977) New sphenoidal electrode assembly to permit long-term monitoring of the patient's ictal or interictal EEG. Electroencephalogr Clin Neurophysiol 42:575–580

    Article  CAS  PubMed  Google Scholar 

  17. Janz D, Meenke HJ, Schörner W (1985) Kernspintomographische Untersuchungen (MRT) bei Patienten mit Temporallappen-Epilepsie. In: Kruse R (ed) Epilepsie 84. Einhorn, Reinbek, pp 238–242

    Google Scholar 

  18. Kertesz A (1987) NMR and the epileptic focus. In: Wieser HG, Elger CE (eds) Presurgical evaluation of epileptics. Springer, Berlin Heidelberg New York (in press)

    Google Scholar 

  19. Kuhl DE, Engel J Jr, Phelps ME, Selin C (1980) Epileptic patterns of local cerebral metabolism and perfusion in humans determined by emission computed tomography of 18FDG and 13NH3. Ann Neurol 8:348–360

    Article  CAS  PubMed  Google Scholar 

  20. Lesser RP, Dinner DS, Lüders H, Morris HH (1984) Differential diagnosis and treatment of intractable seizures. Cleve Clin Q 51:227–240

    Article  CAS  PubMed  Google Scholar 

  21. Lüders H, Hahn J, Lesser RP, Dinner DS, Rothner D, Erenberg G (1982) Localization of epileptogenic spike foci: comparative study of closely spaced scalp electrodes, nasopharyngeal, sphenoidal, subdural and depth electrodes. In: Akimoto H, Kazamatsuri H, Seino M, Ward A (eds) Advances in epileptology. Raven, New York, pp 185–189

    Google Scholar 

  22. McLachlan RS, Nicholson RL, Black S, Carr T, Blume WT (1985) Nuclear magnetic resonance imaging, a new approach to the investigation of refractory temporal lobe epilepsy. Epilepsia 26:555–562

    Article  CAS  PubMed  Google Scholar 

  23. Quesney LF, Gloor P (1985) Localization of epileptic foci. In: Gotman J, Ives JR, Gloor P (eds) Long-term monitoring in epilepsy (EEG Suppl 37). Elsevier, Amsterdam, pp 165–200

    Google Scholar 

  24. Sharborough F (1987) Presurgical evaluation. In: Engel J (ed) Surgical treatment of the epilepsies. Raven, New York (in press)

    Google Scholar 

  25. Spencer SS, Williamson PD, Bridgers SL, Mattson RH, Cicchetti DV, Spencer DD (1985) Reliability and accuracy of localization by scalp ictal EEG. Neurology 35:1567–1575

    Article  CAS  PubMed  Google Scholar 

  26. Sperling MR, Wilson G, Engel J Jr, Babb TL, Phelps M, Bradley W (1986) Magnetic resonance imaging in intractable partial epilepsy: correlative studies. Ann Neurol 20:57–62

    Article  CAS  PubMed  Google Scholar 

  27. Stefan H, Penin H (1979) Methoden der verfeinerten Merkmalserfassung bei Anfallspatienten. In: Doose H, Gross-Selbeck G (eds) Epilepsie 1978. Thieme, Stuttgart, pp 179–187

    Google Scholar 

  28. Stefan H, Wieser HG (1986) Presurgical epileptological intensive evaluation. In: Wieser HG, Elger CE (eds) Presurgical evaluation of epileptics: basis, techniques, implications. Springer, Berlin Heidelberg New York

    Google Scholar 

  29. Theodore WH, Porter RJ, DiChiro G, Sato S (1983) Correlation of positron emission tomography and electroencephalography in patients with complex partial seizures. In: Baldy-Moulinier M, Ingvar DH, Meldrum BS (eds) Cerebral blood flow, metabolism and epilepsy. Libbey, London Paris, pp 71–75

    Google Scholar 

  30. Theodore WH, Dowart R, Holmes M, Porter RJ, DiChiro G (1987) Magnetic resonance imaging in epilepsy: comparison with CT and PET. In: Wolf P, Dam M, Janz D, Dreifuss FE (eds) Advances in epileptology. Raven, New York (in press)

    Google Scholar 

  31. Theodore MW, Dorwart R, Holmes M, Porter RJ, DiChiro G (1986) Neuroimaging in refractory partial seizures: comparison of PET, CT, and MRI. Neurology 36:750–759

    Article  CAS  PubMed  Google Scholar 

  32. Walsh GO, Delgado-Escueta AV (1984) Type II complex partial seizures: poor results of anterior temporal lobectomy. Neurology 34:1–13

    Article  CAS  PubMed  Google Scholar 

  33. Wienhard K, Pawlik G, Herholz K, Wagner R, Heiss WD (1985) Estimation of local cerebral glucose utilization by positron emission tomography of (18F)2-fluoro-2-deoxy-D-glucose: a critical appraisal of optimization procedures. J Cereb Blood Flow Metab 5:115–125

    Article  CAS  PubMed  Google Scholar 

  34. Wyllie E, Lüders H, Morris HH, Lesser RP, Dinner DS (1986) The lateralizing significance of versive head and eye movements during epileptic seizures. Neurology 36:606–611

    Article  CAS  PubMed  Google Scholar 

  35. Yamamoto YL, Ochs R, Ammann W, Meyer E, Evans AC, Cooke B, Sako K, Gotman J, Feindel WH, Diksic M, Thomson CJ, Robitaille Y (1983) Patterns of rCBF and focal energy metabolic changes in relation to electroencephalographic abnormality in the interictal phase of partial epilepsy. In: Baldy-Moulinier M, Ingvar DH, Meldrum BS (eds) Cerebral blood flow, metabolism and epilepsy. Libbey, London Paris, pp 51–61

    Google Scholar 

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Authors and Affiliations

  1. Universitäts-Nervenklinik und Poliklinik/Epileptologie, D-5300, Bonn, Germany

    H. Stefan, W. Burr & H. Penin

  2. Max-Planck-Institut für neurologische Forschung und Nervenklinik der Universität zu Köln — Schwerpunkt Neurologie, Ostmerheimer Strasse, 200, D-5000, Köln 91, Germany

    G. Pawlik, H. G. Böcher-Schwarz & W. -D. Heiss

  3. Institut für Nuklearmedizin der Universität Bonn, D-5300, Bonn, Germany

    H. J. Biersack

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  1. H. Stefan
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  4. H. J. Biersack
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  5. W. Burr
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  6. H. Penin
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  7. W. -D. Heiss
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Stefan, H., Pawlik, G., Böcher-Schwarz, H.G. et al. Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal and ictal EEG, CT, MRI, SPECT and PET. J Neurol 234, 377–384 (1987). https://doi.org/10.1007/BF00314081

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  • DOI: https://doi.org/10.1007/BF00314081

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