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Divisions of Neurology (Drs. Radtke, Hoffman, Walczak, and Lewis), Nuclear Medicine (Drs. Hanson, Hoffman, Beam, and Coleman), Neurosurgery (Dr. Friedmanf, and Neuropathology (Dr. Crain), Duke University Medical Center, Durham, NC.
To investigate the relationship of temporal lobe hypometabolism demonstrated on PET to surgical outcome and underlying pathology, we reviewed 30 consecutive epilepsy patients who underwent interictal PET studies with 18F fluorodeoxyglucose before temporal lobectomy. Two interpreters blindly reviewed the PET studies and graded them for degree, extent, and location of temporal lobe hypometabolism. Pathologic analysis of en bloc resected tissue showed mesial temporal sclerosis (n = 22), astrocytoma (n = 2), and no pathologic diagnosis (n = 6). Outcome (24 to 40 months' follow-up) was rated as seizure-free (21 patients), significantly improved (five patients), and not significantly improved (four patients). Both the degree and extent of the temporal lobe hypometabolism demonstrated on PET were strongly associated with subsequent seizure control. Pathologic findings, however, did not correlate with degree of PET hypometabolism or subsequent outcome. These data demonstrate that in patients judged to have temporal lobe epilepsy, the presence of temporal lobe hypometabolism is associated with a positive outcome after ipsilateral temporal lobectomy.
Address correspondence and reprint requests to Dr. Rodney A. Radtke, Division of Neurology, P.O. Box 2905, Duke University Medical Center, Durham NC 27710.
Received May 6, 1992. Accepted for publication in final form October 5, 1992.
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