Dynamic perfusion patterns in temporal lobe epilepsy

Eur J Nucl Med Mol Imaging. 2009 May;36(5):823-30. doi: 10.1007/s00259-008-1040-6. Epub 2009 Jan 13.


Purpose: To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE).

Methods: We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates.

Results: The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum.

Conclusion: The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Algorithms
  • Epilepsy, Temporal Lobe / diagnosis
  • Epilepsy, Temporal Lobe / diagnostic imaging*
  • Epilepsy, Temporal Lobe / pathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Multivariate Analysis
  • Perfusion
  • Seizures / diagnosis
  • Seizures / diagnostic imaging
  • Temporal Lobe / diagnostic imaging
  • Temporal Lobe / pathology
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon / methods*