In vivo cerebral metabolism and central benzodiazepine-receptor binding in temporal lobe epilepsy

Neurology. 1993 Oct;43(10):1998-2006. doi: 10.1212/wnl.43.10.1998.


Positron emission tomography measured interictal cerebral glucose metabolism with [18F]fluorodeoxyglucose and central benzodiazepine-receptor binding with [11C]flumazenil in 10 mesial temporal lobe epilepsy (TLE) patients and in normal subjects. Eight TLE patients had mesial temporal, lateral temporal, and thalamic hypometabolism ipsilateral to EEG ictal onsets, with additional extratemporal hypometabolism in four. One had unilateral anterior mesial temporal hypometabolism only, and one had normal metabolism. Each patient had decreased benzodiazepine-receptor binding in the ipsilateral anterior mesial temporal region, without neocortical changes. Thus, interictal metabolic dysfunction is variable and usually extensive in TLE, whereas decreased central benzodiazepine-receptor density is more restricted to mesial temporal areas. Metabolic patterns in TLE may reflect diaschisis, while benzodiazepine-receptor changes may reflect localized neuronal and synaptic loss that is specific to the epileptogenic zone. [11C]Flumazenil imaging may be useful in presurgical evaluation of refractory complex partial seizures.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Brain / metabolism*
  • Carbon Radioisotopes
  • Cerebral Cortex / metabolism
  • Deoxyglucose / analogs & derivatives*
  • Deoxyglucose / metabolism
  • Electroencephalography
  • Epilepsy, Temporal Lobe / diagnostic imaging
  • Epilepsy, Temporal Lobe / metabolism*
  • Flumazenil / metabolism*
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Functional Laterality
  • Humans
  • Middle Aged
  • Organ Specificity
  • Receptors, GABA-A / analysis
  • Receptors, GABA-A / metabolism*
  • Reference Values
  • Temporal Lobe / metabolism
  • Thalamus / metabolism
  • Tomography, Emission-Computed


  • Carbon Radioisotopes
  • Fluorine Radioisotopes
  • Receptors, GABA-A
  • Fluorodeoxyglucose F18
  • Flumazenil
  • Deoxyglucose