Misleading lateralization by ictal SPECT in temporal lobe epilepsy - A case report

J. Janszky, A. Holló, P. Barsi, G. Rásonyi, L. Erõss, A. Kalóczkai, P. Halász

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

A 28-year-old woman with temporal lobe epilepsy underwent presurgical evaluation. Scalp-EEG showed non-localizing seizure patterns. MRI revealed a right hippocampal sclerosis. Ictal HMPAO-SPECT showed a marked left temporal hyperperfusion. Video-EEG monitoring with foramen ovale electrodes (FOE) showed an initial seizure pattern which appeared in the right FOE and which shifted to the left 8 s after clinical onset. Three years after a right temporal lobectomy, the patient is seizure-free. In conclusion, although the ictal SPECT suggested a left temporal seizure focus, the intracranial EEG and the postoperative seizure-freedom confirmed the right-sidelocation of the epileptogenic region. A rapid right-left seizure spread explains the mechanism of falsely lateralizing ictal SPECT.

Original languageEnglish
Pages (from-to)159-162
Number of pages4
JournalEpileptic Disorders
Volume4
Issue number2
Publication statusPublished - Jul 23 2002

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Keywords

  • EEG
  • Epilepsy surgery
  • Foramen ovale electrodes
  • Lateralization
  • Seizure spread
  • Single photon emission computed tomography
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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