Bilateral reductions of hippocampal volume, glucose metabolism, and Wada hemispheric memory performance are related to the duration of mesial temporal lobe epilepsy |
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Authors: | H Jokeit Alois Ebner Stefan Arnold Michael Schüller Christine Antke Yanxiong Huang Helmut Steinmetz Rüdiger J Seitz Otto W Witte |
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Institution: | (1) Bethel Epilepsy Center, Clinic Mara I, Epilepsy Surgery Program, Maraweg 21, D-33617 Bielefeld, Germany e-mail: jkt@mara.de, Tel.: +49-521-1443831, Fax: +49-521-1443553, DE;(2) Department of Neurology, University of Düsseldorf, D-40225 Düsseldorf, Germany, DE |
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Abstract: | In refractory temporal lobe epilepsy (TLE) temporal lobe structures and functions are continuously or intermittently affected
by abnormal brain electrical events, noxious neurochemical agents, and metabolic disturbances. There is conflicting evidence
regarding the relationship between the duration of refractory mesial TLE and quantitative measures of temporal lobe functions
and volumes of the hippocampi. Twenty patients (aged 28 ± 7 years, 14 males) with an initial precipitating injury before the
age of 5 years were subjected to high-resolution magnetic resonance imaging, fluoro-2-deoxy-d-glucose positron-emission tomography (PET), and the Wada test. We investigated whether the duration of unilateral refractory
TLE (12 left, 8 right) affects hippocampal volume, glucose metabolism, or Wada hemispheric memory performance. Ipsilateral
to the epileptogenic zone the hippocampal volume, metabolism, and Wada hemispheric memory performance were reduced compared
to the corresponding contralateral measures. The duration of epilepsy controlled for age at investigation, side of seizure
origin, underlying cause, and sex were negatively correlated with ipsi- and contralateral hippocampal volume, hippocampal
metabolism, and Wada hemispheric memory performance. Moreover, ipsilateral Wada hemispheric memory performance and contralateral
hippocampal glucose metabolism were correlated with the frequency of habitual seizures. Refractory TLE seems to be associated
with a slow but ongoing bilateral temporal lobe damage. These cross-sectional results require verification by longitudinal
studies carried out over a period of more than two decades.
Received: 30 July 1998 Received in revised form: 16 March 1999 Accepted: 24 April 1999 |
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Keywords: | Temporal lobe epilepsy Hippocampus Magnetic resonance imaging Fluoro-2-deoxy-d-glucose positron-emission tomography Wada test |
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