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Abstract #0928

Extratemporal cortical morphological changes and hypometabolism revealed in radiological MRI-negative temporal lobe epilepsy

Julia Pia Simon1, Ben A. Duffy1, Yan Li2, Arthur W. Toga1, Wolfgang G. Muhlhofer3, Robert C. Knowlton2, and Hosung Kim1
1University of Southern California, Los Angeles, CA, United States, 2Neurology and UCSF Weill Institute for Neurosciences, San Francisco, CA, United States, 3University of Alabama at Birmingham Epilepsy Center, Birmingham, AL, United States

Radiological MRI-negative temporal lobe epilepsy (TLE) is a common, but challenging subtype for surgical treatment. Compared to MRI-positive cases, these patients often require invasive EEG for localization that may also involve extratemporal regions. Furthermore, these cases entail a lower likelihood of seizure-free surgical outcome. To better understand this important group, we studied cortical surface features of MRI and FDG-PET to relate occult extratemporal damage to epilepsy localization and surgical outcome prediction. Bilateral cortical morphological changes were found. FDG-PET hypometabolism was lateralized in the hemisphere ipsilateral to seizure focus. Extratemporal and bilateral hypometabolism tended to be associated with poor surgical outcome.

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