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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