What happens to temporal hypometabolism contralateral to side of surgery in patients with bilateral temporal hypometabolism?
OBJECTIVE
To see what happens on PET hypometabolism on the temporal lobe contralateral to the side of surgery in patients with bitemporal hypometabolism (BTH).


PATIENTS AND METHODS
This retrospective study with prospectively defined data evaluated the pre- and post-surgical PET hypometabolism on the contralateral temporal lobe after resection of ipsilateral temporal lobe in 10 patients with BTH operated between January, 2010 and May, 2018. On PET we compared standard uptake values (SUV) and relative metabolic activities as compared to normal subjects by means of Z-scores of hypometabolism of unresected temporal lobes before and after surgery.


RESULTS
Surgery did not lead to satisfactory seizure outcome and only 3 patients were seizure free. All but one were still using anti-epileptic drug. No significant change was noted on PET hypometabolism related to the contralateral temporal lobe at the last follow-up. Regarding the mean SUV, comparisons showed that the difference with respect to the mesial structures was significant (p = 0.04). But lateral cortex showed insignificant difference (p = 0.21) before and after surgery. Regarding the mean Z-score, no significant differences were found between both the mesial temporal structures (p = 0.23) and lateral temporal cortex (p = 0.18).


CONCLUSION
Surgery does not lead to improvements on PET hypometabolism of the temporal lobe contralateral to the side of surgery and hypometabolism on the contralateral side may be due to structural damage rather than functional deficits secondary to propagation of repetitive seizures. Seizure outcome is not satisfactory and before surgery patients or their next of kin should be informed in detail.
['Alizada|Orkhan|O|', 'Akgun|Elife|E|', 'Akgun|Mehmet Yigit|MY|', 'Kemerdere|Rahsan|R|', 'Yeni|Seher Naz|SN|', 'Tanriverdi|Taner|T|']
D000293:Adolescent D000328:Adult D017668:Age of Onset D004833:Epilepsy, Temporal Lobe D005260:Female D005500:Follow-Up Studies D007839:Functional Laterality D006624:Hippocampus D006801:Humans D008297:Male D008875:Middle Aged D019635:Neurosurgical Procedures D049268:Positron-Emission Tomography D012189:Retrospective Studies D012640:Seizures D013702:Temporal Lobe D016896:Treatment Outcome
Hypometabolism Epilepsy FDG-PET Hippocampal sclerosis Temporal lobe epilepsy