Ipsilateral and Contralateral Thalamic Hypometabolism as a Predictor of Outcome After Temporal Lobectomy for Seizures

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FIGURE 1.
Transaxial images of patient with temporal lobe epilepsy show markedly decreased metabolism in right temporal lobe (B) and in ipsilateral thalamus (A).
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FIGURE 2.
Transaxial images of patient with temporal lobe epilepsy show markedly decreased metabolism in right temporal lobe (B), particularly in medial aspect, and in contralateral thalamus (A).

TABLE 2.

Percentage of Patients with Postoperative Seizures Based on LI Determined Using Coronal Images

Lobe	LI = 0	LI < 40*	LI ≥ 40
Entire temporal	2/6 (33)	9/37 (24)	7/45 (16)
Medial temporal	5/20 (25)	8/36 (22)	8/41 (20)
Lateral temporal	4/8 (50)	10/39 (26)	6/38 (16)
Inferior temporal	2/10 (20)	8/31 (26)	8/46 (17)

↵* Number of patients includes those with LI = 0.
Values are expressed as number of patients with postoperative seizures over total number of patients with that value of LI; percentage is given in parentheses. For purposes of this analysis, absolute value of LI was calculated to combine patients with right and left temporal lobe epilepsy. The higher the LI, the greater is asymmetry. Value of 40 was used as cutoff point because it corresponds to difference of 1 point on qualitative score between the 2 sides (thus, scores less than 40 represent least degree of asymmetry possible).

Type of asymmetry	Seizures	No seizures	% Seizures
Reverse thalamic asymmetry (n = 5)	5	0	100
No thalamic asymmetry (n = 38)	3	35	8
Thalamic asymmetry (n = 37)	8	29	22