Contribution of SISCOM in the Investigation of Temporal Pole Blurring in Patients with Temporal Lobe Epilepsy and Hippocampal Atrophy: a Brain SPECT study.

Abstract

BACKGROUND: The blurring is a visual change in the temporal pole in Magnetic Resonance Images (MRi), presented ipsilateral to THE epileptogenic zone (EZ) in 32-66% of cases of Mesial Temporal Lobe Epilepsy Syndrome (MTLE) associated with hippocampal sclerosis. There is no scientific consensus on the possible causes for the blurring, which encourages the researches to continue investigating the clinical and pathophysiological implications of this change. OBJECTIVES: (A) Compare the findings of ictal and interictal SPECTs in patients with and without blurring of the temporal lobe and (B) Evaluate, through the subtraction of ictal and interictal SPECT (SISCOM), whether there is a greater hyperfusion on the temporal pole with blurring compared to the contralateral temporal lobe (without blurring). PATIENTS AND METHODS: Retrospective study of 40 patients operated with MTLE, which we will carry out the subtraction between ictal and interictal SPECTs and its alignment to MRi (SISCOM), to evaluate the involvement or not of the temporal pole in the seizures. All patients underwent preoperative evaluation, Video-EEG monitoring, and ictal and interictal SPECTs, which will be aligned to the MRi. OUTCOMES: Elucidation regarding the temporal pole involvement in the seizures of MTLE and possible assessment of the positive predictive value of the SISCOM in predicting the good or bad surgical results.