Status Gelasticus after Temporal Lobectomy: Ictal FDG‐PET Findings and the Question of Dual Pathology Involving Hypothalamic Hamartomas

Purpose: To present the first ictal fluorodeoxyglucose–positron emission tomography (FDG‐PET) evidence of the hypothalamic origin of gelastic seizures in a patient with a hypothalamic hamartoma (HH) and to raise the issue of true dual pathology related to this entity. Methods: Ictal FDG‐PET was acqu...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2005-08, Vol.46 (8), p.1313-1316
Main Authors: Palmini, Andre, Van Paesschen, Wim, Dupont, Patrick, Van Laere, Koen, Van Driel, Guido
Format: Article
Language:English
Subjects:
Adult
Anterior Temporal Lobectomy
Anticonvulsants. Antiepileptics. Antiparkinson agents
Arachnoid Cysts - epidemiology
Arachnoid Cysts - surgery
Biological and medical sciences
Comorbidity
Dual pathology
Epilepsies, Partial - diagnostic imaging
Epilepsies, Partial - etiology
Epilepsy, Complex Partial - surgery
Epilepsy, Temporal Lobe - epidemiology
Epilepsy, Temporal Lobe - pathology
Epilepsy, Temporal Lobe - surgery
Fluorodeoxyglucose F18
Hamartoma - diagnostic imaging
Hamartoma - epidemiology
Hamartoma - pathology
Hamartoma - surgery
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Hypothalamic Diseases - epidemiology
Hypothalamic Diseases - pathology
Hypothalamic Diseases - surgery
Hypothalamic hamartoma
Ictal FDG‐PET
Magnetic Resonance Imaging
Male
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Neuropharmacology
Neuroprotective agent
Pharmacology. Drug treatments
Positron-Emission Tomography
Postoperative Complications - diagnostic imaging
Postoperative Complications - etiology
Status gelasticus
Temporal Lobe - diagnostic imaging
Temporal Lobe - pathology
Temporal lobe epilepsy
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
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Summary:Purpose: To present the first ictal fluorodeoxyglucose–positron emission tomography (FDG‐PET) evidence of the hypothalamic origin of gelastic seizures in a patient with a hypothalamic hamartoma (HH) and to raise the issue of true dual pathology related to this entity. Methods: Ictal FDG‐PET was acquired during an episode of status gelasticus with preserved consciousness, in a patient previously operated on for complex partial seizures (CPSs) due to a temporal lobe epileptogenic cyst. Results: Ictal hypermetabolism was localized to the region of the HH during the status gelasticus. CPSs had been completely eliminated after temporal lobe surgery. Conclusions: Ictal FDG‐PET independently confirmed that gelastic seizures in patients with HH do originate in the diencephalic lesion. An HH may coexist with another epileptogenic lesion, in a context of dual pathology.
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1528-1167.2005.52804.x