Journal of Neurology

, Volume 246, Issue 10, pp 926–933

Bilateral reductions of hippocampal volume, glucose metabolism, and Wada hemispheric memory performance are related to the duration of mesial temporal lobe epilepsy

  • H. Jokeit
  • Alois Ebner
  • Stefan Arnold
  • Michael Schüller
  • Christine Antke
  • Yanxiong Huang
  • Helmut Steinmetz
  • Rüdiger J. Seitz
  • Otto W. Witte
Original communication

DOI: 10.1007/s004150050484

Cite this article as:
Jokeit, H., Ebner, A., Arnold, S. et al. J Neurol (1999) 246: 926. doi:10.1007/s004150050484

Abstract

In refractory temporal lobe epilepsy (TLE) temporal lobe structures and functions are continuously or intermittently affected by abnormal brain electrical events, noxious neurochemical agents, and metabolic disturbances. There is conflicting evidence regarding the relationship between the duration of refractory mesial TLE and quantitative measures of temporal lobe functions and volumes of the hippocampi. Twenty patients (aged 28 ± 7 years, 14 males) with an initial precipitating injury before the age of 5 years were subjected to high-resolution magnetic resonance imaging, fluoro-2-deoxy-d-glucose positron-emission tomography (PET), and the Wada test. We investigated whether the duration of unilateral refractory TLE (12 left, 8 right) affects hippocampal volume, glucose metabolism, or Wada hemispheric memory performance. Ipsilateral to the epileptogenic zone the hippocampal volume, metabolism, and Wada hemispheric memory performance were reduced compared to the corresponding contralateral measures. The duration of epilepsy controlled for age at investigation, side of seizure origin, underlying cause, and sex were negatively correlated with ipsi- and contralateral hippocampal volume, hippocampal metabolism, and Wada hemispheric memory performance. Moreover, ipsilateral Wada hemispheric memory performance and contralateral hippocampal glucose metabolism were correlated with the frequency of habitual seizures. Refractory TLE seems to be associated with a slow but ongoing bilateral temporal lobe damage. These cross-sectional results require verification by longitudinal studies carried out over a period of more than two decades.

Key words Temporal lobe epilepsy Hippocampus Magnetic resonance imaging Fluoro-2-deoxy-d-glucose positron-emission tomography Wada test 

Copyright information

© Steinkopff Verlag 1999

Authors and Affiliations

  • H. Jokeit
    • 1
  • Alois Ebner
    • 1
  • Stefan Arnold
    • 1
  • Michael Schüller
    • 1
  • Christine Antke
    • 2
  • Yanxiong Huang
    • 2
  • Helmut Steinmetz
    • 2
  • Rüdiger J. Seitz
    • 2
  • Otto W. Witte
    • 2
  1. 1.Bethel Epilepsy Center, Clinic Mara I, Epilepsy Surgery Program, Maraweg 21, D-33617 Bielefeld, Germany e-mail: jkt@mara.de, Tel.: +49-521-1443831, Fax: +49-521-1443553DE
  2. 2.Department of Neurology, University of Düsseldorf, D-40225 Düsseldorf, GermanyDE

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