Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10335
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dc.contributor.authorNewton, Mark Ren
dc.contributor.authorBerkovic, Samuel Fen
dc.contributor.authorAustin, M Cen
dc.contributor.authorReutens, David Cen
dc.contributor.authorMcKay, W Jen
dc.contributor.authorBladin, Peter Fen
dc.date.accessioned2015-05-15T23:45:23Z
dc.date.available2015-05-15T23:45:23Z
dc.date.issued1992-02-01en
dc.identifier.citationNeurology; 42(2): 371-7en
dc.identifier.govdoc1736168en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/10335en
dc.description.abstractWe analyzed the lateralizing value of ictal dystonia and head-turning in temporal lobe epilepsy, and sought the biologic basis of these clinical signs by studying the regional changes in perfusion with ictal single-photon emission computed tomography (SPECT). We identified unilateral temporal lobe epilepsy in 40 of 42 patients undergoing evaluation for temporal lobe surgery, and with ictal SPECT all 40 showed striking hyperperfusion of the epileptogenic temporal lobe. Twenty-five of the 40 patients showed unilateral or predominantly unilateral upper limb dystonia, which was opposite the epileptic temporal lobe in all cases. Analysis of regional count ratios in cases with ictal dystonia, compared with those without, showed significant changes only in the basal ganglia. Specifically, we found that ictal dystonia was associated with a relative increase in perfusion of the basal ganglia opposite the dystonic limb. Although we found 26 cases with head-turning, the sign was of no lateralizing value, even when only those with major or "tonic" versions (n = 11) were analyzed. Slight increases in cortical blood flow on the side opposite the direction of version were associated with head-turning, irrespective of the side of seizure focus. In clinical practice, ictal SPECT is a highly accurate aid in the lateralization of temporal lobe foci, in addition to providing a new method to investigate the pathophysiology of clinical signs in focal seizures.en
dc.language.isoenen
dc.subject.otherAdolescenten
dc.subject.otherAdulten
dc.subject.otherAgeden
dc.subject.otherCerebrovascular Circulation.physiologyen
dc.subject.otherDystonia.etiology.physiopathology.radionuclide imagingen
dc.subject.otherElectroencephalographyen
dc.subject.otherEpilepsy, Temporal Lobe.complications.physiopathology.radionuclide imagingen
dc.subject.otherFemaleen
dc.subject.otherFunctional Lateralityen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherTemporal Lobe.blood supply.physiopathology.radionuclide imagingen
dc.subject.otherTomography, Emission-Computed, Single-Photonen
dc.titleDystonia, clinical lateralization, and regional blood flow changes in temporal lobe seizures.en
dc.typeJournal Articleen
dc.identifier.journaltitleNeurologyen
dc.identifier.affiliationDepartment of Neurology, Austin Hospital, Melbourne, Victoria, Australiaen
dc.description.pages371-7en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/1736168en
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