Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10335
Title: Dystonia, clinical lateralization, and regional blood flow changes in temporal lobe seizures.
Authors: Newton, Mark R;Berkovic, Samuel F;Austin, M C;Reutens, David C;McKay, W J;Bladin, Peter F
Affiliation: Department of Neurology, Austin Hospital, Melbourne, Victoria, Australia.
Issue Date: 1-Feb-1992
Citation: Neurology; 42(2): 371-7
Abstract: We 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.
Internal ID Number: 1736168
URI: http://ahro.austin.org.au/austinjspui/handle/1/10335
URL: http://www.ncbi.nlm.nih.gov/pubmed/1736168
Type: Journal Article
Subjects: Adolescent
Adult
Aged
Cerebrovascular Circulation.physiology
Dystonia.etiology.physiopathology.radionuclide imaging
Electroencephalography
Epilepsy, Temporal Lobe.complications.physiopathology.radionuclide imaging
Female
Functional Laterality
Humans
Male
Middle Aged
Temporal Lobe.blood supply.physiopathology.radionuclide imaging
Tomography, Emission-Computed, Single-Photon
Appears in Collections:Journal articles

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