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RIGHT MESIAL TEMPORAL SCLEROSIS
Authored By: Xiaoni Hong and Tom Miller.
Patient: 8 year old female
History: 8-year-old girl with intractable epilepsy.
Image Size:[small][as-submitted]

Fig. 1
Axial brain PET images

Fig. 2
Coronal brain PET images

Fig. 3
Axial brain fusion images

Fig. 4
Coronal brain fusion images
Image Size:[small][as-submitted]

Findings:

Brain PET/CT: Marked hypometabolism is noted within the anterior portion of the right temporal lobe, especially mesially. Additional hypometabolism is noted within the right thalamus. Mildly decreased metabolism bilaterally within the cerebellum may be secondary to treatment with epilepsy medications. FDG uptake within the left hemisphere is normal. 

These findings are consistent with the patient's history of right temporal lobe epilepsy.

MRI scan shows an asymmetrically smaller hippocampus on the right with some increase in signal, suggestive of mesiotemporal sclerosis (images are not available).

Diagnosis:

Right mesial temporal sclerosis correlating with the history and MRI findings.

General Discussion: This 8-year-old female has a history of refractory epilepsy. EEG reported multifocal spikes with the most frequent spikes occurring in the right anterior temporal area.

Radiopharmaceutical: 5.0 mCi F-18 Fluorodeoxyglucose i.v.

Follow-up: The patient underwent right anterior temporal lobectomy with the surgical pathologic reported as - SEVERE NEURON LOSS, CONSISTENT WITH MESIAL TEMPORAL SCLEROSIS.  The patient has been seizure-free since the operation.

Teaching point: This is a typical pattern of mesial temporal sclerosis with correlating history, imaging and pathological findings.
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Additional Details:

Case Number: 206902Owner(s): Xiaoni Hong and Tom MillerLast Updated: 12-07-2011
Anatomy: Cranium and Contents   Pathology: Other
Modality: Nuc Med, PETAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: ptnm

Case has been viewed 45 times.
Certified by Tom Miller on 04-18-2007

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