78 y.o. man with chronic seizure disorder and worsening memory loss.
18-FDG PET images demonstrate decreased cerebral metabolism in the left hippocampus and the bilateral parietal lobes. Coronal T2/Flair MR images demonstrate decreased signal and size of the left hippocampus, relative to the right.
Multiple infarcts / ischemia
Mesial temporal sclerosis
Dx: Mesial Temporal Hypometabolism (sclerosis)
Dx Confirmed by: Mesial temporal sclerosis by MR and history. Possible Alzheimer dementia suggested, not proven.
This case demonstrates how 18-FDG PET can be used for assessment of cerebral metabolism, and corresponding functional deficits. Mesial temporal sclerosis is a well-known cause of refractory seizures. The hypometabolism in the parietal lobes has also been found in patients with Alzheimer's dementia, although often the posterior temporal lobes are involved as well.
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