Figure 3.
Examples of different patterns of postictal hypoperfusion seen on sASL. (A) Coronal T2 MRI from Patient 13 showing right mesial temporal sclerosis (arrow). Postictal ASL shows a ‘lobar’ pattern of hypoperfusion; the presumed SOZ was in the right mesial temporal lobe. (B) Interictal PET image from Patient 21 showing left temporal hypometabolism (arrow). Postictal ASL showed a ‘regional’ pattern of hypoperfusion; the presumed SOZ was in the left temporal lobe. (C) Patient 11 had a non-lesional MRI scan and independent, bilateral mesial temporal SOZs, based on intracranial VEEG monitoring. Postictal ASL from a left mesial temporal seizure showed a ‘hemispheric’ pattern of hypoperfusion on the left side of the brain.