The pathophysiology of MRI-negative temporal lobe epilepsy is not well understood. Here, we used a surface-based approach for investigating metabolic changes in the subregions of mesiotemporal structures for MRI-negative TLE patients. We found significant hypometabolism in the anterior to the intermediate hippocampus, the intermediate entorhinal cortex and the centro-medial and laterobasal amygdala. In patients with poor outcome, metabolism tended to be more interhemispherically symmetric in all three regions compared to those with good outcome, which suggests a more complicated seizure origin in this subtype of the disorder.
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