Objective: In presurgical evaluation, positron emission tomography with fluorodeoxyglucose-F18 (FDG-PET) is an important tool in identifying epileptogenic area. The aim of this study was to evaluate glucose metabolism in FDG-PET in patients with temporal lobe epilepsy (TLE) showing 'switch-of lateralisation' (SL) and 'bilateral asynchrony' (BA) in ictal scalp EEG and compare their results with patients with TLE and none of these patterns.Methods: Twenty-four patients with TLE showing SL and/or BA in at least one of their seizures in video-EEG monitoring and 38 patients with TLE and without these patterns who had epilepsy surgery and a follow-up at least 5-years were included. The clinical, electrophysiological and imaging features were evaluated and a statistical comparison was performed between the groups.