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Seizures are the presenting symptom in about 20% to 40% of patients with brain tumors and occur in about half of them during the course of the disease. Mixed gliomas, oligodendrogliomas and astrocytomas are most frequently associated with epilepsy. In patients with postoperative seizures neuroimaging should be performed to exclude tumor recurrence. We reported a case of 56-years old female admitted to our hospital with clinical signs of increased postoperative partial seizures activity and mild focal deficit. Medical history revealed that patient became symptomatic by brain tumor with sudden onset of generalized tonic-clonic seizure sixteen years ago. A low-grade astrocytoma was verified histologically after surgery. Ten years later the patient experienced right-sided partial motor and sensory seizures. Antiepileptic therapy was initiated and temporary good control of epilepsy was achieved. Current EEG findings showed left frontotemporal focus of epileptic activity. On contrast-enhanced CT scans no recurrent tumor mass was visualized. Brain SPECT images demonstrated no Tc-99m MIBI uptake. Despite the clinical presentation of refractory partial seizures, tumor recurrence was not detected. Based on the literature analysis and our own data, different etiological mechanisms underlying tumor-associated epilepsy were discussed.

Tc-99m MIBI SPECT AND CT NEUROIMAGING IN PATIENT WITH TUMOR-ASSOCIATED POSTOPERATIVE REFRACTORY SEIZURES: IS IT A TUMOR RELAPSE