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Localization of extratemporal epileptic foci during ictal single photon emission computed tomography
Author(s) -
Marks David A.,
Katz Amiram,
Hoffer Paul,
Spencer Susan S.
Publication year - 1992
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410310304
Subject(s) - ictal , single photon emission computed tomography , computed tomography , emission computed tomography , medicine , epilepsy , nuclear medicine , radiology , psychology , neuroscience , positron emission tomography
Abstract We obtained single photon emission computed tomography (SPECT) scans with technetium‐99 M ‐hexamethyl‐propylene‐amine‐oxime in 11 patients during 12 extratemporal partial seizures (9 simple partial, 3 complex partial). Ten ictal SPECT studies in 9 patients showed a focal region of hyperperfusion, which agreed with electrical seizure onset in 5 and with clinical seizure localization in 4 in whom ictal electroencephalography was not localized. Contralateral cerebellar and ipsilateral basal ganglia hyperperfusion was seen in 3 patients with a frontal lobe seizure focus. Ictal hyperperfusion was well circumscribed, unlike the diffuse hyperperfusion changes reported during temporal lobe seizures. This observation may indicate a different degree of seizure spread in temporal as opposed to extratemporal epilepsy. Because electroencephalographic localization is often elusive in extratemporal seizures, ictal SPECT may be very helpful for the localization of extratemporal foci.