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Interictal brain 99m Tc‐HM‐PAO SPECT hypoperfusion in patients with unstable partial epilepsy and normal CT
Author(s) -
Launes J.,
Livanainen M.,
Salmi T.,
Nikkinen P.,
Lindroth L.,
Liewendahl K.
Publication year - 1992
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1992.tb05486.x
Subject(s) - ictal , epilepsy , partial epilepsy , medicine , nuclear medicine , perfusion , electroencephalography , perfusion scanning , psychiatry
Brain perfusion was studied interictally with 99m Tc‐HM‐PAO SPECT in 47 adult patients with partial epilepsy and normal brain CT. Epilepsy was classified as secondarily generalized in 24 patients, as complex partial in 17 patients and as simple partial in 6 patients. In 24 patients good seizure control was not achieved as these patients had a median number of 78 seizures during the preceeding month, while in the rest of the patients seizure controll was relatively good (less than 6 seizures during preceeding month). Local brain hypoperfusion was observed in 41 or 87% of the patients. Hypoperfusion was located close to the EEG foci in 76% and equally often with temporal and frontal foci. Hypoperfusion and the EEG focus were located on the same side in 83%. Hypoperfusion was more frequent in secondarily generalized epilepsy and simple partial epilepsy than in complex partial epilepsy. Left‐sided hypoperfusion was especially associated with complex partial epilepsy. It is likely that the significant epileptogenic brain area was revealed in patients with SPECT focus and EEG focus in the same brain area. In one of our patients MRI showed a small temporal lesion which on successful removal was identified as a low‐grade oligodendroglioma. Abnormalities of regional brain uptake of HM‐PAO demonstrated by SPECT in patients with partial epilepsy and normal brain CT give further information about pathophysiology in partial epilepsy; this may be of use both for selecting appropriate therapy and in presurgical localization of foci.