Single Photon Emission Computed Tomography (SPECT) in a Patient with Bilateral Temporal Seizures: Correlation Between Ictal EEG and Postictal/Ictal SPECT

• Published in: Epilepsia (Copenhagen) Vol. 39; no. 9; pp. 1001 - 1005
• Main Authors: Setoain, F. J., Arroyo, S., Lomeñia, F., Pavía, J., Martinez, I., Fuster, D., Herranz, R., Setoain, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.1998; Blackwell
• Subjects: Adult; Biological and medical sciences; Complex partial seizures; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Electroencephalography; Epilepsy; Epilepsy, Temporal Lobe - diagnosis; Epilepsy, Temporal Lobe - diagnostic imaging; Epilepsy, Temporal Lobe - physiopathology; Female; Functional Laterality - physiology; HMPAO; Humans; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Single photon emission computed tomography; Technetium Tc 99m Exametazime; Temporal Lobe - blood supply; Temporal Lobe - diagnostic imaging; Temporal Lobe - physiopathology; Temporal lobe seizures; Tomography, Emission-Computed, Single-Photon; Radionuclide study; Human; Regional perfusion; Nervous system diseases; Correlation; Complex partial epilepsy; Bilateral; Interictus; Electroencephalography; Interpretation; Photon; Cerebral disorder; Crisis; Case study; Electrodiagnosis; Central nervous system disease; Adult; Temporal lobe epilepsy; Female; Hemodynamics; Emission tomography
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1157.1998.tb01451.x

We report a patient with bilateral independent temporal lobe seizures in whom two [99mTc]HMPAO single photon emission computed tomograph (SPECT) scans were performed during two different seizures. In the first perüctal SPECT, [99mTc]HMPAO was injected in the interval between two closely spaced seizures (one localized in the left temporal lobe and the other in the right temporal lobe). SPECT images showed hypoperfusion in the left lateral temporal lobe, hyper‐perfusion of the left mesial temporal region, and pronounced hyperperfusion in the right anterior temporal lobe. These results suggest both a postictal left temporal SPECT pattern and an ictal right temporal pattern. In the second periictal SPECT, [99mTc]HMPA was injected immediately after a right temporal lobe seizure and showed right lateral temporal lobe hypoperfusion and right mesial hyperperfusion, suggesting a postictal right temporal SPECT pattern. Interpretation of the periictal SPECT should take into account EEG changes at the time or in the minutes immediately after injection of [99mTc] HMPAO.