Technetium-99m-HMPAO Brain SPECT in Medically Intractable Temporal Lobe Epilepsy: A Postoperative Evaluation

• Published in: The Journal of nuclear medicine (1978) Vol. 32; no. 3; pp. 388 - 394
• Main Authors: Grunwald, Frank, Durwen, Herbert F, Bockisch, Andreas, Hotze, Andreas, Kersjes, Wilhelm, Elger, Christian E, Biersack, Hans J
• Format: Journal Article
• Language: English
• Published: Reston, VA Soc Nuclear Med 01.03.1991; Society of Nuclear Medicine
• Subjects: Adolescent; Adult; Biological and medical sciences; Brain Neoplasms - complications; Brain Neoplasms - surgery; Child; Epilepsy, Temporal Lobe - diagnostic imaging; Epilepsy, Temporal Lobe - etiology; Epilepsy, Temporal Lobe - surgery; Female; Gliosis - complications; Gliosis - surgery; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Organotechnetium Compounds; Oximes; Prognosis; Technetium Tc 99m Exametazime; Temporal Lobe - pathology; Temporal Lobe - surgery; Tomography, Emission-Computed, Single-Photon; Postoperative; Temporal lobe epilepsy; Nervous system diseases; Technetium; Radiolabelling; Radiopharmaceuticals
• ISSN: 0161-5505; 1535-5667

The aim of the present study was to evaluate the predictive value of interictal single-photon emission computed tomography (SPECT) using technetium-99m-labeled hexamethyl propyleneamine oxime (HMPAO) for the outcome after temporal lobectomy in patients with complex partial seizures. Out of 40 patients, 21 underwent right-sided and 19 left-sided temporal lobectomy. EEG and CT/MRI were primarily used to select the side of surgery. SPECT results correlated with temporal lobectomy in 68% of the patients. After surgical intervention, memory function was tested for both sides. Following left-sided temporal lobectomy, verbal memory was impaired in 8% of the patients, if SPECT agreed with the side selected for surgery, but in 83%, if it diverged from it. In the present study, there was no relationship between SPECT concordance with the side of temporal lobectomy and outcome as to seizure frequency and non-verbal memory. We conclude that preoperative interictal HMPAO/SPECT can contribute to the prediction of postoperative verbal memory function and that this method should be considered for use prior to temporal lobectomy.