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HIPDM-SPECT Brain Imaging in the Presurgical Evaluation of Patients with Intractable Seizures

Department of Neurology, EEG Section, Department of Nuclear Medicine, and Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana

Correspondence: For reprints contact: Wayne Shen, MD, EEG Lab, Riley Hospital, A599N, 702 Bamhill Dr., Indianapolis, IN 46202-5200.

ABSTRACT

We report the results of interictal and ictal HIPDM-SPECT brain imaging in 34 patients who eventually underwent temporal lobectomy for treatment of medically intractable complex partial seizures. Interictal studies revealed decreased regional cerebral perfusion (rCP) in the temporal lobe corresponding to the eventual site of surgery in 73% of the patients. Similarly, ictal study demonstrated increased rCP in 93% of the patients. In 69% of the patients, the SPECT studies were able to demonstrate both increased rCP on the ictal scan and decreased rCP on the interictal scan in the same location, corresponding to the eventual site of surgery. These results suggest that interictal and ictal SPECT brain imaging can be easily obtained and provide reliable localizing information in the presurgical evaluation of patients with medically intractable epilepsy.

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