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Brain SPECT Imaging for Laminar Heterotopia

Division of Radiology and Department of Psychiatry, National Center Hospital for Mental, Nervous and Muscular Disorders, NCNP
Department of Neuroradiology, Tokyo Metropolitan Hospital for Nervous Diseases, Tokyo, Japan

Correspondence: For correspondence or reprints contact: Hiroshi Matsuda, MD, Division of Radiology, National Center Hospital for Mental, Nervous and Muscular Disorders, NCNP, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187, Japan.

ABSTRACT

Brain perfusion SPECT was performed in an epileptic patient with a rare form of diffuse subcortical laminar heterotopia using ^99mTc-HMPAO. MRI demonstrated generalized laminar heterotopia underlying the cortical mantle. Interictal SPECT imaging revealed identical or increased perfusion of the laminar heterotopia as compared with that of the overlying cortical mantle. Moreover, SPECT revealed low perfusion in the left temporal lobe that agreed with the seizure type of complex partial seizures and the EEG finding of frequent generalized spike-wave complexes with a slight left-sided dominance. Brain SPECT imaging may be useful for appropriate diagnosis of gray matter heterotopia and for detection of functionally focal abnormality associated with epilepsy.

Key Words: SPECT • ^99mTc-HMPAO • epilepsy • heterotopia

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