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Transient seizure activity demonstrated by Tc-99m HMPAO SPECT and diffusion-weighted MR imaging
1Department of Radiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Annals of Nuclear Medicine
|September 8, 2001
Summary
Transient seizure activity in a stroke patient was detected using Tc-99m HMPAO SPECT and diffusion-weighted MRI (DWI). These imaging techniques revealed temporary changes indicating seizure focus and cytotoxic edema.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Cerebral perfusion single photon emission computed tomography (SPECT) is established for epileptic focus localization.
- Diffusion-weighted MR imaging (DWI) is emerging for seizure activity evaluation.
Observation:
- A 61-year-old woman with a history of right middle cerebral artery infarction experienced a generalized seizure during MRI.
- Immediately post-seizure, DWI showed transient frontal gray and white matter hyperintensity with decreased apparent diffusion coefficients (ADC).
Findings:
- The DWI findings correlated with transient hyperperfusion on interictal Tc-99m HMPAO SPECT, identifying the epileptic focus.
- SPECT indicated delayed hyperperfusion due to neuronal overaction, while DWI suggested seizure-induced cytotoxic edema from Na/K-ATPase pump failure.
Implications:
- Transient seizure activity can induce detectable changes on both SPECT and DWI.
- Combined use of SPECT and DWI may offer insights into the pathophysiology of seizure-induced neuroimaging alterations.