Ictal and interictal single photon emission computed tomography in a patient with benign familial infantile...

Area of Science:

• Neurology
• Pediatric Neurology
• Epileptology

Background:

• Benign familial infantile convulsions (BFIC) is a genetic epilepsy syndrome.
• Identifying the epileptic focus is crucial for understanding and managing epilepsy, especially in infants.

Observation:

• Ictal electroencephalography (EEG) revealed bilateral, diffuse propagation originating from a left frontal lobe focus.
• Single photon emission computed tomography (SPECT) showed increased perfusion in the left frontal region during seizures (ictal) and decreased perfusion between seizures (interictal).

Findings:

• The study successfully identified a left frontal lobe epileptic focus in an infant with BFIC.
• Ictal and interictal SPECT findings correlated with EEG localization, indicating hypoperfusion at the focus during interictal periods and hyperperfusion during ictal periods.
• The epileptic foci in BFIC demonstrated similar characteristics to those found in symptomatic partial epilepsy.

Implications:

• This case highlights the utility of combined EEG and SPECT in localizing epileptic foci in infantile epilepsy syndromes.
• The findings suggest that BFIC may share pathophysiological mechanisms with symptomatic partial epilepsies, despite its genetic origin.
• Accurate focus localization can inform potential treatment strategies and prognosis in infants with epilepsy.