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Related Experiment Videos

SPECT changes and their correlation with EEG changes in tuberculous meningitis.

J Kalita1, U K Misra, B K Das

  • 1Department of Neurology, Sanjay Gandhi PGIMS, Lucknow. jkalita@sgpgi.ac.in

Electromyography and Clinical Neurophysiology
|February 20, 2002
PubMed
Summary

Single photon emission computed tomography (SPECT) detects more abnormalities than electroencephalography (EEG) in tuberculous meningitis (TBM). SPECT findings of hypoperfusion correlate with specific EEG changes, aiding in TBM diagnosis.

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Area of Science:

  • Neurology
  • Nuclear Medicine
  • Infectious Diseases

Background:

  • Tuberculous meningitis (TBM) can cause altered cerebral blood flow due to vasculitis, hydrocephalus, and increased intracranial pressure.
  • Electroencephalography (EEG) assesses brain electrical activity, while single photon emission computed tomography (SPECT) evaluates regional cerebral blood flow.
  • Correlating EEG and SPECT findings can offer insights into the pathophysiology of TBM.

Purpose of the Study:

  • To investigate the correlation between EEG and SPECT findings in patients diagnosed with tuberculous meningitis.
  • To determine the sensitivity of EEG and SPECT in detecting abnormalities associated with TBM.

Main Methods:

  • Sixteen patients with TBM (stages I-III) underwent clinical evaluation, radiological imaging (CT/MRI), EEG, and 99mTc-ECD SPECT.

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  • Clinical data included age, sex, and presence of hydrocephalus, infarction, or tuberculoma.
  • SPECT assessed regional cerebral blood flow, focusing on basal ganglia and cortical areas.

    • Main Results:

    • SPECT revealed abnormalities in 14 out of 16 patients, primarily basal ganglionic hypoperfusion (14 patients) and focal cortical hypoperfusion (9 patients).
    • EEG abnormalities were observed in 11 patients, including delta slowing, theta slowing, frontal intermittent rhythmic delta activity (FIRDA), and epileptiform discharges.
    • While most patients with abnormal EEG also had abnormal SPECT, 4 patients had normal EEG despite subcortical hypoperfusion on SPECT.

    Conclusions:

    • SPECT demonstrates a higher frequency of abnormalities compared to EEG and CT scans in TBM.
    • Cortical hypoperfusion, with or without basal ganglia hypoperfusion, is associated with specific EEG patterns like FIRDA and diffuse delta slowing.