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The value of interictal brain SPECT in epilepsy patients without mesial-temporal sclerosis
Alan Siegel1, Petra Lewis, Adrian M Siegel
1Department of Radiology, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. alan.h.siegel@hitchcock.org
Purpose:
Most of the literature concerning interictal SPECT brain scanning in patients with seizures has involved the evaluation of those with temporal lobe epilepsy. The authors' aim was to determine the utility of interictal SPECT in patients with neocortical epilepsy.
Materials And Methods:
Eighty-four patients with neocortical epilepsy were evaluated with 95 interictal SPECT scans and magnetic resonance imaging (MRI).
Results:
Fifty-four percent of studies with normal MRI findings had SPECT images without regions of hypoperfusion. Sixty-one percent of patients with abnormal MRI results had matching defects visible on SPECT images. Fourteen scans (only 24%) had focal hypoperfusion by SPECT and no obvious matching MRI finding.
Conclusions:
Interictal SPECT, without a comparison ictal study, is of potentially limited value in localizing neocortical seizure foci. SPECT findings usually match MRI findings. Interictal SPECT, however, may still be of value in confirming abnormalities detected by ictal examination.