[Early 123I-IMP SPECT in patients with epilepsy]

Early single photon emission computed tomography (SPECT) using N-isopropyl-p-[123I]iodoamphetamine (123 I-IMP) was performed in seventy-one patients with epilepsy admitted to Kanagawa Rehabilitation Hospital from July 1987 to February 1989; epilepsy and epileptic syndrome 27, encephalitis/encephalopathy 10, clinical Reye syndrome 3, cerebro-vascular disorders 8, sequelae of head trauma 4, cerebral palsy 5, brain anomaly 4, others 10. We classified these cases according to the 1989 criteria of the International League Against Epilepsy, and compared with the findings of the SPECT studies with the EEG and CT. In idiopathic epilepsy, the SPECT findings were within normal limits. Abnormal foci on EEG were not correlated with low uptake areas on SPECT. In the symptomatic epilepsy, especially in the West and Lennox syndromes, SPECT showed a decrease in diffuse cerebral cortical blood flow during ACTH therapy. This was also seen in some cases with normal CT imaging. The results suggest that the hemodynamic pathophysiology of the brain and the indications of therapeutic effectiveness in epilepsy are shown more accurately by SPECT than CT.