Single photon emission computed tomography in seizure disorders.

Area of Science:

• Neurology
• Nuclear Medicine
• Pediatrics

Background:

• Pediatric seizure disorders often require advanced neuroimaging to identify underlying causes.
• Cerebral blood flow (CBF) abnormalities can be indicative of epileptogenic foci.
• Single photon emission computed tomography (SPECT) is a valuable tool for assessing regional CBF.

Purpose of the Study:

• To evaluate the utility of 123I iodoamphetamine SPECT in characterizing cerebral blood flow in children with various seizure disorders.
• To correlate SPECT findings with radiological findings and clinical status in pediatric epilepsy patients.

Main Methods:

• Fourteen children with diverse seizure disorders underwent SPECT imaging.
• A cerebral blood flow tracer, 123I iodoamphetamine, was administered at a dose of 0.05 mCi/kg.
• SPECT scans were analyzed for perfusion abnormalities and compared with computed tomography (CT) findings.

Main Results:

• SPECT revealed abnormalities in children with both normal and abnormal CT scans.
• Abnormalities included focal hypoperfusion, diffuse hemispheric hypoperfusion, multifocal/bilateral hypoperfusion, and focal hyperperfusion.
• Focal lesions on SPECT were associated with tonic-clonic seizures, suggesting secondary generalization.
• Extensive SPECT impairment correlated with poor intellectual and seizure control outcomes.
• Normal SPECT findings were linked to infrequent seizures and normal neurodevelopment.

Conclusions:

• 123I iodoamphetamine SPECT is a sensitive imaging modality for detecting cerebral blood flow alterations in pediatric seizure disorders.
• SPECT findings provide prognostic information regarding intellectual development and seizure control.
• SPECT can identify lesions not evident on CT, aiding in the etiological diagnosis of pediatric epilepsy.