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Related Experiment Video

Updated: Apr 29, 2026

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Ictal SPECT success rate using a single SPECT session protocol.

Zheng-Yang Lee1, Kheng-Seang Lim1, Si-Lei Fong1

  • 1Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.

Clinical Neurology and Neurosurgery
|February 4, 2025
PubMed
Summary
This summary is machine-generated.

A single ictal SPECT session during video-EEG monitoring (VEM) is a cost-effective method for localizing the epileptogenic zone. This approach is particularly successful in patients experiencing multiple seizures during VEM.

Keywords:
Epilepsy surgerySingle-photon emission computed tomography (SPECT)Video EEG monitoring (VEM)

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Area of Science:

  • Neurology
  • Nuclear Medicine
  • Epileptology

Background:

  • Ictal single-photon emission computed tomography (SPECT) aids in localizing the epileptogenic zone but is resource-intensive.
  • A novel, more affordable protocol utilizing a single SPECT radiotracer session during 48-hour video-EEG monitoring (VEM) has been developed.

Purpose of the Study:

  • To evaluate the success rate of ictal SPECT using a single SPECT session (HMPAO or ECD) within a 48-hour VEM protocol.
  • To identify predictors for successful ictal SPECT acquisition in pre-surgical epilepsy evaluation.

Main Methods:

  • Retrospective observational study of 189 epilepsy patients undergoing VEM with SPECT at University Malaya Medical Centre (2011-2024).
  • Analysis of VEM data, including seizure frequency and duration, in relation to single-session ictal SPECT acquisition.

Main Results:

  • 44 (23.3%) patients underwent single-session ictal SPECT.
  • Higher seizure frequency during VEM (p<0.001) and younger age (p<0.05) were associated with single-session ictal SPECT.
  • Multivariate analysis identified the number of seizures during VEM as a significant predictor (OR 1.073, p=0.002).
  • Patients with ≥3 seizures during VEM had a ≥30% chance of successful ictal SPECT; those with ≥6 seizures had a ≥40% chance.

Conclusions:

  • A single SPECT session during VEM is a feasible and cost-effective strategy for epileptogenic zone localization.
  • This method is particularly beneficial for patients with frequent seizures during the initial 48 hours of VEM, especially after rapid medication tapering.