PARTIAL EPILEPTIC SEIZURE WITH VERSIVE MOVEMENTS EXAMINED BY [TC-99M]HM-PAO BRAIN SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY - AN EARLY POSTICTAL CASE-STUDY ANALYZED BY COMPUTERIZED BRAIN ATLAS METHODS

The consecutive steps of a seizure with leftward versive movements of the head and eyes were analyzed after video monitoring and correlated with findings on single photon emission computed tomography (SPECT) us ing [Tc-99m]hexamethyl propylene amine oxime (HM-PAO). Evaluation incl uded reconstruction of subtraction images from the early postictal sta te, obtained immediately after the video-monitored seizure, and the in terictal baseline. Based on normalized perfusion indexes within voxels of Talairach space, we concluded that the primary epileptogenic focus was in the premotor cortex of the contralateral hemisphere. We then p laced the functional data in an anatomic context by adapting a dedicat ed computerized brain atlas (CBA) to the patient's brain with the aid of magnetic resonance imaging (MRI) slices, By inverse transformation, the patient's data were aligned with the standard geometry of the bra in atlas for comparison purposes with data from the literature. The va lidated activation field projected exactly onto the right precentral s ulcus with the anterior border zone including the right frontal eye fi eld.