NEURONAL MIGRATIONAL DISORDERS IN CHILDREN WITH EPILEPSY - MRI, INTERICTAL SPECT AND EEG COMPARISONS

Single-photon emission computed tomography (SPECT) is being increasing ly used in the investigation of children with epilepsy and may provide insights into congenital malformations, We analyzed the interictal Tc -99-HMPAO-SPECT in a series of seven children with developmental disor ders of the neocortex, each of them representing a prototype of cerebr al dysgenesis, such as lissencephaly, pachygyria, opercular dysplasia, polymicrogyria, nodular heterotopia and band heterotopia, The patient s studied were selected among 22 epileptic children with neuronal migr ational disorders (NMDs), Interictal SPECT hypoperfusion was observed in the area homologous to MRI findings in all the examined children, I n three patients low perfusion was also present in the opposite hemisp here, probably due to functional involvement or related to an underlyi ng microdysgenesis, not revealed by structural imaging, EEG features w ere in agreement with low perfusion areas, both anatomically and funct ionally, in all children, In one patient hypoperfusion area differed f rom that revealed by MRI and EEG, Ictal SPECT has been considered a us eful tool for accurately locating the epileptic focus, Nevertheless, i nterictal brain perfusion studies, together with proton magnetic reson ance spectroscopy, may play an important role in detecting anatomic su bstrate in developmental disorders of the neocortex.