ICTAL TC-99M-HMPAO SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY IN CHILDREN WITH TEMPORAL-LOBE EPILEPSY

Seventeen ictal Tc-99m-HMPAO single photon emission computed tomograph y (SPECT) studies were performed in 15 children with temporal lobe epi lepsy (TLE) aged 7-14 years (mean 10.3 years). Ictal SPECT was informa tive in 16 of 17 (94%) studies in 14 of 15 (93%) children, showing uni lateral temporal lobe hyperperfusion. In all 16 informative ictal SPEC T studies, lateralization was concordant with ictal EEG, magnetic reso nance imaging (MRI), and pathology. In 4 children, ictal SPECT provide d additional localizing information that was not apparent from concurr ent ictal EEG recording. Blinded interpretation of ictal SPECT studies hy two independent investigators showed correct lateralization of the epileptic focus in every child. Results of visual analysis of ictal S PECT images were corroborated by quantitative analysis. Although inter ictal SPECT studies showed a degree of temporal lobe hypoperfusion in all children, in 9 of 15 hypoperfusion was either minimal, bilateral, contralateral, or associated with extratemporal hypoperfusion. In chil dren with TLE, ictal SPECT provides reliable lateralizing information to corroborate or supplement that obtained from surface EEG and MRI.