SPECT in refractory childhood epilepsy: what for?

Special problems are adressed when performing and interpretating SPECT in c hildren: sedation? may be necessary and images are changing with cerebral m aturation. Brit SPECT does take place among the presurgical investigations of refractory epilepsies at this age. Ictal SPECT and comparison between ic tal and interictal images contribute to localize the epileptogenic focus in temporal as well as in extratemporal epilepsy, together with EEG recording s. SPECT can also diagnose partial epilepsy in apparently generalized featu res. SPECT is sometimes more accurate than MR! to detect cerebral lesions, particularly in infants when myelin is still immature. The comparison betwe en SPECT and neuropsychology may shed light on some cognitifs disorders ass ociated with epilepsy. SPECT is also able to study the functional value of the remaining brain in order to improve postsurgical outcome.