ICTAL AND INTERICTAL SPECT IN A NEWBORN-INFANT WITH INTRACTABLE SEIZURE

Neonatal seizures can be difficult to classify according to partial vs generalized onset based on clinical appearance, electroencephalogram (EEG) or other adjunctive imaging techniques. Single-photon emission c omputed tomography (SPECT) has proven to be useful in adults; however, its use is limited in the paediatric age group, particularly in neona tes. A case of a 12-d-old infant with intractable seizures is reported , on whom an interictal Tc-99m HMPAO SPECT showed an area of hypoperfu sion in the left temporal cortex, whereas the ictal SPECT revealed pro minent hyperperfusion in the same area. The EEG of the infant demonstr ated generalized epileptiform activity, while computed tomography and magnetic resonance (MR) imaging findings were normal. This case indica tes that the use of SPECT may provide valuable data in evaluation of n eonatal seizures, particularly with poorly localized EEG changes and n ormal MRI scans.