Ictal SPECT hyperperfusion reflects the activation of the symptomatogenic cortex in spontaneous and electrically-induced non-habitual focal epilepticseizures: correlation with subdural EEG recordings

We report a patient with left temporal lobe epilepsy and a left parietal an gioma, in whom ictal SPECT showed hyperperfusion in a spontaneous and an el ectrically-induced, non-habitual focal seizure. A SPECT investigation durin g an habitual seizure originating in the left temporal robe showed a left t emporal hyperperfusion. Electrical stimulation of the parietal cortex adjac ent to the location of a previously resected angioma using subdural electro des resulted in a non-habitual seizure beginning with a unilateral somatose nsory aura. Ictal SPECT of this seizure demonstrated contralateral central hyperperfusion. We conclude from our findings that ictal SPECT hyperperfusi on reflects the activation of symptomatogenic cortex, which can be induced by both epileptic discharge and electrical stimulation.