CORTICAL HYPOPERFUSION IN SYMPTOMATIC WEST-SYNDROME - A SPECT STUDY

Diffuse and focal changes in glucose utilization and abnormal cerebral cortical perfusion were found in West syndrome by PET and SPECT inves tigations. In this study Tc-99m-HMPAO SPECT was performed on seven pat ients with symptomatic West syndrome several months after the onset of the spasms. Regions of interest of the cerebral cortex and cerebellum were delineated by an automated computer program and cortical/cerebel lar ratios of the HMPAO uptake in the patients were compared to those of controls. The basal ganglia/cerebellar ratios were compared after m anual placement of regions of interest. Significantly reduced perfusio n was found in the bilateral anterior, mid frontal and perisylvian cor tex, and in the left posterior frontal and temporal areas. Well locali zed, focal changes in the cortical perfusion were not found and the pe rfusion in the basal ganglia proved to be normal. These abnormalities in the cortical perfusion may reflect a pre-existing brain pathology t ogether with an encephalopathy due to the hypsarrhythmia and infantile spasms. (C) 1997 Elsevier Science Ireland Ltd.