Technetium-99m-HMPAO brain SPECT in medically intractable temporal lobe epilepsy: a postoperative evaluation.
The aim of the present study was to evaluate the predictive value of interictal single-photon emission computed tomography (SPECT) using technetium-99m-labeled hexamethyl propyleneamine oxime (HMPAO) for the outcome after temporal lobectomy in patients with complex partial seizures. Out of 40 patients, 21 underwent right-sided and 19 left-sided temporal lobectomy. EEG and CT/MRI were primarily used to select the side of surgery. SPECT results correlated with temporal lobectomy in 68% of the patients. After surgical intervention, memory function was tested for both sides. Following left-sided temporal lobectomy, verbal memory was impaired in 8% of the patients, if SPECT agreed with the side selected for surgery, but in 83%, if it diverged from it. In the present study, there was no relationship between SPECT concordance with the side of temporal lobectomy and outcome as to seizure frequency and non-verbal memory. We conclude that preoperative interictal HMPAO/SPECT can contribute to the prediction of postoperative verbal memory function and that this method should be considered for use prior to temporal lobectomy.
Grünwald
F
F
Department of Nuclear Medicine, University of Bonn, Federal Republic of Germany.
Durwen
H F
HF
Bockisch
A
A
Hotze
A
A
Kersjes
W
W
Elger
C E
CE
Biersack
H J
HJ
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery; D002648:Child; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005260:Female; D005911:Gliosis / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011379:Prognosis; D019690:Technetium Tc 99m Exametazime; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime