Technetium-99m HM-PAO brain SPECT in epileptic patients before and during unilateral hemispheric anesthesia (Wada test): report of three cases.
The lipophilic brain SPECT agent [99mTc]hexamethyl propylene amine oxime (HM-PAO) was used in three cases before and during unilateral anesthesia of one hemisphere for lateralization of speech dominance (Wada test). This procedure led to a decrease of regional cerebral blood flow (rCBF) in each of the hemispheres to 55 and 90%, respectively. Diminution of rCBF was significantly more pronounced in the dominant hemisphere. A second phenomenon observed during the Wada test was crossed cerebellar diaschisis. These findings support the assumption that HM-PAO allows monitoring of brain perfusion, as rapid changes of rCBF due to decreased neuronal activity cause respective alterations of cerebral and cerebellar uptake of this new brain agent.
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D004292:Dominance, Cerebral / Q000502:physiology*; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009942:Organometallic Compounds; D010091:Oximes; D013667:Technetium; D019690:Technetium Tc 99m Exametazime; D014055:Tomography, Emission-Computed
D009942:Organometallic Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D013667:Technetium