title: Cerebral perfusion SPECT imaging in epileptic and nonepileptic seizures.
abstract: Patients with epileptic and nonepileptic seizures are commonly encountered in clinical practice, and they can pose a difficult diagnostic problem. We present two cases that show the difficult task of differentiating between true epileptic and nonepileptic or psychogenic seizures in some patients. The clinical presentations were complex and the use of video-monitored EEG alone was insufficient to make definitive diagnoses. Ictal and interictal Tc-99m HMPAO brain perfusion SPECT imaging examinations were used to help establish the correct diagnoses. This report describes the advantage of using the brain perfusion SPECT imaging examination. The injection of stabilized Tc-99m HMPAO during an ictal event followed by appropriate medical therapy provides a method of obtaining a reasonable image of relative perfusion (activity) during the seizure. These images can then be compared with interictal examinations and an epileptic or nonepileptic focus may be localized. The Tc-99m HMPAO brain perfusion SPECT imaging study was helpful in establishing the correct diagnosis in both cases.
authors.affiliation: Section of Nuclear Medicine, University of Illinois College of Medicine, Chicago, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Blend
authors.forename: O A
authors.initials: OA
authors.lastname: de León
authors.forename: T H
authors.initials: TH
authors.lastname: Jobe
authors.forename: Q
authors.initials: Q
authors.lastname: Lin
authors.forename: J J
authors.initials: JJ
authors.lastname: Sychra
authors.forename: M
authors.initials: M
authors.lastname: Gaviria
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging* / Q000187:drug effects; D002560:Cerebrovascular Circulation; D003700:Delta Rhythm; D003863:Depression / Q000150:complications; D003937:Diagnosis, Differential; D003975:Diazepam / Q000627:therapeutic use; D004569:Electroencephalography; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D017029:Epilepsy, Complex Partial / Q000000981:diagnostic imaging; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D015609:Organotechnetium Compounds; D010091:Oximes; D011602:Psychophysiologic Disorders / Q000150:complications; D019275:Radiopharmaceuticals; D012640:Seizures / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013382:Subtraction Technique; D019690:Technetium Tc 99m Exametazime; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014741:Video Recording
chemical_list: D000927:Anticonvulsants; D015609:Organotechnetium Compounds; D010091:Oximes; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D003975:Diazepam