The practical utility of performing peri-ictal SPECT in the evaluation of children with partial epilepsy.
Peri-ictal brain single-photon emission computed tomography (SPECT) is increasingly being established as a useful test in localizing partial epilepsy in adults. However, obtaining an ictal injection and acquiring the SPECT images poses a greater challenge in pediatric patients, and few reports have specifically addressed the practical use of this technique in children. The Mayo Clinic experience of peri-ictal SPECT in the evaluation of children with partial epilepsy is reported here. Peri-ictal SPECT was attempted during 71 admissions involving 59 patients (median age 12 years, range 1 year 6 months-17 years). A peri-ictal SPECT injection was performed on 48 (67.6%) of these admissions in 43 (72.9%) patients, and only two patients could not be scanned. Of the 46 peri-ictal images successfully obtained, 30 (65.2%) were from ictal injection and 16 (34.8%) from post-ictal injections. Forty-two (91.3%) of the successfully obtained SPECT images, in 38 patients (92.3%), were classified as localizing (15 temporal, 24 extratemporal). We conclude that, with the appropriate unit setup and well-trained staff, peri-ictal SPECT scans can be obtained in most pediatric partial epilepsy patients. Moreover, the procedure provides specific localizing information in a high proportion of these patients.
O'Brien
T J
TJ
Department of Neurology, The Mayo Clinic and Mayo Medical School, Rochester, Minnesota 55905, USA.
Zupanc
M L
ML
Mullan
B P
BP
O'Connor
M K
MK
Brinkmann
B H
BH
Cicora
K M
KM
So
E L
EL
D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D002648:Child; D002675:Child, Preschool; D004292:Dominance, Cerebral / Q000502:physiology; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017034:Epilepsy, Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon