title: The usefulness of subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome.
abstract: The recent findings on subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome were summarized and its availability for presurgical evaluation was discussed. The subtraction ictal SPECT study in patients with West syndrome demonstrated the cortical epileptic region and subcortical involvement, which may consist of epilepsy networks related to the spasms. Moreover, subtraction ictal SPECT may have predictive power for short-term seizure outcome. Patients with a symmetric hyperperfusion pattern are predicted to have a better seizure outcome, whereas patients with asymmetric hyperperfusion pattern may develop poor seizure control. Importantly, asymmetric MRI findings had no predictive power for seizure outcome. Multichannel near-infrared spectroscopic topography applied to the patients with West syndrome detected an increase in regional cerebral blood volume in multiple areas which were activated either simultaneously or sequentially during spasms. Topographic changes in cerebral blood volume were closely correlated with spasm phenotype, suggesting that the cortex is involved in the generation of spasms. In conclusion, subtraction ictal SPECT may be considered as a useful tool for presurgical evaluation of patients with West syndrome and investigation of the pathophysiology of spasms. The ictal near-infrared spectroscopic topography should be more investigated to see if this is useful tool for presurgical evaluation.
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai 980-8574, Japan; Department of Pediatric Neurology, Takuto Rehabilitation Center for Children, Sendai 982-0241, Japan. Electronic address: khaginoya@kha.biglobe.ne.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Haginoya
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Uematsu
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Munakata
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kakisaka
authors.forename: Atsuo
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Tojo
authors.initials: T
authors.lastname: Nakayama
authors.forename: Naomi
authors.initials: N
authors.lastname: Hino-Fukuyo
authors.forename: Rie
authors.initials: R
authors.lastname: Tsuburaya
authors.forename: Taro
authors.initials: T
authors.lastname: Kitamura
authors.forename: Ikuko
authors.initials: I
authors.lastname: Sato-Shirai
authors.forename: Yu
authors.initials: Y
authors.lastname: Abe
authors.forename: Yoko
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Wakusawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Mamiko
authors.initials: M
authors.lastname: Ishitobi
authors.forename: Noriko
authors.initials: N
authors.lastname: Togashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Nakasato
authors.forename: Kazuie
authors.initials: K
authors.lastname: Iinuma
mesh_terms: D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007223:Infant; D012039:Regional Blood Flow; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
keywords: Infantile spasms; NIRS; Near-infrared spectroscopy; SPECT; Subtraction; West syndrome