title: Ictal Phase Perfusion SPECT of Nonketotic Hyperglycemia-Induced Parieto-occipital Seizure.
abstract: A 68-year-old man with diabetes mellitus type 2 presented himself with visual distortion and apraxia. Nonketotic hyperglycemic seizure with both motor and sensory components was suspected. Tc-ECD perfusion SPECT demonstrated hyperperfusion at right parieto-occipital lobe during ictal phase. Normalization of hyperperfused area was noted on follow-up perfusion SPECT after intense glucose control. In nonketotic hyperglycemic state, the depletion of GABA in cerebral neurons lowers the seizure threshold. We demonstrated that ictal phase perfusion SPECT contributed to not only diagnosis but also served as a follow-up tool.
authors.affiliation: From the Departments of *Nuclear Medicine and †Neurology, National Taiwan University Hospital, Taipei; and ‡Molecular Imaging Center, National Taiwan University, Taipei, Taiwan.
authors.forename: Chia-Ju
authors.initials: CJ
authors.lastname: Liu
authors.forename: Hsin-Hsi
authors.initials: HH
authors.lastname: Tsai
authors.forename: Kuan-Yin
authors.initials: KY
authors.lastname: Ko
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Lu
authors.forename: Ruoh-Fang
authors.initials: RF
authors.lastname: Yen
mesh_terms: D000368:Aged; D003545:Cysteine / Q000031:analogs & derivatives; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D009778:Occipital Lobe / Q000000981:diagnostic imaging; D015609:Organotechnetium Compounds; D010296:Parietal Lobe / Q000000981:diagnostic imaging; D055420:Perfusion Imaging; D019275:Radiopharmaceuticals; D012640:Seizures / Q000000981:diagnostic imaging* / Q000209:etiology; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine