Cerebral Perfusion SPECT Imaging in Epileptic and Nonepileptic Seizures

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. Th...

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Bibliographic Details
Published in:Clinical nuclear medicine 1997-06, Vol.22 (6), p.363-368
Main Authors: BLEND, MICHAEL J, DE LEóN, OVIDIO A, JOBE, THOMAS H, LIN, QING, SYCHRA, JERRY J, GAVIRIA, MOISÉS
Format: Article
Language:English
Subjects:
Adult
Anticonvulsants - therapeutic use
Biological and medical sciences
Brain - diagnostic imaging
Brain - drug effects
Cerebrovascular Circulation
Delta Rhythm
Depression - complications
Diagnosis, Differential
Diazepam - therapeutic use
Electroencephalography
Epilepsy - diagnostic imaging
Epilepsy - drug therapy
Epilepsy - physiopathology
Epilepsy, Complex Partial - diagnostic imaging
Female
Frontal Lobe - diagnostic imaging
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Image Enhancement - methods
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Nervous system
Nervous system (semeiology, syndromes)
Neurology
Organotechnetium Compounds
Oximes
Psychophysiologic Disorders - complications
Radionuclide investigations
Radiopharmaceuticals
Seizures - diagnostic imaging
Seizures - drug therapy
Seizures - etiology
Seizures - physiopathology
Subtraction Technique
Technetium Tc 99m Exametazime
Temporal Lobe - diagnostic imaging
Tomography, Emission-Computed, Single-Photon - methods
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Summary: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 ethod 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.
ISSN:0363-9762
1536-0229
DOI:10.1097/00003072-199706000-00003