Ictal Technetium-99 M Ethyl Cysteinate Dimer Single-photon Emission Tomographic Findings in Epileptic Patients with Polymicrogyria Syndromes: a Subtraction of Ictal-interictal SPECT Coregistered to MRI Study

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2007 Dec 22

PMID 18097663

Citations 6

Authors

Lauro Wichert-Ana

Paulo Mazzoncini de Azevedo-Marques

Lucas Ferrari Oliveira

Regina Maria Franca Fernandes

Tonicarlo Rodrigues Velasco

Antonio Carlos Santos

David Araujo

Mery Kato

Marino Muxfeldt Bianchin

Americo Ceiki Sakamoto

Affiliations

Soon will be listed here.

Abstract

Purpose: To describe the ictal technetium-99 m-ECD SPECT findings in polymicrogyria syndromes (PMG) during epileptic seizures.

Methods: We investigated 17 patients with PMG syndromes during presurgical workup, which included long-term video-electroencephalographic (EEG) monitoring, neurological and psychiatry assessments, invasive EEG, and the subtraction of ictal-interictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM).

Results: The analysis of the PMG cortex, using SISCOM, revealed intense hyperperfusion in the polymicrogyric lesion during epileptic seizures in all patients. Interestingly, other localizing investigations showed heterogeneous findings. Twelve patients underwent epilepsy surgery, three achieved seizure-freedom, five have worthwhile improvement, and four patients remained unchanged.

Conclusions: Our study strongly suggests the involvement of PMG in seizure generation or early propagation. Both conventional ictal single-photon emission computed tomography (SPECT) and SISCOM appeared as the single contributive exam to suggest the localization of the epileptogenic zone. Despite the limited number of resective epilepsy surgery in our study (n = 9), we found a strong prognostic role of SISCOM in predicting surgical outcome. This result may be of great value on surgical decision-making of whether or not the whole or part of the PMG lesion should be surgically resected.

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