Ictal SPECT in nonlesional extratemporal epilepsy

Gregory D Cascino, Jeffrey R. Buchhalter, Brian P. Mullan, Elson L. So

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: Ictal single-photon emission computed tomography (SPECT) may be a reliable indicator of the ictal onset zone in patients with intractable partial epilepsy who are being considered for epilepsy surgery. The rationale for the illustrated case report is to evaluate the use of an innovation in SPECT imaging in a patient with nonlesional extratemporal epilepsy. Methods: We investigated the presurgical evaluation and operative outcome in a patient with intractable partial epilepsy. The ictal semiology indicated a "hypermotor" seizure with bipedal automatism. The electroclinical correlation and magnetic resonance imaging (MRI) did not suggest the appropriate localization of the epileptogenic zone. A subtraction periictal SPECT coregistered to MRI (SISCOM) was peformed. Results: SISCOM revealed a region of localized hyperperfusion in the right supplementary sensorimotor area. Chronic intracranial EEG monitoring confirmed the relationship between the localized SISCOM alteration and the ictal onset zone. The patient was rendered seizure free after surgical treatment. Conclusions: SISCOM may be used to identify potential candidates for surgical treatment of nonlesional extratemporal epilepsy. Periictal imaging may also alter the strategy for intracranial EEG recordings and focal cortical resection.

Original languageEnglish (US)
Pages (from-to)32-34
Number of pages3
JournalEpilepsia
Volume45
Issue numberSUPPL. 4
DOIs
StatePublished - 2004

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Single-Photon Emission-Computed Tomography
Epilepsy
Stroke
Partial Epilepsy
Seizures
Magnetic Resonance Imaging
Automatism
Therapeutics

Keywords

  • Extratemporal epilepsy
  • Periictal neuroimaging
  • SPECT

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Cascino, G. D., Buchhalter, J. R., Mullan, B. P., & So, E. L. (2004). Ictal SPECT in nonlesional extratemporal epilepsy. Epilepsia, 45(SUPPL. 4), 32-34. https://doi.org/10.1111/j.0013-9580.2004.04007.x

Ictal SPECT in nonlesional extratemporal epilepsy. / Cascino, Gregory D; Buchhalter, Jeffrey R.; Mullan, Brian P.; So, Elson L.

In: Epilepsia, Vol. 45, No. SUPPL. 4, 2004, p. 32-34.

Research output: Contribution to journalArticle

Cascino, GD, Buchhalter, JR, Mullan, BP & So, EL 2004, 'Ictal SPECT in nonlesional extratemporal epilepsy', Epilepsia, vol. 45, no. SUPPL. 4, pp. 32-34. https://doi.org/10.1111/j.0013-9580.2004.04007.x
Cascino, Gregory D ; Buchhalter, Jeffrey R. ; Mullan, Brian P. ; So, Elson L. / Ictal SPECT in nonlesional extratemporal epilepsy. In: Epilepsia. 2004 ; Vol. 45, No. SUPPL. 4. pp. 32-34.
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