Single photon emission computed tomography (SPECT) brain imaging using N,N,N′‐trimethyl‐N′‐(2 hydroxy‐3‐methyl‐5– ¹²³ Iiodobenzyl)‐1,3‐propanediamine 2 HCl (HIPDM)

TLDR

HIPDM‑SPECT was performed on four patients with intractable complex partial seizures, three of whom had temporal‑lobe foci and underwent anterior temporal lobectomy. Interictal HIPDM‑SPECT showed decreased perfusion only in one patient, while ictal imaging revealed increased perfusion in all three temporal‑lobe patients, and in a fourth patient perfusion rose interictally but fell with medication, demonstrating the technique’s utility for localizing epileptogenic foci in CPS.

Abstract

HIPDM-SPECT brain imaging was performed in four patients with intractable complex partial seizures (CPS). Three patients had an epileptogenic focus in one temporal lobe and underwent anterior temporal lobectomy. Interictal HIPDM-SPECT demonstrated decreased regional cerebral perfusion (rCP) in the epileptogenic area in only one patient, but ictal studies showed increased rCP in the epileptic foci of all three patients. In the fourth patient, interictal HIPDM-SPECT showed increased rCP in the area of epileptogenic focus; when antiepileptic medication was taken, rCP decreased. HIPDM-SPECT brain imaging is useful for localizing epileptogenic foci in CPS.