Seizures in paediatric Chiari type I malformation: the role of single-photon emission computed tomography |
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Authors: | Iannetti P Spalice A De Felice Ciccoli C Bruni O Festa A Maini C L |
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Institution: | Division of Pediatric Neurology La Sapienza University, Roma, Italy. iannetti@uniroma1.it |
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Abstract: | Chiari type I malformation is one of the posterior fossa maldevelopments with which different clinical manifestations have been associated. Seizures have only recently been associated with Chiari type I malformation. This study reports on 4 children with epilepsy (2M, 2F; age range 8-15 y) diagnosed with Chiari type I malformation by brain magnetic resonance imaging (MRI), in whom no cortical structural involvement was observed. In these patients an interictal ethylcysteinate-dimer-single-photon emission computed tomographic (ECD-SPECT) study was performed to define more precisely the relationship between Chiari type I malformation and seizures. In these patients the hypoperfusion area correlated with electroencephalographic (EEG) focal abnormalities. These hypoperfusions may represent the functional aspect of a cerebral microdysgenesis; seizures and EEG epileptic anomalies may also be linked to the complex network connection between cortices and cerebellar hemispheres. A cerebellar hypoperfusion was also detected in two of the four examined patients, indicating a functional or structural involvement. CONCLUSION: Interictal SPECT scans are helpful for the clarification of seizures in patients with Chiari type I malformation. |
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Keywords: | Chiari I malformation hypoperfusion microdysgenesis seizures SPECT |
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