Reexamination of 123I-IMP-SPECT at interictal stages in adult partial epilepsy |
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Authors: | I Jibiki T Kubota K Fujimoto N Yamaguchi H Matsuda S Tsuji K Hisada |
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Affiliation: | Department of Neuropsychiatry, Kanazawa University School of Medicine, Japan. |
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Abstract: | 123I-IMP-SPECT scans at the interictal stages in 13 epileptic patients with normal X-ray CT findings were reexamined at intervals of 1.9 +/- 0.8 years. Interictal scalp EEGs were recorded a few hours after each SPECT scan. All of the SPECT abnormalities indicated focal hypofixation images of 123I-IMP, i.e. zones of a decreased rCBF reflecting a functional inactivation. Among 11 patients with the SPECT abnormalities in the first SPECTs, eight cases had the complete or partial regional reproduction of the abnormalities in the second SPECTs. As changes in the SPECT findings, an alteration from the abnormal SPECT images to normal images (normalization), the reverse change, the enlargement and reduction of hypofixation sites were seen. Also the EEG foci had various changes (right and left regional changes, etc.). Because of these SPECT and EEG changes, the regional relationship between the SPECT abnormalities and EEG foci altered in 7 patients (a change from disagreement to agreement, etc.). The high reproduction rate of SPECT abnormalities appears to increase the reliability or utility of SPECT scans for a regional diagnosis of epileptic foci. The present SPECT changes, especially the normalization or the severse change, suggest that the interictal epileptic focus may have a functional fluctuation. In addition, the causes of regional disagreement between the SPECT abnormalities and EEG foci were discussed on the basis of the present SPECT and EEG changes. |
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