Comparison of modern diagnostic methods in children with intractable focal epilepsy

The basic aim of neuroimaging in children with intractable focal epilepsy is stablishing localization of epileptogenic zone. In this study 34 children (age 11-17 years) with intractable focal epilepsy were examined including: clinical history, physical examination, EEG, CT, MR, 99mTc-HMPAO SPECT. The hypoperfused region in interictal SPECT was concordant with clinical seizure characteristics in 22 children, with EEG in 13, with MR with 13 children. The localization of hyperperfused region in ictal SPECT was concordant with the clinical seizure characteristics in 9 from 10 examined children, with EEG in 7 and with MR in 8. The diagnostic value of estimation of the localization of epileptogenic zone in interictal SPECT (63 per cent) was comparable with the results of EEG (56 per cent) and MR (59 per cent), but ictal SPECT offers more information (100 per cent). In conclusion, performing both ictal and interictal SPECT studies may provide data about both seizure origin and its relationship with structurally abnormal regions of the brain.