The practical utility of performing peri-ictal spect in the evaluation of children with partial epilepsy

Terence J. O'Brien, Mary L. Zupanc, Brian P. Mullan, Michael K. O'Connor, Benjamin H. Brinkmann, Kathleen M. Cicora, Elson L. So

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Abstract

Peri-ictal brain single-photon emission computed tomography (SPECT) is increasingly being established as a useful test in localizing partial epilepsy in adults. However, obtaining an ictal injection and acquiring the SPECT images poses a greater challenge in pediatric patients, and few reports have specifically addressed the practical use of this technique in children. The Mayo Clinic experience of peri-ictal SPECT in the evaluation of children with partial epilepsy is reported here. Peri-ictal SPECT was attempted during 71 admissions involving 59 patients (median age 12 years, range 1 year 6 months-17 years). A peri-ictal SPECT injection was performed on 48 (67.6%) of these admissions in 43 (72.9%) patients, and only two patients could not be scanned. Of the 46 peri-ictal images successfully obtained, 30 (65.2%) were from ictal injection and 16 (34.8%) from post-ictal injections. Forty-two (91.3%) of the successfully obtained SPECT images, in 38 patients (92.3%), were classified as localizing (15 temporal, 24 extratemporal). We conclude that, with the appropriate unit setup and well-trained staff, peri-ictal SPECT scans can be obtained in most pediatric partial epilepsy patients. Moreover, the procedure provides specific localizing information in a high proportion of these patients.

Original languageEnglish
Pages (from-to)15-22
Number of pages8
JournalPediatric Neurology
Volume19
Issue number1
DOIs
Publication statusPublished - 1 Jul 1998
Externally publishedYes

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