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IMAGE PLACEHOLDER · Diagnostic study
Original study · Companion image placeholders
24-year-old female with a history of medication refractory epilepsy was admitted to the hospital for Ictal brain SPECT.
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Ictal images demonstrate asymmetrically increased perfusion to the right temporal lobe compared to the left.
Most complex partial seizures arise from foci in the temporal lobes.
The imaging techniques for seizure localization attempt to localize seizure foci based on metabolic or perfusion status.
In many cases, seizure foci exhibit hyperperfusion (SPECT) and hypermetabolism (FDG PET) during the seizure (ictal) and hypoperfusion and hypometabolism between seizures(interictal).
Companion case demonstrates increased blood flow within the left temporal lobe during the ictal scan and hypometabolic activity on interictal scan. In this case subtraction images were obtained and then fused to a prior MRI to add in detection of an anatomical lesion.
“Central Nervous System.” Essentials of Nuclear Medicine Imaging, by Fred A. Mettler and Milton J. Guiberteau, Elsevier Saunders, 2012, pp. 71–97.