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Handb Clin Neurol. 2013;111:759-65. doi: 10.1016/B978-0-444-52891-9.00078-6.

SPECT (single photon emission computed tomography) in pediatrics.

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  • INSERM UMR663, Université Paris Descartes, Paris and CEA, France; Hôpital Necker-Enfants Malades, Paris, France. Electronic address: catherine.chiron@nck.aphp.fr.


Surgery of focal epilepsies in childhood has largely benefited from the recent advances of the noninvasive functional imaging techniques, particularly SPECT which presurgically contributes to the localization of the seizure onset zone, in order to select the patients, decide the optimal placement of intracranial electrodes, and plan the resection. Peri-ictal SPECT (ictal and postictal) proved especially useful when video-EEG is not contributory, when MRI looks normal or shows multiple abnormalities, or in cases of discrepant findings within the presurgery workup. Because of a poor temporal resolution, peri-ictal SPECT must be coupled with video-EEG. Multimodal imaging so-called SISCOM (peri-ictal - interictal SPECT subtraction image superimposed on MRI) increases the sensitivity of peri-ictal SPECT by about 70% and makes it a good predictor of seizure-free outcome after surgery. In addition, interictal SPECT occasionally provides some interesting results regarding functional cortical maturation and learning disorders in childhood.

Copyright © 2013 Elsevier B.V. All rights reserved.

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