Abstract
Brain perfusion SPECT, 18F-FDG PET and 123I-iomazenil SPECT are used to detect epileptic foci in candidates with partial seizures for epileptic surgery. Interictal 18F-FDG PET detects decreased glucose metabolism in epileptic focus and its surrounding area. It has high detectability of epileptic focus in temporal lobe epilepsy, but low detectability in extratemporal lobe epilepsy. 123I-iomazenil SPECT that is partial agonist to central type benzodiazepine receptor detects a focus as more localized decreased accumulation than 18F-FDG PET or brain perfusion SPECT. Although interictal brain perfusion SPECT detects decreased perfusion in epileptic focus and its surrounding area, it has low detectability as compared to 18F-FDG PET. In contrast ictal SPECT has high detectability of a focus as increased perfusion. Statistical image analysis is useful for detection of epileptic focus. This statistical approach is also applicable to detection of focal cortical dysplasia as an epileptic focus in voxel-based morphometry using structural MRI.
