Infantile Spasms with Localized Cerebral Lesion Detected by ^99mTcHMPAO-SPECT

Abstract

We experienced a 6-month-old girl with infantile spasms who had localized cerebral lesion detected by ^99mTcHMPAO-SPECT. She was born vaginally after a full term uncomplicated deliverywith a birth weight of 3, 100g. She developed emprosthotonic spasms with series formation and EEG showed asymmetric periodic hypsarrhythmia which was predominant in the right hemisphere. While MRI could not detected any focal lesion, ^99mTcHMPAO-SPECT disclosed hypoperfusion at the right anterior temporal and frontal areas. Although vitamin B6, clonazepam and sodium valproate were administered with no remarkable benefit, the treatment with ACTH-Z or carbamazepine resulted in cessation of spasms and improvement of the EEG findings. Consequently, the study with ^99mTcHMPAO-SPECT was useful to clarify the pathology of infantile spasms, and we concluded that a patient with localized cerebral lesions should be given carbamazepine.