John Libbey Eurotext

Ictal SPECT reveals different epileptogenic zones in frontal lobe epilepsy Volume 20, numéro 5, October 2018


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Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany
* Correspondence: Soheyl Noachtar Epilepsy Center, Dept. of Neurology, University of Munich, Marchioninistr. 15 D-81377 Munich, Germany

We report a patient with frontal lobe epilepsy due to a right frontal astrocytoma (WHO Grade III) in whom two ictal SPECTs (single photon emission tomography) were performed during two seizures with different semiology and different EEG seizure patterns. Subtraction of ictal and interictal SPECT showed right lateral frontal hyperperfusion during a left face clonic seizure, and right mesial fronto-polar hyperperfusion during a subclinical seizure. This report demonstrates that ictal SPECT may reflect different seizure semiology from the frontal lobe of the same individual and that simultaneous EEG is indispensable for the correct interpretation of SPECT in epilepsy.