Utility of Ictal Single Photon Emission Computed Tomography in Mesial Temporal Lobe Epilepsy With Hippocampal Atrophy: A Randomized Trial

Abstract

Ictal-SPECT did not add localizing value beyond what was provided by EEG-video telemetry and structural MRI that altered the surgical decision and outcome for MTLE-HS patients. Ictal-SPECT increased hospital stay was associated with increased costs and a higher chance of SGS during video-EEG monitoring. These findings support the notion that a protocol including ictal SPECT is equivalent to one without SPECT in the presurgical evaluation of adult patients with MTLE-HS.

Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study

“…Histopathology was carried out in 48 patients and confirmed hippocampus sclerosis. We excluded patients with extrahippocampal lesions, focal motor or sensory abnormalities on physical examination, bilateral synchronous or extratemporal interictal spikes, and impaired neurodevelopment because such features put the diagnosis of MTLE‐HS in doubt …”

Predictors of quality of life in patients with refractory mesial temporal lobe epilepsy

“…All patients had complete medical history, seizure semiology, neurological examination, psychiatric and neuropsychological evaluation, interictal and ictal video-EEG analyses, and MRI results consistent with MTLE-HS [14][15][16][17][18][19].…”

“…We excluded patients with extrahippocampal lesions, focal motor-sensory abnormalities on physical examination, generalized or extratemporal interictal spikes and marked cognitive impairment on neuropsychological testing because such features place the diagnosis of MTLE in doubt [14][15][16][17][18][19]. Patients presenting with acute psychotic symptoms during evaluation were also excluded from the study.…”

Two-Dimensional Temporal Clustering Analysis for Patients with Epilepsy: Detecting Epilepsy-Related Information in EEG-fMRI Concordant, Discordant and Spike-Less Patients

“…Patients were enrolled during pre-surgical evaluation following previously described protocols (Velasco et al 2011), which is based on video-EEG, MRI, foramen ovale electrodes, ictal single photon emission computed tomography (SPECT)and positron emission tomography (PET). A total of 18 patients (12 M, mean= 38 yrs ± 11 yrs) (Table 1) were considered eligible by the following selection criteria: (1) the surgery follow up 18 months after surgery was Engel score I–II (Engel et al, 1993) and(2) no large head movement (fMRI data with movements greater than 2mm volume -to-volume, based on realignment parameters, were excluded).…”