Single photon emission computed tomography (SPELT) using N-isopropyl-p-(123I)iodoamphetamine (IMP) in the evaluation of patients with epileptic seizures

To evaluate the clinical usefulness of IMP SPECT in the diagnosis of epilepsy, 6 normals and 52 patients in the interictal phase were studied. Thirty min after an intravenous injection of 111 MBq IMP, SPECT was performed using a rotating gamma camera. Of 21 patients with simple partial seizures, a localized decrease of uptake was shown in 16, and an increase in 3. Topologically, these findings corresponded well to the ictal symptoms. Nine of 13 patients with localized epileptic EEG had a good correspondence between the findings on EEG and IMP SPELT. In 20 of 23 with complex partial seizures, the coronal images showed laterality of uptake in the temporal lobes, whereas the CT was normal in 14. However, these findings on IMP SPECT agreed with the EEG in the temporal leads in only 5 cases. Of 8 patients with primary generalized seizures, a diffuse cerebral decrease was shown in 3 of 4 patients with convulsive seizures (grand mal), and a normal uptake in 3 of 4 patients with non-convulsive seizures (petit mal). However, 2 patients showed a localized decrease, therefore, we determined that they suffered from partial seizures evolving to secondarily generalization. From these data, we concluded that IMP SPELT could be a useful method in the diagnosis of epilepsy.