Skip to main content
Log in

Hexa-methyl-propylene-amine-oxime (HMPAO) single photon emission computed tomography (SPECT) in epilepsy

  • Published:
Brain Topography Aims and scope Submit manuscript

Summary

Twenty-eight normal volunteers and 74 seizure patients were investigated with hexa-methyl-propylene-amine-oxime (HMPAO) brain single photon emission computed tomography (SPECT). Fifty-four patients suffered from partial seizures and 20 patients had generalized seizures. Indices describing regional tracer distribution (RIs) were calculated in all investigated subjects. Regions whose RI exceeded the mean normal RI +/-3 SD were defined as abnormally perfused. In normals a significant interhemispheric asymmetry of HMPAO deposition was found, with higher RI values in the right frontal, parietal, temporal and occipital regions. In 59.3% of partial seizure patients abnormal RIs were found. Low RIs were detected predominantly in the frontal and temporal cortex, while elevated RIs were observed predominantly in the anterior basal ganglia. Only in 20% of the cases with generalized seizures, abnormal RIs were found. In one patient an ictal and 3 follow-up SPECT studies were obtained. Here SPECT results indicated transient rCBF changes between the ictal and seizure free state. EEG and SPECT foci were ipsilaterally located in 69.2% of the partial seizure cases. The results indicate that HMPAO brain SPECT is valuable for the detection of rCBF abnormalities in seizure patients and that patients with partial seizures have mostly several abnormally perfused areas in their brains.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abou-Khalil, B.W., Siegel, G., Sackellares, J.C., Gilman, S., Hichwa, R. and Marshall, R. Positron emission tomography studies of cerebral glucose metabolism in chronic partial epilepsy. Ann. Neurol., 1987, 22:480–486.

    Google Scholar 

  • Alavi, A., Gur, R.E., Resnick, S., Gur, R.C. and Reivich, M. Prominence of basal ganglia metabolic activity in schizophrenia. J. Nucl. Med., 1986, 27:901 (abstr.).

    Google Scholar 

  • Andersen, A.R., Friberg, H., Lassen, N.A., Kristensen, K. and Neirinckx, R.D. Serial studies of cerebral blood flow using99Tcm-HMPAO: a comparison with133Xe. Nucl. Med. Commun., 1987, 8:549–557.

    Google Scholar 

  • Biersack, H.J., Frötscher, W., Klüneberg, H., Reske, S.N., Rasche, A., Reichmann, K. and Winkler, C. SPECT des Hirns mit123J-Isopropyl-Amphetamin bei Epilepsie. NucCompact., 1983, 14:62–72.

    Google Scholar 

  • Biersack, H.J., Linke, D., Brassel, F., Reichmann, K., Kurthen, M., Durwen, H.F. and Reuter, B.M., Wappenschmidt, J., Stefan, H. Technetium-99m HMPAO brain SPECT in epileptic patients before and during unilateral hemispheric anaesthesia (Wada test): report of three cases. J. Nucl. Med., 1987, 28:1763–1767.

    Google Scholar 

  • Devous, M.D., Stokely, E.M., Chebabi, H.H. and Bonte, F.J. Normal distribution of regional blood flow measured by dynamic single-photon emission tomography. J. Cereb. Blood Flow Metabol., 1986, 6:95–104.

    Google Scholar 

  • Dodrill, C.B. and Batzel, L.W. Interictal behavioral features of patients with epilepsy. Epilepsia, 1987, 27 (Supl. 2):64–67.

    Google Scholar 

  • Engel, J.Jr., Kuhl, D.E. and Phelps, M.E. Patterns of human local cerebral glucose metabolism during epileptic seizures. Science, 1982, 218:64–66.

    Google Scholar 

  • Engel, J.Jr., Caldecott-Hazard, S. and Bandler, R. Neurobiology of behavior: Anatomic and physiological implications related to epilepsy. Epilepsia, 1986, 27 (Suppl. 2.):3–6.

    Google Scholar 

  • Heiss, W.D., Ilsen, H.W., Wagner, R., Pawlik, G. and Wienhard, K. Remote functional depression of glucose metabolism in stroke and its alteration by activating drugs. In: W.D. Heiss, M.E. Phelps, (Eds.), Positron Emission Tomography of the Brain, Springer Verlag, Berlin, 1982, 163–168.

    Google Scholar 

  • Hougaard, K., Oikawa, T., Sveinsdottir, E., Skinhij, E., Ingvar, D.H. and Lassen, N.A. Regional cerebral blood flow in focal cortical epilepsy. Arch. Neurol., 1976, 33:527–535.

    Google Scholar 

  • Kuhl, D.E., Engel, J.Jr. and Phelps, M.E. Emission computered tomography of 18FDG and 13NH3 in partial epilepsy. In: J. Mossy, O.M. Reinmuth, (Eds.), Cerebrovascular disease, Raven Press, 1981, New York, 73–75.

    Google Scholar 

  • Lang, W., Podreka, I., Suess, E., Steiner, M., Müller, C.H., Zeitlhofer, J., and Deecke, L. Functional imaging using single photon emission computerized tomography in ictal and interictal partial seizure states. J. Neurol., 1988, 235:277–284.

    Google Scholar 

  • Metter, J.E., Riege, W.H., Kuhl, D.E. and Phelps, M.E. Cerebral metabolic relationships for selected brain regions in healthy adults. J. Cereb. Blood Flow Metabol., 1984, 4:1–7.

    Google Scholar 

  • Perlmutter, J.S., Powers, W.J., Herscovitch, P., Fox, P.T. and Raichle, M. Regional asymmetries of cerebral blood flow, blood volume, and oxygen utilisation and extraction in normal subjects. J. Cereb. Blood Flow Metabol., 1987, 7:64–67.

    Google Scholar 

  • Podreka, I., Mamoli, B., Lesch, O., Suess, E., Wimberger, D., Mayr, N., Miller, C.H., Steiner, M. and Deecke, L. Detection of rCBF changes in partial complex seizures or hallucinations by N-isopropyl(I-123)piodoamphetamine. J. Nucl. Med. 1986, 1029 (abs.).

  • Podreka, I., Suess, E., Goldenberg, G., Steiner, M., Brücke, T., Müller, C.H., Lang, W., Neirinckx, R.D. and Deecke, L. Initial experience with Technetium-99m HM-PAO brain SPECT. J. Nucl. Med., 1987, 28:1657–1666.

    Google Scholar 

  • Sharp, P.F., Smith, F.W., Gemmell, H.G., Lyall, D., Evans, N.T.S., Gvozdanovic, D.G., Davidson, J., Tyrrell, D.A., Pickett, R.D. and Neirinckx, R.D. Technetium99m HM-PAO Stereoisomers as potential agents for imaging regional cerebral blood flow: human volunteer studies. J. Nucl. Med., 1985, 27:171–177.

    Google Scholar 

  • Stefan, H., Pawlik, G., Boecher-Schwarz, H.G., Biersack, H.J., Burr, W., Penin, H. and Heiss, W.D. Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal and ictal EEG, CT, MRI, SPECT and PET. J. Neurol., 1987, 234:377–384.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Podreka, I., Lang, W., Suess, E. et al. Hexa-methyl-propylene-amine-oxime (HMPAO) single photon emission computed tomography (SPECT) in epilepsy. Brain Topogr 1, 55–60 (1988). https://doi.org/10.1007/BF01129340

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01129340

Keywords

Navigation