The Correlation between clinic, EEG, CT, MRI and interictal SPECT in patients with partial epilepsy

THE CORRELATION BETWEEN CLINIC, EEC, CT, MRI AND INTERICTAL SPECT IN PATIENTS WITH PARTIAL EPILEPSY ABSTRACT This study was conducted in department of pediatric neurology in Çukurova University medical faculty, with 102 children who have been followed up for partial epilepsy, with the aim of evaluating the value of interictai SPECT for exploring laterisation and supporting diagnosis and additionally to investigate the correlation between clinic, EEG, neuroradiologic findings and SPECT. In 65 % of the patients EEG, in 22 % CT, in 28 % MRI and 38.2 % interictai SPECT was found to be abnormal. 20 % of the patients who were observed to have hypoperfusion in the interictai SPECT, the hypoperfused area was monofocal in 20 patients (51.2%), in 19 patients multifocal (48.8%), in 9 patients (24%) bilateral, and in 30 patients unilateral (76%). The anatomical distribution of hypoperfused areas were frontal lobe in 17 patients (43. 1%), temporal lobe 16 patients (41%), occipital lobe in 12 patients (31%), and parietal lobe 19 patients (49%). There is not a direct correlation between seizure type, seizure frequency, duration of epilepsy and SPECT abnormality whereas there was a significant correlation between the age of seizure onset and abnormal SPECT, and the ones with older seizure onset was found to have higher SPECT abnormality. When the patients were grouped according to their seizure type in abnormal SPECT group, there was no significant difference between mean L.I. and A.I (p>0.05). Furthermore, the groups with refractor seizures and nonrefractor seizures, the percentage of SPECT abnormality was not different in terms of the multifocal hypoperfusion percentage and L.I. and A.I. averages (p>0.05). Positive clinic, EEG, CT, MRI findings correlated with the percentage of SPECT abnormality. This was proved significant (p<0.05). Although there was no significant correlation between SPECT abnormality and EEG abnormality, there was a significant and positive correlation between SPECT abnormality and MRI, CT. There was no significant abnormality between SPECT normal-abnormal group and EEG normal-abnormal group in terms of the avereges of the thickness of temporal lobe and hippocampal in axial sectional areas, As a result, we can say that in the patients with partial epilepsy, interictai SPECT is in more correlation with neuroradiologic imaging techniques than with EEG, and in uncertain diagnosis or insignificant lateralisation, it adds to the patients data. Key Words: Partial epilepsy, EEG, CT, MRI, interictai SPECT.