Comparing Single-Photon Emission Computed Tomography (SPECT), Electroencephalography (EEG), and Magneto-encephalography (MEG) Seizure Localizations in Pediatric Cases of Laser Ablation

摘要

Intractable epilepsy may have a more severe effect on children in comparison to adults because the motor, sensorial, and cognitive functions of children are still undergoing development. For this same reason, however, children maintain a greater potential for recovery from intractable epilepsy because of the remaining cerebral plasticity. Thus, after 2 unsuccessful antiepileptic medications, surgical intervention is recommended. Pre-surgical localization of the epileptogenic zone increases seizure-freedom post-surgery by 200% to 300%. Single-photon emission computed tomography (SPECT) is commonly used, with magneto-encephalography (MEG) and electroencephalography (EEG), to localize the epileptogenic zone, because it localizes cerebral blood flow. There is limited research in the efficacy of SPECT localization in pediatric pharmacoresistant epilepsy. Therefore, the objective of this study was to determine the efficacy of SPECT in it’s ability to localize the epileptogenic zone in laser ablation cases of pediatric pharmacoresistant epilepsy. Out of 122 SPECTs conducted at Dell Children’s Medical Center from July 2010 to January 2015, 12 underwent laser ablation. In the 12 cases of laser ablation, SPECT displayed more sensitivity and specificity than EEG and more specificity than MEG when held against the laser ablation outcomes. This study further proves that SPECT is efficacious in epileptogenic zone localization of pediatric pharmacoresistant epilepsy.