Use of Innovative SPECT Techniques in the Presurgical Evaluation of Patients with Nonlesional Extratemporal Drug-Resistant Epilepsy

Figure 4

An illustrative example of a patient with distinct brief focal motor seizures involving the left leg without an EEG correlate and with a normal three tesla MRI with epilepsy protocol. SISCOM at two standard deviations (a) matched intracranial monitoring with cortical mapping (b). (a) A SISCOM (Injection latency of 6 seconds during a 14-second habitual clinical seizure without scalp EEG correlate) revealed increased uptake in the right paracentral region (leg area). (b) Cortical mapping identified the left leg motor activity in the area of seizure onset. A typical electroclinical seizure was produced by stimulation in the same region. The patient underwent responsive neurostimulation (RNS) implant leading to 100% seizure reduction.

(a)

(b)