Table of Contents

HK J Paediatr (New Series)
Vol 18. No. 3, 2013

HK J Paediatr (New Series) 2013;18:178-181

Case Report

Presurgical Evaluation of Epileptogenic Focus in Temporal Lobe Epilepsy by 11C-Flumazenil PET and 123I-Iomazenil SPECT: A Case Report

G Imataka, M Ogino, S Sakamoto, O Arisaka


Meticulous neuroradiological evaluations, including 123I-iomazenil (IMZ) single photon emission computed tomography (SPECT) and 11C-flumazenil (FMZ) positron emission tomography (PET), preoperatively disclosed epileptogenic foci in a 16-year-old boy with temporal lobe epilepsy. Interictal scalp electroencephalography showed spikes in the left temporal region. Left hippocampal sclerosis was seen on magnetic resonance imaging. Hypoperfusion in the entire left temporal lobe was seen on 99mTc ethyl-cysteinate dimer (ECD) SPECT. Hypometabolism over most of the left temporal lobe was apparent on 18F-fluorodeoxyglucose (FDG) PET. An area of hypoperfusion dominating the left temporal lobe was identified on 123I-IMZ SPECT. A low-uptake area in the left temporal lobe was seen on 11C-FMZ PET. Anteromedial temporal lobectomy and multiple subpial transection with intraoperative electrocorticography resulted in satisfactory seizure outcomes. Use of 123I-IMZ SPECT and 11C-FMZ PET appeared to demonstrate the epilepsy focus more localised than 99mTc ECD SPECT and 18F-FDG PET.

Keyword : Hippocampal sclerosis; Positron emission tomography (PET); Single photon emission computed tomography (SPECT)

Abstract in Chinese


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