The promise of subtraction ictal SPECT co-registered to MRI for improved seizure localization in pediatric epilepsies: Affecting factors and relationship to the surgical outcome
Ictal SPECT is a powerful non-invasive imaging modality for seizure localization in pediatric epilepsies. Successful ictal SPECT localization depends both on the timing of radiotracer injection and the cerebral lobe (particularly temporal versus frontal) of seizure onset. MRI abnormalities, seizure characteristics and epilepsy etiology do not significantly affect the ictal SPECT localization. Early radiotracer injection (within ≤25 s from seizure onset) is critical for optimizing the ictal SPECT result.