Abstract
This chapter discusses the role of single-photon-emission computed tomography (SPECT) in epilepsy. SPECT is a valuable clinical tool that is used in the management of patients with medically resistant partial epilepsy, who are under evaluation for surgical treatment. This technique provides useful and complementary data for localization of the seizure focus and is regularly employed in most epilepsy surgery centers. The sensitivity of SPECT for the detection of seizure focus is higher than that of structural imaging but gives little indication of the underlying pathology. The complete three-dimensional dataset provided by SPECT enables the selection of optimal image planes. Moreover, coregistration of SPECT with magnetic resonance imaging (MRI) is useful particularly for the interpretation of subtraction images. It has the advantage of an anatomic correlation and may highlight an area of relative hyperperfusion or hypoperfusion. The main role of interictal SPECT is to aid interpretation of ictal SPECT studies by providing a baseline for visual comparison or image subtraction.
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