Abstract
The combination of interictal brain fluorine-18 fluorodeoxyglucose positron emission tomography (F18-FDG PET) and ictal brain Tc-99m ethylcysteinate dimer (ECD) SPECT is currently used for identification of epileptic foci. Usually, hypometabolism is demonstrated on the F-18 FDG PET and hyperperfusion in the same region on the Tc-99m ECD ictal SPECT. The authors report a rare occurrence of left frontal hypermetabolism in a young girl with multiple recurring epileptic seizures, on F18-FDG PET, which was confirmed on ictal Tc-99m ECD SPECT. The patient's seizures were characterized by head deviation and movements of the upper extremities. The seizures were occurring non stop every 3 to 5 minutes, even during imaging, lasting about 15 seconds. Magnetic resonance imaging (MRI) showed evidence of dysplastic cortex which was consistent with the focal abnormalities on PET and SPECT.
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