Interictal cerebral and cerebellar blood flow in temporal lobe epilepsy as measured by a noninvasive technique using Tc-99m HMPAO.

Abstract

The usefulness of noninvasive regional cerebral blood flow measurements using Tc-99m hexamethylpropylene amine oxime (HMPAO) was evaluated in 45 patients with interictal temporal lobe epilepsy. Seizure frequency did not show any influence on flow values or side-to-side asymmetry. Patients taking phenytoin had a significantly lower mean cerebral blood flow (mean 9.5%) and lower mean cerebellar blood flow (mean 12.9%) than those not taking it. Moreover, phenytoin reduced regional cerebral blood flow in the temporal regions more prominently on the contralateral side of the epileptic focus than on the ipsilateral side. Positive MRI findings of hippocampal sclerosis along with visually detected temporal hypoperfusion on SPECT showed a lower regional cerebral blood flow and greater flow asymmetry than other imaging findings in the temporal region. Results suggest that noninvasive cerebral blood flow measurements using Tc-99m HMPAO may give useful information about interictal cerebral blood flow around an epileptic focus and about the effects of antiepileptic drugs on brain function in temporal lobe epilepsy.