Single photon emission computed tomography in intractable infantile seizures.

We aimed to determine the site of ictal foci and the pathogenesis of seizures in 4 infants with intractable seizures. The patients were studied using simultaneous video and electroencephalographic (EEG) monitoring, structural studies and ictal and interictal single photon emission computed tomography (SPECT). Ictal neurophysiology showed multifocal seizure propagation in Patients 1 and 2 and generalised abnormal electrical patterns in Patients 2, 3 and 4. Magnetic resonance imaging (MRI) demonstrated a focal abnormality in Patient 4. SPECT studies showed focal or multifocal increased uptake in 3 subjects (Patients 1,3,4) and increased uptake in the thalamic and basal ganglia regions of 2 subjects (Patients 2,3). SPECT studies contributed to an understanding of the pathogenesis of seizure initiation and propagation in the 4 patients studied.