Usefulness of 123I-iomazenil SPECT for childhood focal epilepsies

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Purpose: We investigated the usefulness of 123I-iomazenil (IMZ-) SPECT to detect epileptic foci in children with symptomatic focal epilepsy (SFE).Subjects: 21 children with SFE who underwent IMZ-SPECT to identify the epileptic focus were studied.Methods: We retrospectively compared the localization and lateralization of epileptic foci obtained from visualization of IMZ-SPECT images and those speculated based on a combination of clinical manifestations, EEG findings, and brain MRI. We then verified the concordance of the results between the two methods.Results: There was concordance in both lateralization and localization in 9⁄12 patients with temporal lobe epilepsy (75%), in 2⁄5 patients with frontal lobe epilepsy (40%), and in 2⁄4 patients with parieto-occipital lobe epilepsy (50%). Overall, the epileptic foci detected by IMZ-SPECT was consistent with those speculated based on other findings at least in 13 of 21 patients (62%) with SFE.Discussion: As IMZ-SPECT is a potentially useful method for detecting epileptic foci, we should accumulate cases to verify the limitations and appropriate application of this method in the diagnosis of childhood SFE.