Korean J Nucl Med.  2000 Aug;34(4):312-321.

Crossed Cerebellar Hyperperfusion on Ictal Tc-99m HMPAO Brain SPECT: Clinical Significance for Differentiation of Mesial or Lateral Temporal Lobe Epilepsy and Related Factors for Development

• Park SA
• Lee DS
• Kim SK
• Lee SG
• Jang MJ
• Sohn MH
• Lim ST
• Chung JK
• Lee MC

Abstract

PURPOSE: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. MATERALS AND METHODS: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4+/-7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I , II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6+/-19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis
RESULTS
CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH.
CONCLUSION
Crossed cerebellar hyperperfusio ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.

Keyword

Tc-99m HMPAO; Single photon emission tomography (SPECT); Epilepsy; Crossed cerebellar hyperperfusion

MeSH Terms

Brain*
Electroencephalography
Epilepsy
Epilepsy, Temporal Lobe*
Humans
Logistic Models
Retrospective Studies
Technetium Tc 99m Exametazime*
Temporal Lobe*
Tomography, Emission-Computed, Single-Photon*
Technetium Tc 99m Exametazime