The hazards of lack of co-registration of ictal brain SPECT with MRI: A case report of sinusitis mimicking a brainstem seizure focus.

TitleThe hazards of lack of co-registration of ictal brain SPECT with MRI: A case report of sinusitis mimicking a brainstem seizure focus.
Publication TypeJournal Article
Year of Publication2004
AuthorsButler T, Hirsch LJ, Claassen J
JournalBMC Nucl Med
Volume4
Issue1
Pagination2
Date Published2004 Nov 29
ISSN1471-2385
Abstract

BACKGROUND: Single photon emission computed tomography (SPECT) following injection of radiotracer during a seizure is known as ictal SPECT. Comparison of an ictal SPECT study to a baseline or interictal study can aid identification of a seizure focus. CASE PRESENTATION: A young woman with encephalitis and refractory seizures underwent brain SPECT during a period of frequent seizure-like episodes, and during a seizure-free period. A focal area of increased radiotracer uptake present only when she was experiencing frequent seizure-like episodes was originally localized to the brainstem, but with later computerized co-registration of SPECT to MRI, was found to lie outside the brain, in the region of the sphenoid sinus. CONCLUSION: Low-resolution SPECT images present difficulties in interpretation, which can be overcome through co-registration to higher-resolution structural images.

DOI10.1186/1471-2385-4-2
Alternate JournalBMC Nucl Med
PubMed ID15569392
PubMed Central IDPMC535895
Related Institute: 
Brain Health Imaging Institute (BHII)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065