Question about SPECT scan.

[omgzitsmiranda]

My husband had a 8 second 'blip' show up on his VEEG Wednesday night & we were told about it Thursday morning. Thursday later morning they brought in nuclear dye to inject to him in the middle of a seizure, so they finally got that done in one of his clusters in order to do a SPECT scan to see where the blood flow of the brain, etc.

Doctor said he's wanting to see where exactly the blood flow goes/how it works etc and if it's correlating with where the 'blip' came from [right frontal lobe; which is what we *on our own* were thinking because of his symptoms] so I'm just curious if this is normal procedure? Has anyone else had this done?

 

[Nakamova]

SPECT scanning is usually only done if epilepsy surgery is being contemplated, since it can help point to the areas where seizures are originating, and show if they are small enough for safe surgical removal. SPECT imaging needs two scans — one during a seizure and one during a nonseizure period, performed on separate days. The seizure and nonseizure scan are then compared on a computer to see the area of the brain with the greatest activity during the seizure.

 

[omgzitsmiranda]

That's really weird then because there have been absolutely ZERO talks about possible surgery because I don't really think that's the route my husband wants to go right now at least unless things keep getting significantly worse.

His Neuro said that he was looking for the "main area" where the seizures are coming from just to confirm they're actually coming from where it was picked up out of on the VEEG [right front temporal lobe] just to confirm this.

They injected him in the middle of a big cluster of his seizures, then they had to wait an hour & a half; then took him down and did it for 32 minutes. They were pulling his old MRI from last year and a recent CT scan from last month to review them side by side.

So I'm assuming this isn't common practice lol. I guess we just have to wait and see because I really don't feel like it showing up on the EEG as abnormal is just a fluky thing? His Neuro said it was seizure activity, did this SPECT scan and then immediately put him on a 8x higher dose of Topamax than he was originally on. I don't feel like he would do that unless he was pretty sure it was actual seizures..?

Other guy working the EMU said it could possibly be just an electrode artifact but DH's neuro seemed to pretty much shoot that down when I asked about that.

confused lol.

 

[Nakamova]

Interpretation of EEG test isn't an exact science, and there can be both false positives and false negatives. But it sounds like the nature of the "blip" on your husband's EEG was, at minimum, fairly suggestive of seizure activity. If the neurologist wasn't 100% sure based on the EEG alone, he may have ordered the SPECT to see if he could get additional confirmation. But it would still be standard practice to wait a day and then do a separate, non-seizure SPECT for comparison purposes.

If you have any questions, your best bet is ask the neurologist for an explanation when you see him next. I hope the Topomax works. You might want to ask the neuro about possible side effects to look out for.

 

[omgzitsmiranda]

Interpretation of EEG test isn't an exact science, and there can be both false positives and false negatives. But it sounds like the nature of the "blip" on your husband's EEG was, at minimum, fairly suggestive of seizure activity. If the neurologist wasn't 100% sure based on the EEG alone, he may have ordered the SPECT to see if he could get additional confirmation. But it would still be standard practice to wait a day and then do a separate, non-seizure SPECT for comparison purposes.

If you have any questions, your best bet is ask the neurologist for an explanation when you see him next. I hope the Topomax works. You might want to ask the neuro about possible side effects to look out for.

That's exactly what I was wondering since I'm pretty new to all of this lol. Thanks for the help I definitely will ask him on 11/28 and make sure. His Neuro now [we just switched to him less than a month ago] is supposed to be the *best* in our area, but it doesn't mean that if I don't feel ~right~ about the way things go with the doctor or how he does things, it doesn't mean I won't expand to best in the STATE. There's a level 4 EMU 4 hours away, so that may be another option in case this is ruled "inconclusive" or something.

I just want to know for SURE what is going on. But I'm going to wait until 11/28's appointment before I [freak out] lol.

Thanks for all the help