Partial seizures presented as apnea in an adult

Although several cases of apneic seizures have been reported in neonates, epileptic seizures presented with apnea only in adults are very rare. We present a 19-year-old man who suffered from viral encephalitis and frequent episodes of apneic seizures. Ictal EEGs, recorded during apneic episodes, showed repetitive sharp waves or rhythmic theta activ-ities arising from the left or right independent bitemporal region. Ictal SPECT was performed during one episode of apnea accompanied by ictal EEG discharges arising from the left posterior temporal area. Ictal-interictal subtraction SPECT coregistered with MRI revealed that the seizures were originated from the left posterior mid-lateral temporal cortex. Previous studies, with ictal EEG or brain stimulation, suggested that apneic seizures might be mediated through the limbic and the associated cortical systems. This is a very rare case of partial seizures presented with apnea in an adult patient, which was supported by ictal EEG and ictal-interictal subtraction SPECT coregistered with MRI.

Optimization of Subtraction Brain Perfusion SPECT with Basal / Acetazolamide Consecutive Acquisition / 대한핵의학회잡지

This study investigated the method to adjust acquisition time(a) and injection dose(i) to make the best basal and subtraction images in consecutive SPECT. Image quality was assumed to be mainly affected by signal to noise ratio(S/N). Basal image was subtracted from the second image consecutively acquired at the same position. We calculated S/N ratio in basal SPECT images(S1/N1) and subtraction SPECT images(Ss/Ns) to find a(time) and i(dose) to maximize S/N of both images at the same time. From phantom images, we drew the relation of image counts and a(time) and i(dose) in our system using fanbeam-high-resolution collimated triple head SPECT. Noise by imaging process depended on Poisson distribution. We took maximum tolerable duration of consecutive acquisition as 30 minutes and maximum injectible dose as 1,850MBq(50 mCi)(sum of two injections) per study. Counts of second-acquired image(S2), counts(Ss) and noise(Ns) of subtraction SPECT were as follows. C1 was the coefficient of measurement with our system.