Parietal lobe epileptic focus identified on SPECT-MRI fusion imaging in a case of epilepsia partialis continua.

Epilepsia partialis continua, or "Kozhevnikov syndrome," is a rare condition characterized by persistent localized motor seizures usually localized in a distant limb. It is most often seen in children under 16 years old without gender preference. We report a 12-year-old girl with epilepsia partialis continua who presented to the emergency room after the onset of seizures. Routine electroencephalography (EEG) was performed with no clear ictal localization. Magnetic resonance imaging (MRI) was unremarkable. Ictal single photon emission computed tomography (SPECT) images with Tc-99m exametazime fused with MRI images revealed a parietal lobe epileptic focus within the superior segment of the postcentral gyrus. This case illustrates a rare disorder with an unusual epileptic localization identified by SPECT-MRI fusion.

Abdominal muscle uptake on FDG PET secondary to multiple rib fractures and use of accessory muscles of respiration.

A 69-year-old man with a history of lung cancer was referred for FDG whole body positron emission tomography (PET) with computed tomography (CT) fusion. Three days before the study, the patient was involved in a motor vehicle accident (MVA). In addition to hypermetabolic lesions representing metastatic lung cancer, PET scan showed marked anterior and lateral abdominal muscle uptake. Multiple focal abnormalities were seen on the PET scan that corresponded to multiple rib fractures on the CT scan that were secondary to the MVA. When the patient was interviewed, he stated that he had thoracic wall pain that prevented him from breathing properly. This case illustrates an unusual pattern of increased anterior and lateral abdominal muscle uptake as a result of pain while breathing.