The usefulness of subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome

Kazuhiro Haginoya, Mitsugu Uematsu, Mitsutoshi Munakata, Yosuke Kakisaka, Atsuo Kikuchi, Tojo Nakayama, Naomi Hino-Fukuyo, Rie Tsuburaya, Taro Kitamura, Ikuko Sato-Shirai, Yu Abe, Yoko Matsumoto, Keisuke Wakusawa, Tomoko Kobayashi, Mamiko Ishitobi, Noriko Togashi, Masaki Iwasaki, Nobukazu Nakasato, Kazuie Iinuma

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)

Abstract

The recent findings on subtraction ictal SPECT and ictal near-infrared spectroscopic topography in patients with West syndrome were summarized and its availability for presurgical evaluation was discussed. The subtraction ictal SPECT study in patients with West syndrome demonstrated the cortical epileptic region and subcortical involvement, which may consist of epilepsy networks related to the spasms. Moreover, subtraction ictal SPECT may have predictive power for short-term seizure outcome. Patients with a symmetric hyperperfusion pattern are predicted to have a better seizure outcome, whereas patients with asymmetric hyperperfusion pattern may develop poor seizure control. Importantly, asymmetric MRI findings had no predictive power for seizure outcome. Multichannel near-infrared spectroscopic topography applied to the patients with West syndrome detected an increase in regional cerebral blood volume in multiple areas which were activated either simultaneously or sequentially during spasms. Topographic changes in cerebral blood volume were closely correlated with spasm phenotype, suggesting that the cortex is involved in the generation of spasms. In conclusion, subtraction ictal SPECT may be considered as a useful tool for presurgical evaluation of patients with West syndrome and investigation of the pathophysiology of spasms. The ictal near-infrared spectroscopic topography should be more investigated to see if this is useful tool for presurgical evaluation.

Original languageEnglish
Pages (from-to)887-893
Number of pages7
JournalBrain and Development
Volume35
Issue number10
DOIs
Publication statusPublished - 2013 Nov 1

Keywords

  • Infantile spasms
  • NIRS
  • Near-infrared spectroscopy
  • SPECT
  • Subtraction
  • West syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

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