Cerebral blood flow studies in patients with partial epilepsy

Aim of the study was to evaluate CBF in patients with partial epilepsy and normal TCT. A Tomomatic 64 and Xe-133 inhalation was used to measure CBF in 10 patients with a mean age of 31 ± 12 years with partial seizures and two with nocturnal paroxysm dystonia. A good correlation was observed between the site of the intercritical hypoperfusion and the origin of focal EEG alterations. In the two patients with suspected paroxysmal nocturnal dystonia and negative EEG, the CBF study showed a diffuse CBF reduction in the left hemisphere and in one case also in the deep frontal regions. In general the extension of the CBF focal decrease proved to be greater in respect to the focal alterations detectable with EEG and may involve in some cases even remote brain regions. In conclusion these preliminary data may seem to indicate: 1) CBF reductions correlate topographically with the cortical sit of seizure focus, documented by scalp EEG; moreover, with the CBF reduction generally extending also to the cerebral structures underlying cortical focus; 2) a CBF study may be useful when a deep focus is suspected but difficult to detect with a surface technique such as EEG; 3) remote effects may be observed due to the epileptic focus.