Twenty-one children with various seizure disorders were studied using
Tc-99m HMPAO brain SPECT, cranial CT, and electroencephalography (EEG)
. The rates of pathologic findings on SPECT, CT, and EEG were 67%, 38%
, and 52%, respectively, SPECT showed congruent, or more extensive, le
sions in all eight patients with CT lesions. Six of the 13 children wh
o had normal CT results, had abnormal SPECT study results, In this pos
tictal series, 4 of the 14 abnormalities detected in the first SPECT s
tudy that was applied within 24 hours of a seizure, were in the form o
f hyperperfused areas. Eight of the 14 abnormal first SPECT studies ha
d become normal by the second SPECT. We conclude that, with respect to
the depiction of some kind of abnormality, HMPAO brain SPECT is super
ior to CT and EEG, and considerable changes in brain perfusion are lik
ely to occur over a period of a few weeks.