INTRODUCTION: Several patients with partial epilepsies do not present an easily identified epileptogenic focus on scalp EEG or visible lesion on MRI. There are some useful functional neuroimaging techniques that could be considered in these cases, such as interictal positron emission tomography (PET) scan and ictal single-photon emission computed tomography (SPECT). These techniques can guide the placement of deep electrodes or even prevent their use in some situations. Unfortunately, PET scanners are not easily available in a great number of epilepsy centers because of its cost. OBJECTIVE: To demonstrate that 18F-FDG SPECT could be a good alternative replacing PET scan on localization of epileptic focus and surgical planning in places where this technology is not available. MATERIALS AND METHODS: Case report of a patient with refractory neocortical temporal lobe epilepsy, with normal MRI and nuclear EEG localization. RESULTS: The patient was submitted to interictal 18F-FDG SPECT scan, that showed hypometabolism in the anterior, mesial and lateral parts of the right temporal lobe. These areas were surgically resected and the patient outcome after 24 moths has been very good (Engel IB). CONCLUSION: We suggest that in some situations an interictal 18F-FDG SPECT scan could replace 18F-FDG PET scan where this technique is not available.
temporal lobe epilepsy; EEG; magnetic resonance imaging; nuclear medicine
