Paradoxical enhancement of hypoperfusion single photon emission CT images in epileptic focus with bemegride activation. Observation from subtraction of 99mTc hexamethyl-propyleneamine oxime brain single photon emission CT images.
Changes of brain images in single photon emission CTs (SPECTs) before and after intravenous injection of bemegride were examined with simultaneous EEG recording in a patient with occipital lobe epilepsy and in a hysteric patient, using a new method, i.e. subtraction of the SPECT images with 99mTc hexamethyl-propyleneamine oxime. The bemegride injection in the epileptic patient paradoxically intensified the hypoperfusion images as epileptic foci in SPECTs, associated with enhanced interictal epileptic discharges, whereas the hysteric showed no such effects. These findings suggest that the hypoperfusion images closely correlate to the severity of epileptic activity, reflecting a functional rather than a morphological deficit.