SPECT

What is a prolonged EEG with SPECT?

In children with refractory epilepsy, a prolonged EEG combined with a SPECT examination can help determine very precisely where seizures begin in the brain.

To perform a SPECT scan (Single Photon Emission Computed Tomography) a small, safe amount of radioactive material is used to show which areas of the brain receive increased blood flow during a seizure.
This increased blood flow may indicate the region that triggers the epilepsy.

This examination is often performed as preparation for possible epilepsy surgery.

Why is this examination done?

A prolonged EEG with SPECT is used when earlier tests (MRI, PET, video‑EEG, …) do not yet provide a clear answer.

The goals are to:

record spontaneous seizures in a safe environment,
see exactly where a seizure starts,
determine which brain regions are involved,
refine the treatment plan based on this information.

How does the admission work?

Your child will be admitted to a monitoring unit for a few days. During the admission, we do everything we can to make the stay as comfortable as possible. The hospital school and play support team will be involved so your child can continue to learn, play, and relax.

1. Arrival and preparation

Your child is safely connected to EEG monitoring.
Nurses place electrodes on the head using a special gel.
The cables are bundled into a small backpack so your child can still move freely within the room.

2. Continuous EEG recording and video observation

Cameras in the room record continuously.
This makes it possible to link behaviour or movements to the brain activity.

We kindly ask you to keep your child within camera view as much as possible.

3. Parent stay

You stay in the room with your child and sleep there as well.
You are always close by.

4. Intravenous access

Because a SPECT scan must be performed quickly after a seizure begins, your child receives an IV line.
This allows the radioactive tracer to be administered immediately at the right moment.

5. Neuropsychological assessment

A neuropsychological evaluation is also conducted during the hospital stay.
Read more about this assessment here.

When a seizure occurs

As soon as your child has a seizure, please alert the nurses as quickly as possible.
The team will then administer the radioactive tracer through the IV.

This substance is safe and used daily in hospitals.
It rarely causes side effects.

On the scan, the tracer shows which brain areas received increased blood flow during the seizure.

The SPECT scan

One to two hours after the injection, the actual SPECT scan takes place:

Your child lies on an examination table with their head in a soft, open head support.
If needed, small straps are used to help keep the head still.
The scanner rotates automatically around the head and produces 3D images.
The scan takes about 35 minutes and is completely painless.

The hospital stay ends once a useful SPECT scan has been obtained.
Sometimes more than one seizure is needed to get the right images.

A second SPECT at a non‑seizure moment

A few weeks later, your child returns for a second SPECT, this time without a seizure.
This is a day admission.

Comparing the two scans helps the team determine which brain areas are more active during a seizure, allowing much more accurate localisation of the epileptic focus.