SPECT

In refractory epilepsy, a long-term EEG with SPECT can be performed, possibly in preparation for epilepsy surgery. ‘SPECT’ stands for Single Photon Emission Computed Tomography and is a medical imaging technique that uses a small amount of radioactive material to create 3D images of organs and bones. 

In the case of a long-term EEG with SPECT, the child is admitted to the hospital for a few days. During this admission, the child will be monitored with EEG. During an EEG, we attach electrodes (measuring points) to the child's head to measure brain activity. This allows us to see whether there is epileptic activity in the brain. As a parent, you stay overnight with your child and are always close to them.

Nurses apply the electrodes to the head for the EEG using an adhesive gel. We bundle all the wires of the electrodes in a backpack so that the child can walk around freely. In the meantime, we also film what is happening in the room, so that we can better understand the brain activity later. You are asked to keep the child in the picture as much as possible during the examination. In addition, an IV is inserted into the child, so that the fluid needed for the SPECT can be administered as quickly as possible.

If the child has a seizure, the nurses are asked to inform them as soon as possible so that a SPECT can be performed. The nurses will inject a slightly radioactive fluid, which is used every day and has no side effects in most patients. This fluid can make the location of increased blood flow in the brain visible to the scanner, which could be the part of the brain that is causing the epileptic seizures. In children under 8 years old, we also administer a light anaesthetic, so that it is easier to lie still while we perform the SPECT. One or two hours after the injection of the radioactive fluid, we can start the SPECT.

The child lies down on the examination table with the head in a special headrest. Sometimes extra straps are attached to keep the head still. The scanner then automatically rotates around the head and takes those images. This takes about 35 minutes. The hospital stay is terminated as soon as a usable SPECT has been made, which sometimes requires several attempts.

A few weeks later the child is asked to come back to the hospital for a second SPECT. This is a day admission, where a scan is made at a time when there is no epileptic seizure. We compare this scan with the first SPECT in order to draw a conclusion.