Abstract:

Objective: The effect of chronic carbamazepine (CBZ) therapy on regional blood flow (rCBF) was evaluated using single photon emission computed tomography (SPECT) with technetium-99m hexamethylpropyleneamineoxime. Methods: Interictal SPECT scans and electroencephalography (EEG) examinations in 13 (8 males, 5 females) children with partial epilepsy were performed twice before administering CBZ and between 4-12 months (8.00±2.23 months) after starting the therapy. Results: Visual assessment of interictal SPECT images showed stable perfusion abnormalities in 9 of 11 cases who had regions of hypoperfusion in the first scans. Before CBZ therapy, EEG correlated well with SPECT in 9/11 patients in localizing focal abnormality and the rate of correlation was 7/11 during the therapy. By quantitative evaluation, no significant change of rCBF in all cerebral cortical regions except right inferior frontal (p<0.03) was found after initiation of CBZ therapy. Repeated SPECT scans done in 6 healthy volunteers at intervals of 6 to 10 months (7.20±3.45 months) demonstrated no significant change of rCBF. Conclusion: Our results suggest that chronic CBZ therapy does not affect blood flow of the epileptogenic zone nor of the other parts of cerebral cortex. The absence of any effect due to chronic CBZ therapy may be related to the partial clinical improvement.

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