Fig. 1

Standardized display for visual reading. The upper and lower parts were provided as page 1 and page 2 of a 2-page pdf-document (separate pdf-document for each patient). On the first page, the left side shows the patient’s ictal perfusion SPECT coregistered to the individual T1-weighted MRI shown on the right. On the second page, the left side shows the patient’s ictal perfusion SPECT after stereotactical normalization into the anatominal standard space, the righ side shows the statistical hyperperfusion map thresholded at a z-score of 3.0 and overlaid to the patient’s SPECT. This representative report is from a 16y old female with post-encephalitic lesion in the left temporal lobe. Ictal perfusion SPECT was performed with 500 MBq ^99mTc-ECD injected 19 s after electrical start of the seizure. The seizure continued for 41 s after the tracer injection. All three readers lateralized the SOZ in the left hemisphere and localized it to the left tempotal lobe, both with highest certainty. After surgical resection of the lesion, the subject was free of seizures (Engel IA) during the entire follow-up of 60 months