Figure 1.

Patient #3 had pharmacoresistant epilepsy. The seizures began at 8 months of age, presenting with 1–2 seizures per week and in some periods 3–5 seizures per day. The EEGs showed epileptiform and non-epileptiform abnormalities in the left temporal region. MRI showed a mild thickening in the opercular region in the left frontal lobe. The reference standard determined the epileptogenic zone to involve the left frontal and left temporal lobes. (A) The ictal and (B) interictal SPECT images visual analysis were inconclusive. The (C) ¹⁸F-FDG PET/CT scan showed normal metabolism. However, the (D) SISCOM performed with SPM showed a cluster of hyperperfusion (arrow) in the left temporal lobe, which was compatible with the suspected regions by all studies and the reference standard.