Technetium-99m-HMPAO SPECT in patients with hemiconvulsions followed by Todd's paralysis

We performed technetium-99m-hexamethylpropylene- amineoxime (Tc-HMPAO) single photon emission computed tomography in two patients with prolonged hemiconvulsions followed by transient hemiparesis (Todd's paralysis), In both cases, a prolonged post-ictal cerebral hyperperfusion state of approximately 24 h was observed, even after the neurological deficits had resolved, The cerebral hyperperfusion in both cases was of much longer duration than that in previously reported cases of single and uncomplicated focal seizures. The prolonged cerebral hyperperfusion might have been due to impairment of the cerebrovascular autoregulation in seizures followed by Todd's paralysis.