A 15 year old boy had 10–12 partial complex seizures per day inspite of adequate 4 drugs antiepileptic regime. He had a history of repeated high-grade fever in childhood. MRI for epilepsy protocol revealed normal brain scan. What should be the best noninvasive strategy to make a definite diagnosis so that he can be prepared to undergo epilepsy surgery –
If localization of epileptic focus is unrevealed on MRI, Ictal SPECT with HMPAO is the most practical and best method. Addition of video EEG further helps in localization of epileptic foci.