Authors' objectives:

The objective of the report was to to analyze the use of SPECT for the pre-surgical evaluation of patients with epilepsy.

Authors' results and conclusions: Measurement of Changes in Cerebral Flow Three systematic reviews were found. In one review with meta-analysis, the SPECT sensitivity to detect the electroencephalic epileptogenic focus was 0.438 (CI95% 0.0323 0.553) for the interictal SPECT; 0,754 (CI 95% 0.631 0.852) for the post-ictal and 0.97 (0.887 0.996) for the ictal. The other 2 reviews (without meta-analysis) showed consistent results, with higher sensitivity for the ictal SPECT. One of them also evaluated the usefulness of SPECT to predict the post-surgical outcome, thus finding a positive trend. Seven additional studies, which were extremely heterogeneous, with few patients, were found. One study did not find any association between SPECT results and post-surgical evolution. Another study reported that the sensitivity and specificity of the subtraction ictal/interical images is 93% and 87% for mesial temporal lobe epilepsy and; 77% and 93% for neocortical epilepsy, respectively. Another study reported that pre-surgical interictal SPECT did not provide additional information in patients with consistent electroencephalogram and magnetic resonance imaging. Quantification of Benzodiazepine Receptors Three studies were found; two of them were published in Japanese. In the remainder, SPECT could adequately locate the epileptogenic focus in 6 out of 7 patients with refractory temporal lobe epilepsy who underwent surgery to achieve cure. Quantification of Muscarinic Receptors Two studies were found about patients with refractory temporal lobe epilepsy. The number of patients whose epileptogenic focus was adequately located with SPECT was 18 out of 25 in the first study and 11 out of 12 in the second one.

Authors' recommendations: In general, the quality of the studies associated with educational treatment programs for autistic children are methodologically poor and Floor Time therapy is not an exception. However, it seems that there is a certain degree of benefit from these interventions. There is not enough evidence, with adequate follow-up periods to support the use of floor-time therapy on a routine basis. Nonetheless, this may be significant in autistic children with social interaction disorders when integrated with some approach that enables objective measurements of progress in acquired skills, as in the case of the applied behavioral analysis approach.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.iecs.org.ar/

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)