DOI: https://doi.org/10.36347/sasjm.2025.v11i10.021

Pages: 1060-1064

Epilepsy is a chronic neurological disorder, and up to 30% of patients remain pharmacoresistant despite adequate treatment. Precise localization of the epileptogenic focus is essential for surgical management, particularly when CT or MRI findings are inconclusive. We report the case of a 21-year-old patient with post-traumatic pharmacoresistant epilepsy. Brain perfusion SPECT with 99mTc-HMPAO, performed in both ictal and interictal phases, revealed focal hyperperfusion and hypoperfusion patterns that guided localization of the epileptogenic zone. This case illustrates the key role of functional imaging in the pre-surgical evaluation of refractory epilepsy.