Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families
SPECT scan investigations
investigations and what to expect when your
Why does my child
need this investigation?
child comes to Great Ormond Street Hospital
Your child needs this test to examine
(GOSH) to have the tests.
their seizures in more detail, to find out
This leaflet explains about SPECT scan
What are SPECT
scan investigations?
A SPECT scan is used to look at the
flow of blood in the brain. When your
child has a seizure, blood flow to the
area responsible for causing the seizure
the location of the seizures and whether
they are confined to certain areas of the
brain. Your child will also be observed
and recorded on video too. The results
of this test will give the doctors more
information so that they can treat the
seizures better.
increases. In between seizures, there
is a reduced flow of blood in this area.
doctors information about the location of
Are there any risks
with this procedure?
seizures and whether they are confined to
It is sometimes necessary to reduce or stop
certain areas of the brain. The scans work
your child’s anticonvulsant medicines while
by injecting a substance called an isotope
the test is happening so that your child
into your child’s veins, which then travels
can have a seizure while in hospital. The
to the brain. There are no side effects to
doctors will decide this when you and your
this injection. The isotope shows the blood
child come into hospital for the test. If your
flow clearly on the scan.
child has had a number of seizures recently,
This means that these scans can give the
There are two types of SPECT scan, an Ictal
SPECT scan and an Inter-Ictal SPECT scan.
The word ‘ictus’ means attack or seizure so
an ‘Ictal SPECT scan’ is used immediately
after an epileptic seizure. An ‘Inter-Ictal
SPECT scan’ is used between seizures.
even though on anticonvulsant medicines,
they may be able to continue taking them
during the test. There is always a risk in
reducing or stopping your child’s medicines
suddenly for this test. This can cause your
child to have longer or more intense
seizures than usual. However, the doctors
and nurses will monitor your child closely
to stop this happening.
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If you are pregnant or think you could
this with you at your appointment
be pregnant, please let us know at least
before you come into hospital. The Ictal
two days before your child is due to come
SPECT scan will usually take place on the
to GOSH. There is a risk that the isotope
Wednesday with the Inter-Ictal SPECT scan
given to your child could harm your
on the Friday. However, if your child is
unborn baby, so we advise you to organise
having the Ictal SPECT scan under general
another adult to help look after your child
anaesthetic, we will usually arrange the
for the first 24 hours after the scan. If this
Inter-Ictal SPECT scan for another visit.
is not possible, we may have to reschedule
your appointment.
The doctors will explain about the test in
more detail, discuss any worries you may
If your daughter is 12 years old or older,
have and ask you to give permission for
we will ask her about her periods and any
the test by signing a consent form. If your
possibility that she could be pregnant.
child is having the test under sedation
or a general anaesthetic, another doctor
Are there any
alternatives to this test?
The doctors can tell a lot from
electroencephalogram (EEG) monitoring,
but SPECT scan investigations can help
fill any gaps in their information. It can
also be useful to see a seizure as it is
(anaesthetist) will discuss this with you.
If your child has any medical problems, for
instance allergies, please tell the doctors
about these.
If your child has had any infectious
diseases like chicken pox or head lice
recently, please tell the doctors.
happening on the video recording.
What happens
before the test?
Your child may need to stay on Tiger Ward
for up to five days, depending on which
type of scan they are having. If your child
is having both scans, they will probably be
admitted to Tiger Ward on the Monday
morning. Ward staff will then attach your
child to a continuous EEG monitor, which
will stay in place until the Friday.
The doctors can carry out the SPECT scans
What does the
test involve?
Before the test starts the doctor or nurse
will put a cannula (a small plastic tube)
into a vein in your child’s hand so that
they can inject the isotope more easily.
The doctor or nurse can put some local
anaesthetic cream on your child’s hand
an hour beforehand. This will numb the
skin so the cannula does not hurt so much.
If your child is apprehensive or scared,
please telephone us beforehand to discuss
your concerns with our play specialist.
with your child under sedation, under
a general anaesthetic or without either
of these. The doctors will have discussed
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The Ictal SPECT scan
A nurse or doctor will inject the isotope
into the cannula in your child’s hand
during a seizure. They will then have
a scan within about four hours. As the
isotope has to be injected during a
seizure, a nurse or doctor will be sitting
with or near your child while they wait for
a seizure. They will usually put aside about
five hours for this test. If your child does
not have a seizure within this time, the
What happens
after the test?
If your child has had to reduce or stop
taking anticonvulsant medicines, these will
be started again. You will be able to take
your child home once they have been back
on full medication for 24 hours and the
frequency of seizures is back to normal.
The doctors will pass on the results of the
test at your next outpatient appointment.
test may be rearranged for another day.
The Inter-Ictal SPECT scan
A radiographer will inject the isotope into
the cannula in your child’s hand. They
will then have a scan, lasting about 45
minutes, either within the next hour or
after being sedated or given a general
anaesthetic.
If you have any questions or
worries, please telephone the
Clinical Nurse Specialist – Epilepsy
Surgery on 020 7405 9200
Extension 5824 or out of hours
ring Tiger Ward on 020 7829 8827
Notes
Compiled by the Epilepsy Surgery team and Radiology department
in collaboration with the Child and Family Information Group
Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH
www.gosh.nhs.uk
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