{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:22:02Z","timestamp":1785896522889,"version":"3.56.0"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report ictal SPECT findings in a patient with focal epilepsy and ictal central apnea (ICA). We describe the history, EEG findings, and SPECT analysis of a 38\u2010year\u2010old female with left posterior quadrant epilepsy post intracerebral hemorrhage due to ruptured aneurysm, whose seizures are accompanied by ICA. The patient underwent continuous EEG monitoring as a presurgical candidate for her epilepsy, during which several typical seizures associated with ICA were captured. Ictal SPECT was performed during a typical seizure with ICA, with tracer administration 15\u2009s after the ICA onset, 14\u2009s after the EEG onset, 7\u2009s after the first video\u2010appreciated clinical change, and 24\u2009s before evolution to focal\u2010to\u2010bilateral tonic\u2013clonic seizure. Ictal SPECT revealed significant hyperperfusion in the anterior pons with mild left &gt; right lateralization. Ictal SPECT hereby demonstrates the potential to highlight ICA\u2010associated regions in patients with focal epilepsy. Vigilance for similar imaging markers is recommended in centers that have access to SPECT without incorporating respiratory monitoring during routine EMU procedures, as pontine hyperperfusion may suggest underlying ICA and considerable risk of sudden unexpected death in epilepsy.<\/jats:p>","DOI":"10.1002\/epd2.70047","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T10:03:57Z","timestamp":1747994637000},"page":"668-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pontine hyperperfusion associated with ictal central apnea"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4309-5455","authenticated-orcid":false,"given":"Vasileios","family":"Kokkinos","sequence":"first","affiliation":[{"name":"Comprehensive Epilepsy Center Northwestern Memorial Hospital  Chicago Illinois USA"},{"name":"Department of Neurology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0759-4414","authenticated-orcid":false,"given":"Stephen A.","family":"VanHaerents","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center Northwestern Memorial Hospital  Chicago Illinois USA"},{"name":"Department of Neurology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9407-3427","authenticated-orcid":false,"given":"Cody L.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center Northwestern Memorial Hospital  Chicago Illinois USA"},{"name":"Department of Neurology Feinberg School of Medicine, Northwestern University  Chicago Illinois 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