SMART syndrome (stroke-like migraine attacks after radiotherapy) is a rare and late complication of cerebral radiotherapy, occurring at least 10 years after irradiation; it is characterized by headaches and reversible unilateral episodic neurological dysfunction, less often by epileptic seizures. SMART syndrome was first described by Shuper et al. [1]. Diagnosis of SMART syndrome requires integration of clinical features, analyses of CSF, EEG, MRI and functional imaging findings. Indeed, F-18-FDG PET/CT, an imaging technique assessing glucose metabolism, is a recognized tool to localize cortical substrate in refractory epilepsy.

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