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Updated: May 30, 2026

Recording Human Electrocorticographic (ECoG) Signals for Neuroscientific Research and Real-time Functional Cortical Mapping
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Scalp EEG does not predict hemispherectomy outcome.

Hansel M Greiner1, Yong D Park, Katherine Holland

  • 1Department of Pediatrics, Division of Child Neurology, Cincinnati Children's, Hospital Medical Center, 3333 Burnet Avenue, MLC 2015, Cincinnati, OH, United States.

Seizure
|August 5, 2011
PubMed
Summary
This summary is machine-generated.

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Scalp electroencephalography (EEG) findings do not solely predict hemispherectomy outcomes. Nonlateralizing EEG results do not indicate poor seizure control after hemispherectomy, regardless of epilepsy cause.

Area of Science:

  • Neurosurgery
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Functional hemispherectomy offers significant seizure reduction and developmental benefits in select patients.
  • Scalp electroencephalography (EEG) may show bilateral or contralateral ictal onset, potentially conflicting with imaging findings.
  • The predictive value of pre-operative scalp EEG lateralization for hemispherectomy outcomes requires investigation.

Observation:

  • A retrospective review of 54 patients undergoing hemispherectomy with at least one year of follow-up was conducted.
  • Pre-operative EEGs were analyzed for lateralizing versus nonlateralizing ictal and interictal abnormalities.
  • Patient outcomes were assessed, with 78% achieving seizure freedom post-surgery.

Findings:

  • Twenty-four patients (44%) had nonlateralizing ictal or interictal EEGs.

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  • Nonlateralizing EEG findings did not correlate with poor outcomes across different epilepsy etiologies, including malformation of cortical development, Rasmussen syndrome, and stroke.
  • Scalp EEG abnormalities in contralateral or bilateral hemispheres, in isolation, do not predict poor surgical outcomes.

    • Implications:

    • Scalp EEG lateralization alone is insufficient for determining hemispherectomy candidacy.
    • Comprehensive pre-operative assessments, including other non-invasive and invasive evaluations, are essential for patient selection.
    • These findings refine the interpretation of pre-operative EEG in the context of hemispherectomy planning.