Electrocorticography: information derived from intraoperative recordings during seizure surgery

The findings of 100 consecutive electrocorticographies in 94 epileptic patients were reviewed. Most of these patients underwent temporal lobectomies. A well defined and circumscript cortical spike focus was found in only 28 tracings whereas multiple sub-foci of spike activity or dissipated areas of spiking were demonstrated in 46 recordings. Cortical spike activity was minimal in 14 and absent in 12 tracings. Additional one-lead depth electrodes (inserted mainly into amygdala and hippocampus) yielded rather little information in contrast to the wealth of information derived from chronic multiple-leads depth implants prior to surgery. The frequent occurrence of dissipated spike foci suggests that, in partial epilepsies (and especially in temporal lobe epilepsy), epileptogenic zones are more widespread than one would expect from the scalp EEG recordings. These findings lend support to the use of en-bloc removal of large portions of an affected lobe.