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Electrocorticography and stimulation
C D Binnie1, M C McBride, C E Polkey
1Maudsley Hospital, London, England.
Acta Neurologica Scandinavica. Supplementum
|January 1, 1994
Summary
Resecting the entire irritative zone during epilepsy surgery is not always essential for seizure control. Detailed analysis of electrocorticography (ECoG) is needed to establish clear interpretive criteria for surgical planning.
Area of Science:
- Neuroscience
- Neurosurgery
- Epileptology
Background:
- Acute electrocorticography (ECoG) is a standard procedure in epilepsy surgery.
- There is ongoing debate regarding the precise value and interpretation criteria for ECoG.
Purpose of the Study:
- To review the clinical utility of ECoG in epilepsy surgery.
- To evaluate specific issues related to ECoG interpretation and its impact on surgical outcomes.
Main Methods:
- Literature review and analysis of personal studies.
- Examination of ECoG data in relation to surgical resection and patient outcomes.
Main Results:
- Resection of the entire irritative zone may not be critical for successful seizure control.
- The topography of epileptiform discharges, not just the extent of resection, can predict pathology and surgical outcomes.
- Activation of ECoG by barbiturates and intraoperative stimulation require further investigation for clinical value.
Conclusions:
- Current ECoG interpretive criteria are insufficient for optimal surgical planning.
- More detailed topographic and quantitative analysis of ECoG is necessary to enhance its value in epilepsy surgery.