Partial seizures with onset in central area: use of the callosal grid system for localization

Focal seizures arising in the central area require precise anatomic and physiologic mapping of ictal onset. The central sulcus is identified by the callosal grid system whose mid-vertical plane identifies the central sulcus inferiority where the central artery passes into the central sulcus. 5 patients with intractable seizures of central origin where localized with this method. Extent of resection was confirmed on postoperative NRI. The subdural grid was accurately placed on the central sulcus, confirmed by electrophysiologic means. Grid planes compartmentalized ictal onset, and post-operative resection correlated precisely. All patients are seizure-free. Seizures arising in the central area, precisely located, can be treated with good to excellent results. Localization of onset is facilitated by use of the callosal grid system, and allows superimposition of pre-, intra- and post-operative anatomic and physiologic data.