Tong Yang1, Shahin Hakimian2, Theodore H Schwartz3. 1. Department of Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York. 2. Department of Neurology, Regional Epilepsy Center at Harborview Medical Center, University of Washington Medical Center, Seattle, Washington. 3. Department of Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, Department of Neurology and Neuroscience, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA.
Abstract
AIMS: To describe the technique, indications, and utility of intraoperative ECoG monitoring during various surgeries for medically intractable epilepsy. METHODS: Literature was reviewed to obtain published results on using intraoperative ECoG techniques for the surgical treatment of medically intractable epilepsy of various underlying aetiologies. RESULTS General intraoperative ECoG techniques were described, including effects of anaesthetic agents on intraoperative ECoG signals. Use of intraoperative ECoG in temporal lobe epilepsy with mesial temporal sclerosis (MTS) is generally considered not necessary, whereas intraoperative ECoG in temporal lobe epilepsy without mesial temporal sclerosis may provide useful information. Intraoperative ECoG in extra-temporal epilepsy with structural lesions may facilitate resection, whereas the use of intraoperative ECoG in extra-temporal epilepsy without a structural lesion is more controversial. CONCLUSIONS: Intraoperative ECoG is a useful technique to be employed in surgical treatment of medically intractable epilepsy. However, its effectiveness may vary depending on the underlying pathological causes of the seizures.
AIMS: To describe the technique, indications, and utility of intraoperative ECoG monitoring during various surgeries for medically intractable epilepsy. METHODS: Literature was reviewed to obtain published results on using intraoperative ECoG techniques for the surgical treatment of medically intractable epilepsy of various underlying aetiologies. RESULTS General intraoperative ECoG techniques were described, including effects of anaesthetic agents on intraoperative ECoG signals. Use of intraoperative ECoG in temporal lobe epilepsy with mesial temporal sclerosis (MTS) is generally considered not necessary, whereas intraoperative ECoG in temporal lobe epilepsy without mesial temporal sclerosis may provide useful information. Intraoperative ECoG in extra-temporal epilepsy with structural lesions may facilitate resection, whereas the use of intraoperative ECoG in extra-temporal epilepsy without a structural lesion is more controversial. CONCLUSIONS: Intraoperative ECoG is a useful technique to be employed in surgical treatment of medically intractable epilepsy. However, its effectiveness may vary depending on the underlying pathological causes of the seizures.