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Intracranial EEG Monitoring: Depth, Subdural, Foramen Ovale, and Microarrays 

Intracranial EEG Monitoring: Depth, Subdural, Foramen Ovale, and Microarrays
Chapter:
Intracranial EEG Monitoring: Depth, Subdural, Foramen Ovale, and Microarrays
Author(s):

Margitta Seeck

, and Donald L. Schomer

DOI:
10.1093/med/9780190228484.003.0029
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date: 13 October 2019

Intracranial electroencephalography (iEEG) is used to localize the focus of seizures and determine vital adjacent cortex before epilepsy surgery. The two most commonly used electrode types are subdural and depth electrodes. Foramen ovale electrodes are less often used. Combinations of electrode types are possible. The choice depends on the presumed focus site. Careful planning is needed before implantation, taking into account the results of noninvasive studies. While subdural recordings allow better mapping of functional cortex, depth electrodes can reach deep structures. There are no guidelines on how to read ictal intracranial EEG recordings, but a focal onset (<5 contacts) and a high-frequency onset herald a good prognosis. High-frequency oscillations have been described as a potential biomarker of the seizure onset zone. Intracranial recordings provide a focal but magnified view of the brain, which is also exemplified by the use of microelectrodes, which allow the recording of single-unit or multi-unit activity.

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