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Invasive EEG and Hippocampal Sclerosis 

Invasive EEG and Hippocampal Sclerosis
Invasive EEG and Hippocampal Sclerosis

Jerome Engel

, Richard Staba

, and Itzhak Fried

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date: 15 July 2020

Hippocampal sclerosis is the most common lesion associated with pharmacoresistant epilepsy, and anterior temporal lobe resection for hippocampal sclerosis remains the most common surgical treatment for epilepsy in adults. There are several different types of hippocampal sclerosis. Although the predominant causes of this condition are unknown, much is understood concerning the pathophysiology and anatomy of the neuronal networks most often constituting the epileptogenic region, the resection of which is necessary and sufficient to eliminate spontaneous epileptic seizures. Advances in neuroimaging, clinical neurophysiology, neurocognitive testing, and other diagnostic procedures now permit successful surgical treatment of intractable seizures with a standardized anteromesial temporal resection in most patients. Invasive monitoring is necessary in a minority of patients and is based on the known anatomy and pathophysiology of mesial temporal lobe epilepsy. A seizure-free outcome can be expected in 70–85% of patients.

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