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Subdural EEG in Posterior Cortex Epilepsy 

Subdural EEG in Posterior Cortex Epilepsy
Chapter:
Subdural EEG in Posterior Cortex Epilepsy
Author(s):

Americo C. Sakamoto

, Tonicarlo R. Velasco

, and Jorge Gonzalez Martinez

DOI:
10.1093/med/9780198714668.003.0026
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date: 20 August 2019

Surgery for extratemporal epilepsy surgery provides seizure control or reduction, but its overall results are less rewarding than those for temporal lobe epilepsy. Strategies for planning extratemporal surgery are more challenging and complex. Completeness of resection of the epileptogenic zone (EZ) is the single most important predictor of postsurgical seizure outcome, and therefore precise spatial delimitation of the EZ is at least as important as its localization. Moreover, careful definition and mapping of the functional state of the cortex bordering the EZ is crucial to ensure more precise and less risky surgical procedures. Invasive studies play a central role in the presurgical evaluation of extratemporal pharmacoresistant epilepsies. This chapter describes the rationale supporting the use of subdural electrodes, their role and limitations in definition of the irritative and ictal onset zones, in functional mapping of the eloquent cortex, and especially in planning of the surgical strategy.

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