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To the Editor:
In their article, Altay et al. localize functional neurologic activity to a specific area of the cortex by utilizing EEG and SPECT to localize the “epileptic focus.”1 Such methodology for the localization of cortical function may be inadequate. Previously used concepts of “epileptogenic zone, irritative zone, ictal-onset zone,” may be too simplistic. Rather than seizures arising from a particular “focus,” they may be the manifestation of an intercortical hyperactive system or network. Reproducible clinical manifestations may arise from any of these areas or even from an area not in the epileptic network to which the primary epileptic system projects.
For example, occipital epilepsy usually involves propagation to other areas of the brain outside the network producing variable clinical manifestations.2 The concept of neural networks in epilepsy has been described; the medial temporal/limbic network …
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