Resecting without detecting the lesion in extratemporal lobe epilepsy?
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Nonlesional extratemporal lobe epilepsy (ETLE) often persists following resection of the site of ictal onset, localized with definitive intracranial EEG recordings.1,2 In lesional ETLE, however, lesionectomy with resection of a single electrophysiologically defined ictal onset (ictogenic) zone often stops seizures immediately and permanently.1,2 In temporal lobe epilepsy (TLE), a single ictogenic site can be resected, either with an accompanying lesion or in the absence of an MRI-detected lesion, and is a highly efficacious epilepsy therapy.2 Efforts to increase surgical efficacy in nonlesional ETLE have focused on localization by functional imaging to substitute for lesion localization by structural imaging.
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