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In well over a century of performing epilepsy surgery, only 60%–65% of patients are, on average, seizure-free postoperatively.1 Despite multiple advances in neuroimaging and electrophysiologic techniques for localizing the epileptogenic zone and determining its boundaries, defining the exact amount of neuronal tissue required to resect in order to achieve postoperative seizure freedom remains challenging. The quest for a reliable biomarker of the epileptogenic zone continues. In addition to long-term intracranial EEG recordings to identify the seizure onset zone, cortical resections are also tailored in the operating room by including areas with abundant epileptic spikes and seizure-like interictal activity (ictiform patterns) recorded with corticography.2 Intraoperative localization based on interictal EEG activity would be much more cost-effective than chronic recording to capture spontaneous seizures.
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- © 2015 American Academy of Neurology
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