Annals of Indian Academy of Neurology
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Year : 2014  |  Volume : 17  |  Issue : 5  |  Page : 40-44

Electrophysiology in epilepsy surgery: Roles and limitations

Department of Neurology, University of Virginia, Charlottesville, Virginia, USA

Correspondence Address:
Edward H Bertram
Department of Neurology, University of Virginia, P.O. Box 800394, Charlottesville, Virginia 22908-0394
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Source of Support: This work was supported in part by grants from the National Institutes of Health NS25605 and NS75157, Conflict of Interest: None

DOI: 10.4103/0972-2327.128649

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Successful epilepsy surgery depends on the localization of the seizure onset zone in an area of the brain that can be safely resected. Defining these zones uses multiple diagnostic approaches, which include different types of electroencephalography (EEG) and imaging, and the results are best when all of the tests point to the same region. Although EEG obtained with scalp recordings is often sufficient for the purposes of localization, there are times when intracranial recordings directly from the brain are needed; but the planning, use, value, and interpretation of the these recordings are not standardized, in part because the questions that are to be answered vary considerably across many patients and their heterogenous types of epilepsy that are investigated. Furthermore, there is a desire to use the opportunity of direct brain recordings to understand the pathophysiology of epilepsy, as these recordings are viewed as an opportunity to answer questions that cannot be otherwise answered. In this review, we examine the situations that may require intracranial electrodes and discuss the broad issues that this powerful diagnostic tool can help address, for identifying the seizure focus and for understanding the large scale circuits of the seizures.

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