Electrocorticographic Monitoring as An Alternative Tool for the Pre-surgical Evaluation of Patients with Bi-temporal Epilepsy

Background: To analyze the surgical outcomes of patients with temporal lobe epilepsywith bilateral foci after one-week bilateral subdural strip electrocorticographic(ECoG) recording.Methods: We retrospectively evaluated 12 patients with bilateral epileptic foci afterscalp electroencephalography examination who underwent ECoG betweenMay 1995 and July 2000. Subdural strips were implanted in the bilateral subtemporalregions for a one-week ECoG recording.Results: All but one of the patients exhibited unilateral dominance of epileptogenicdischarges (> 65%) and, following an anterior temporal lobectomy, themajority of patients (8 of 11) enjoyed a seizure-free life during the ensuing 3years. No mortality or morbidity such as intracranial hemorrhage or woundinfection was noted.Conclusions: The dominance of an epileptic focus in patients with bitemporal epileptogenicdischarges can thus be successfully recorded by electrocorticographicmonitoring prior to anterior temporal lobectomy.