ELECTROCORTICOGRAPHY AND TEMPORAL-LOBE EPILEPSY - RELATIONSHIP TO QUANTITATIVE MRI AND OPERATIVE OUTCOME

We investigated the relationship between electrocorticography (ECoG), quantitative magnetic resonance imaging (MRI), and surgical outcome in 165 patients with intractable nonlesional temporal lobe epilepsy (NLT LE). A standard mesial temporal resection was performed in all patient s. Patients with an operative followup <1 year were excluded from the study. The extent of the lateral temporal neocortex resection (LCR) wa s guided by ECoG and the side of surgery. The extent of the LCR was no t predictive of seizure outcome in patients with or without hippocampa l formation atrophy (p > 0.5). Patients undergoing a right anterior te mporal lobectomy had a larger LCR (p < 0.0001), but the side of surger y was not of predictive value in determining seizure outcome (p > 0.1) . The topography of the acute intracranial spikes did not correlate wi th operative outcome (p > 0.5) and was independent of hippocampal volu metric studies (p > 0.5). The postexcision ECoG was also shown not to be of prognostic importance (p > 0.5). Our results indicates that the extent of the lateral temporal cortical resection and the ECoG finding s are not important determinants of surgical outcome in patients with NLTLE.