Invasive electrographic recording techniques in temporal lobe epilepsy

The management of uncontrolled partial epilepsy is a process dependent on a multidisciplinary and analytic approach. It is necessary to understand whi ch lesions are epileptogenic, and if they are indeed responsible for the ge neration of seizures. In addition to localizing seizure onset, the function al and eloquent areas of the brain need to be identified. As in many other centres, we perform resective surgeries on the basis of combined informatio n derived from seizure semiology, EEG abnormalities, neuroimaging and other tests of cerebral function. If surface EEG recording yields inconclusive o r ambiguous results, then invasive intracranial techniques using intracereb ral depth or subdural electrodes can be used to improve diagnostic or progn ostic accuracy. The indications, principles, results and complications of t hese recording techniques based on extensive experience at two epilepsy sur gery centres are reviewed.