Utilization of Electroencephalography in Epilepsy Surgery and Invasive Electroencephalography

Ceren GÜNBEYa, Dilek YALNIZOĞLUa

aÇocuk Nörolojisi BD, Hacettepe Üniversitesi Tıp Fakültesi, Ankara, TÜRKİYE

ABSTRACT
Interictal electroencephalogram (EEG) with scalp electrodes is recommended as an essential presurgical investigation in children by the ILAE Pediatric Epilepsy Surgery Subcommission. Video-EEG monitoring is a key feature of presurgical evaluation for epilepsy surgery which reveals the relation of seizure semiology and associated EEG changes. Analysis of seizure semiology along with interpretation of interictal and ictal EEG features provide critical information in identifying the epileptogenic zone in epilepsy surgery candidates. If presurgical noninvasive tests are discordant or yield inadequate data, invasive EEG recordings may be necessary. Intracranial electrodes are also used for cortical stimulation and mapping when the epileptogenic zone is in close proximity with the eloquent cortex. Invasive EEG is performed with subdural grid/strip electrodes and depth electrodes and may either be limited to intraoperative recordings or obtained long-term while the patient is admitted to video-EEG monitoring unit. Stereoelectroencephalography (sEEG) with stereotactically implanted electrodes have been utilized increasingly, particularly for determination of deep foci. Video-EEG monitoring should be performed in specialized centers that have dedicated health professionals.
Keywords: Epilepsy; electrocorticography; electroencephalography

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