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 epilepsy with bilateral foci after one-week bilateral subdural strip electrocorticographic (ECoG) recording. METHODS We retrospectively evaluated 12 patients with bilateral epileptic foci after scalp electroencephalography examination who underwent ECoG between May 1995 and July 2000. Subdural strips were implanted in the bilateral subtemporal regions for a one-week ECoG recording. RESULTS All but one of the patients exhibited unilateral dominance of epileptogenic discharges (> 65%) and, following an anterior temporal lobectomy, the majority of patients (8 of 11) enjoyed a seizure-free life during the ensuing 3 years. No mortality or morbidity such as intracranial hemorrhage or wound infection was noted. CONCLUSIONS The dominance of an epileptic focus in patients with bitemporal epileptogenic discharges can thus be successfully recorded by electrocorticographic monitoring prior to anterior temporal lobectomy.