• Tong Yang, Shahin Hakimian, and Theodore H Schwartz.
• Department of Neurosurgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York.
• Epileptic Disord. 2014 Sep 1;16(3):271-9.

AimsTo describe the technique, indications, and utility of intraoperative ECoG monitoring during various surgeries for medically intractable epilepsy.MethodsLiterature was reviewed to obtain published results on using intraoperative ECoG techniques for the surgical treatment of medically intractable epilepsy of various underlying aetiologies. RESULTS General intraoperative ECoG techniques were described, including effects of anaesthetic agents on intraoperative ECoG signals. Use of intraoperative ECoG in temporal lobe epilepsy with mesial temporal sclerosis (MTS) is generally considered not necessary, whereas intraoperative ECoG in temporal lobe epilepsy without mesial temporal sclerosis may provide useful information. Intraoperative ECoG in extra-temporal epilepsy with structural lesions may facilitate resection, whereas the use of intraoperative ECoG in extra-temporal epilepsy without a structural lesion is more controversial.ConclusionsIntraoperative ECoG is a useful technique to be employed in surgical treatment of medically intractable epilepsy. However, its effectiveness may vary depending on the underlying pathological causes of the seizures.

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