• Tom Theys, Lorella Minotti, Laura Tassi, Lo Russo Giorgio G Epilepsy Surgery Center, "Claudio Munari" Niguarda Hospital, Milan, Italy., Alim-Louis Benabid, Philippe Kahane, and Stephan Chabardès.
• Department of Neurosurgery, Univer-sity Hospitals Leuven, Leuven, Belgium.
• Neurosurgery. 2017 Feb 1; 80 (2): 269-278.

BackgroundExtratemporal lobe epilepsy surgery remains a diagnostic and therapeutic challenge. Scalp electroencephalography (EEG) correlates, clinical semiology, and imaging findings are often ambiguous or difficult to interpret, necessitating the need for invasive recordings. This is particularly true for those extratemporal lobe epilepsy cases in which seizures develop from the midline.ObjectiveThe aim of this study was to examine the clinical features and surgical strategies in mesial extratemporal lobe epilepsy.MethodsA retrospective study reviewing clinical and surgical characteristics was conducted in 30 patients who underwent epilepsy surgery in mesial extratemporal areas at our institution between 1991 and 2011.ResultsAlthough the location of the epileptogenic zone was associated with specific seizure types, semiology proved to be heterogeneous. Although scalp EEG was of good lateralizing value, it was poor for localizing the epileptogenic zone, necessitating a frequent need for invasive electroencephalographic recordings.ConclusionSurgical resections in mesial extratemporal regions were found to be safe and resulted in satisfactory seizure outcomes.

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