Patient database was reviewed to associate pre-operative studies, including MRI, interictal and ictal scalp EEG, and functional imaging such as SPECT, to the side of surgical treatment and post-operative seizure outcome. Methods: This study included 17 consecutive patients with medically intractable temporal lobe epilepsy who underwent implantation of subdural electrodes on the both temporal lobes for pre-surgical evaluation of epilepsy. In this study, we reviewed our surgical cases who had undegone bilateral implantation of subdural electrodes before temporal lobe surgery, in order to define what subgroup of patients could potentially have omitted the invasive evaluation. However, the indication of such procedures, with a certain degree of surgical risks, is not well defined. In some cases, implantation of subdural or depth electrodes is required on both temporal lobes to define, or confirm, the epileptogenic hemisphere before proceeding to surgical treatment. Rationale: Various degree of bilateral epileptic activity is often found in scalp EEG in temporal lobe epilepsy. Neurosurgery, Kohnan Hospital, Sendai, JapanĢ Neurosurgery, Tohoku University Hospital, Sendai, Japan )
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