Intraoperative electrocorticography and direct cortical electrical stimulation

Summary First performed by Victor Horsley in 1886, the surgical management of epilepsy has increased substantially over the past 20 years. The goals of surgery are to render a patient seizure-free without additional neurological deficits. ECoG provides information on the location of abnormal spiking cortex in lesional and nonlesional epilepsy surgery and may aid in determining margins of resection in epilepsy surgery. DCES provides information on the location of eloquent areas of cortex that should not be removed during epilepsy surgery. Conscious sedation and general anesthetic regimens are available, which provide maximal comfort for a patient without significant alteration of ECoG or alteration in ability to cooperate with functional mapping procedures when needed.