Continuous Potential Display of Ictal Electrocorticography

Summary The objective of this study was to determine whether the animation of electrical activity recorded on ictal electrocorticograms (ECoGs) can demonstrate the propagation of seizure discharges from the epileptogenic zone (EZ) to the surrounding cortical area. A computer program, continuous potential display (CPD), was designed to animate the color-coded potential changes in 5-msec intervals at each recorded site. This program was used to analyze 35 ictal ECoGs recorded by subdural grid electrodes from 11 subjects who underwent epilepsy surgery for intractable partial seizures. Continuous potential display demonstrated recurrent cycles of seizure propagation from the EZ to the surrounding cortical area even when seizure discharges appeared widespread on ECoG. Hence, the EZ could be mapped at any time during the seizure course. The EZ mapped by analyzing a small fraction of ECoG during widespread seizure discharges using CPD only overlapped 69 ± 24% (mean ± standard deviation) of the surgical area. The EZ mapped by CPD had 34 ± 22% false positives and 35 ± 27% false negatives. Animation of potential changes recorded by ictal ECoG can assist in studying the temporal and spatial patterns of seizure propagation and in mapping the EZ for surgical resection.