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Brain, Vol. 124, No. 9, 1683-1700, September 2001
© 2001 Oxford University Press

Invited review

Presurgical evaluation of epilepsy

Felix Rosenow1 and Hans Lüders2

1 Department of Neurology, Philipps University, Marburg, Germany and 2 Department of Neurology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Correspondence to: Hans O. Lüders, MD, Department of Neurology S90, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA E-mail: scolarc{at}ccf.org

An overview of the following six cortical zones that have been defined in the presurgical evaluation of candidates for epilepsy surgery is given: the symptomatogenic zone; the irritative zone; the seizure onset zone; the epileptogenic lesion; the epileptogenic zone; and the eloquent cortex. The stepwise historical evolution of these different zones is described. The current diagnostic techniques used in the definition of these cortical zones, such as video-EEG monitoring, MRI and ictal single photon emission computed tomography, are discussed. Established diagnostic tests are set apart from procedures that should still be regarded as experimental, such as magnetoencephalography, dipole source localization and spike-triggered functional MRI. Possible future developments that might lead to a more direct definition of the epileptogenic zone are presented.


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