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Long-term (days) continuous intracranial EEG recordings from two patients, who underwent presurgical evaluation for localization of their epileptogenic focus at the epilepsy monitoring unit (EMU) of Shands Hospital in Gainesville, Florida, were analyzed (see Table 1).
The detection of the epileptogenic focus is further enhanced using Subtraction Ictal SPECT Co-registered with MRI (SISCOM), which requires subtraction of the interictal SPECT from the ictal SPECT, and superimposing the images onto anatomical MRI for accurate anatomical localisation of the lesion (Fig.
During chronic DBS, the stimulation is applied constantly to the epileptogenic focus, regardless of the area's own discharge.
At the time, the researchers surmised that the noise may have resulted from either (1) vibration of the vocal cords as air is exiting from the lungs; (2) vibration of upper airway tissues above the point of the vocal cords as air is exiting from the lungs; or (3) as a consequence of a brain tumor, epileptogenic focus, or other lesion in brain areas that control respiration.
In one case, a combination of neuronavigation and intraoperative electrocorticography was used to tailor the extent of the epileptogenic focus along with the cavernous malformation (Table 1).