Cortical stimulation during intracranial electroencephalography (EEG) is used in defining the epileptogenic zone in patients with epilepsy, with the aim of removing the seizure onset zone (SOZ). However, the effect of cortical stimulation on surgical outcomes has not been well studied. In this cohort study, investigators performed neurophysiologic characterization of stereo-electroencephalography (SEEG) data for 103 patients with focal drug-resistance epilepsy in order to examine the correlation between cortical stimulation findings with surgical outcomes. Investigators found that SEEG was able to induce at least 1 electroclinical seizure in 57.3% of patients, with a median response rate of 2 cortical stimulation-induced seizures per patient. The percentage of patients with a cortical stimulation-induced electroclinical seizure was 70.5% in the good outcome group and 47.5% in the poor outcome group (p=0.02). The results from this study indicate that patients who have cortical stimulation-induced typical electroclinical seizures have a higher likelihood of having a good surgical outcome than those without such induced seizures, and as such the inability to induce a cortical stimulation-induced seizure may prompt re-evaluation of surgical candidacy.
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