Optimal use of EEG montages to identify inferior temporal epileptiform activity

The 10/20 EEG electrode position system recommended by Herbert Jasper at the 2nd International EEG Congress has remarkably stood the test of time (Klem et al., 1999). Image localization and studies of closely spaced electrode systems have generally confirmed that 10/20 electrode positions are located similarly, within 1 cm of major anatomic landmarks in individuals despite their varying head sizes and shapes (Homan et al., 1987). Silverman and other recognized, however, that interictal and ictal epileptiform discharges often originate in basal and anterior temporal regions that are poorly sampled by standard 10/20 leads and recommended T1/T2 electrodes for recording anterior inferior sources (Silverman, 1960).

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