Delayed high-frequency suppression after automated single-pulse electrical stimulation identifies the seizure onset zone in patients with refractory epilepsy

Twenty to thirty percent of patients with epilepsy are pharmacoresistent (Tonini et al. , 2004). Epilepsy surgery, in which the seizure focus is removed, is an option for some patients and leads to seizure freedom in ∼55-70% of temporal resections and 30-50% of neocortical resections (Tonini et al. , 2004). Many patients require surgical implantation of intracranial electrocorticography (ECoG) electrodes for seizure monitoring to estimate the seizure onset zone (SOZ). Because ECoG is invasive and involves prolonged hospitalization, some patients are hesitant to undergo the procedure, and some neurologists are reluctant to refer patients despite the possibility of seizure freedom.

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