This chapter reviews the application of intracranial EEG monitoring and cortical stimulation in the surgical treatment of tuberous sclerosis (TS) patients with uncontrolled epilepsy. It begins with a review of issues related to seizure localization and determination of epileptogenic tubers, followed by a review of surgical series in which intraoperative electrocorticography (ECoG) or extraoperative EEG monitoring with subdural or depth electrodes was utilized. Specific interictal and ictal EEG patterns suggesting intrinsic epileptogenicity of tubers are described, and similarities with focal cortical dysplasia are emphasized. The discussion is illustrated with examples of invasive EEG findings in patients with TS, and their relationship to the centre and rims of epileptogenic and non-epileptogenic tubers, and to perituberal and remote cortex. The chapter provides a comprehensive resource that will help epileptologists and neurophysiologists to decide on the need for invasive EEG, and the significance of findings, in TS patients with uncontrolled epilepsy.
Presurgical non-invasive diagnosis of focal cortical dysplasia
