Stereoelectroencephalographic Language and Memory Mapping Complements Traditional Methodologies Used to Evaluate Epilepsy Surgery Candidacy

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Abstract Intracranial electroencephalography is frequently used to study patients with drug-resistant epilepsy and offers a unique opportunity to study human cognition. Its utility can be extended to better understand functional neuroanatomical profiles of patients and guide a tailored, minimally invasive surgical approach. We present prospective data on a 20-year-old patient with drug-resistant left temporal lobe epilepsy who underwent stereoelectroencephalography (SEEG) as a part of epilepsy surgical workup. Given obscurity regarding hemispheric dominance of language and memory, the patient’s workup included functional MRI, Wada procedure, and electrocortical stimulation and mapping of high frequency activity and phase amplitude coupling using SEEG to characterize his anatomofunctional profile. We describe the complementary use of these methods to inform surgical decision-making and functional prognostication. Data from mapping of high frequency activity and phase amplitude coupling, as a relatively new technique, is correlated with results from other procedures to advocate for increasing their utility in surgical planning.

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