Use of an anteromedial subdural strip electrode in the evaluation of medial temporal lobe epilepsy

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Abstract
The temporal lobe is the most common site of partial epilepsy that is amenable to surgical therapy, and therefore ictal localization in this region is important. The authors describe the application of an anteromedial subdural strip electrode for the evaluation of epilepsy originating from the medial temporal lobe. This strip is advanced around the temporal pole and underneath the lesser wing of the sphenoid bone as it follows the medial temporal lobe contour. The advantages of this method of placement are the consistent path and reliable final position of the strip along the medial basal temporal lobe surface. This method allows adequate coverage of the parahippocampal gyrus along its long axis extending posterior to the level of the collicular plate. This technique has been used with no complications during intracranial monitoring of more than 100 patients with presumed temporal lobe epilepsy.