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A Critical Analysis of Electrocorticography in Temporal Lobe Epilepsy.
A. Earl Walker, Robert S. Lichtenstein (by invitation) and Curtis Marshall (by invitation).The results of electrical recordings and stimulation of the temporal cortex and medial temporal structures in 30 patients are reported, of whom 20 were conscious during the operation. From electrodes placed randomly over the temporal and subjacent cortex, inserted into medial temporal structures and passed beneath the temporal lobe, widespread discharges were encountered, the dispersal varying from patient to patient. Afterdischarge thresholds ranged from 21/2 to over 8 volts with no definite lowering of threshold at sites of spontaneous discharge. After-discharges at spontaneously discharging points elicited clinical signs in 5 of 14 patients, in 4 of whom medial temporal structures were involved. Electrical spread following stimulations was variably accompanied by clinical manifestations, their nature varying with the locus stimulated. The seizure aura was reproduced in 4 instances, approximately