[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-142958-en":3,"doc-seo-142958-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},142958,1099513958607,"Jiven","https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399",7,"Healthcare","Definition and Localization of the Epileptogenic Zone - General Principles","The article traces historical and conceptual shifts in defining the epileptogenic zone, from early epilepsy surgery ideas and cortical lesion localization to the roles of EEG, electrocorticography, and stereo-electroencephalography (SEEG). It reviews the move toward a more modern, practical interpretation centered on the minimal cortical area required for resection to achieve seizure freedom. A 1993 definition is presented and then streamlined, with key assumptions and limitations discussed, including constraints on surgical control via disconnection strategies.","Definition and localization of the epileptogenic zone  \nEpileptic Disord 2006; 8 (Suppl. 2): S1-9  \nThe epileptogenic zone: general principles  \nHans O. Lüders, Imad Najm, Dileep Nair, Peter Widdess-Walsh, William Bingman  \nEpilepsy Center, Cleveland Clinic Foundation, Cleveland, USA  \nCorrespondence:  \nH.O. Lüders  \nEpilepsy Center,  \nCleveland Clinic Foundation, Cleveland, OH  \nUSA  \n\u003C[scolarc@ccf.org](scolarc@ccf.org)>  \nSir Victor Horsley, a British neurosurgeon, pioneered epilepsy surgery and, in 1886, published the reports of successful cortical resections that resulted in a significant reduction in epileptic seizures in three patients (Horsley, 1886) . At that time, V. Horsley assisted by J.H. Jackson (epileptologist) and D. Ferrier (neurophysiologist), identified the region to be resected by the location of either a structural lesion and/orthe area of cortex which, on stimulation, reproduced the initial symptoms of the clinical seizure. As J. H. Jackson indicated, they hoped that surgery would result in “cutting out the discharging lesion” that they believed was “the very local cause of the fits”. In other words, in the 19th century, the so-called “discharging lesion”, defined by the location of the macroscopic cortical lesion and/or clinical ictal semiology, was equivalent to theepileptogenic zone of modern epileptology.  \nIn 1929, H. Berger (Berger, 1929) published the first report of EEG recordings in humans, and in 1934 O. Foerster (Foerster and Altenburger 1934) reported the first electrocorticogram. However, the extent of the “epileptogenic zone” was defined almost exclusively by the limits of the macroscopical cortical lesion until the early 1950s. At that time, Bailey and Gibbs (Bailey and Gibbs 1951) and Penfield and Jasper (Penfield and Jasper 1954) also used complementary interictal scalp EEG and interictal corticography to establish the limits of the epileptogenic zone. For the next 10-20  \nyears these techniques remained the essential armamentarium used to define the epileptogenic zone, even if researchers realized the limitations and lack of precision intrinsic to the interictal epileptiform activity as an index of the epileptogenic zone. Anew breakthrough was the introduction of the stereo-electroencephalography (SEEG) by Jean Talairach and Jean Bancaud that revolutionized our concept of the epileptogenic zone (Bancaud et al. 1962a, Bancaud and Chauvel 1987, Buser et al. 1973, Talairach and Bancaud 1973, Talairachand Bancaud 1974) . The French investigators assumed that “stereoencephalographie” would actually provide the ideal methodology to define, with extreme precision, what they defined as the epileptogenic zone.  \nSince the pioneer work of Talaraichand Bancaud in the 1960s, extensive surgical experience and the emergence of new, powerful diagnostic techniques have led to the redefinition of the epileptogenic zone, clearly distinctive from that originally described by Talairach and Bancaud (Lüders et al. 1993) . The approach of this definition was significantly more abstract and allowed the inclusion of modern diagnostic techniques and possible future technological advances. For example, the epileptogenic zone in Talaraich and Bancaud definition was determined by the results of the stereo-EEG evaluation and therefore was primarily an ictal EEG concept. On the other hand, the modern/ practical “epileptogenic zone” is de-  \nH.O. Lüders, et al.  \nfined as the “minimal area of cortex that must be resected to produce seizure-freedom”(see below), independent of the technique used to determine the extent of the surgical resection.  \nDefinition of epileptogenic zone  \nIn 1993, we defined the epileptogenic zone as the “area of cortex that is necessary and sufficient for initiating seizures and whose removal (or disconnection) is necessary for complete abolition of seizures”(Lüders et al. 1993) . Without deviating significantly from this definition, we would like to propose the following, simplified definition of theepileptogenic zo","cbCaicVran3ncgbA","https://ap.wps.com/l/cbCaicVran3ncgbA","pdf",571519,1,9,"English","en",105,"# The Epileptogenic Zone: General Principles\n## Historical foundations of localization\n## Development of EEG and SEEG concepts\n## Modern practical definition and rationale\n## Definition, assumptions, and shortcomings","[{\"question\":\"Why did early epilepsy surgery concepts equate lesions with the epileptogenic zone?\",\"answer\":\"Early surgical thinking treated the resected structural lesion and cortex that reproduced the initial seizure symptoms on stimulation as the local cause of fits, aligning the “discharging lesion” with what is now termed the epileptogenic zone.\"},{\"question\":\"How did SEEG change the understanding of the epileptogenic zone?\",\"answer\":\"Stereo-electroencephalography (SEEG) introduced a methodology intended to define the epileptogenic zone with extreme precision, helping to revolutionize the concept beyond macroscopic lesion limits.\"},{\"question\":\"What is the simplified definition of the epileptogenic zone proposed in the text?\",\"answer\":\"The text proposes a simplified definition as the minimum amount of cortex that must be resected (inactivated or completely disconnected) to produce seizure freedom.\"}]","Definition and Localization of the Epileptogenic Zone - 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