Intraoperative electrocorticography (ioECoG)-guided surgery to resect epileptogenic lesions may enhance seizure outcomes. Researchers looked at the postoperative seizure-free time and memory changes in a retrospective cohort of patients with mesial temporal lobe epilepsy.  The researchers enlisted 82 patients with Temporal Lobe Epilepsy (TLE) and Hippocampal Sclerosis (HS) surgically treated. Anterior temporal lobectomy (ATL) was eventually conducted after an ocular inspection revealed interictal epileptic discharges from the lateral temporal lobe on ioECoG. The time of seizure recurrence in the SA and ATL groups was compared using the Kaplan-Meier survival analysis. Epileptic focal laterality, age at seizure onset, seizure frequency; history of focal to the bilateral tonic-clonic outbreak; infectious etiology; and surgical procedure were among the factors studied using the Cox proportional hazards model. Memory function was assessed pre-and postoperatively using the Wechsler Memory Scale-Revised.

According to Kaplan-Meier analysis, seizures recurred substantially earlier in the SA group than in the ATL group (p = 0.031). In each memory category, they conducted a 2-way ANOVA analysis to compare the SA and ATL groups, and it demonstrated that there was no significant difference regardless of the operation side. In individuals with TLE coupled with HS, visual examination of ioECoG cannot predict epileptic focal excision. Although ATL is more successful at preventing seizures, both ATL and SA can preserve memory function.