|The practice of epilepsy surgery has largely shifted from invasive investigations with chronic intracranial electrodes to high resolution imaging modalities that may delineate the epileptogenic zone in a non-invasive manner. Refractory epilepsy in the setting of negative conventional radiological evaluation is often due to subtle focal cortical dysplasias (FCDs). It remains a great challenge for contemporary epilepsy surgery, particularly in extratemporal cases, where the semiological presentation and the scalp EEG recordings are variable and frequently misleading. Many of these cases end up being implanted with chronic subdural electrodes. Cortical dysplasias along with tumors constitute the majority of extratemporal epilepsy causes. Extratemporal lobe epilepsy is a more heterogeneous group that poses several challenges in the quest for the epileptogenic zone.
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