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Electrocorticography: Current Trends and Future Perspectives
  1. SIMON BONIFACE

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    Electrocorticography: Current Trends and Future Perspectives. Edited by lf quesney, cd binnie, and g-e chatrian. (Pp172, US $161.00). Published by Elsevier Science, Amsterdam 1998. ISBN 0 444 82509 6.

    This is a book of 172 pages dedicated to the memory of Frank Morrell. It is a multiauthor text, originating largely from North America (with a notable United Kingdom contribution from the Maudsley Hospital). After a historical review including stimulation and recording techniques, novel approaches to using electrocorticography to predict surgical outcome after temporal lobe resection are presented convincingly and then followed by another chapter showing how parallel approaches can be applied in tailored resections. Electrocorticography findings in extratemporal epilepsy are then dealt with, confirming that restricted frontal lobe abnormalities predict a favourable outcome, particularly when combined with a well defined structural lesion. The technique of chronic electrocorticography is also reviewed, including a demonstration of how important it can be to define the limits of interictal epileptiform activity and the ictal onset zone if a complete resection of the structural lesion is not possible.

    The dispirate results in clinical studies using pharmacological activation are then considered, but sensible conclusions are drawn about the relatively minor role of this approach in determining the limits of a potential cortical excision, showing that this book keeps its feet on the ground where necessary.

    A comprehensive multicentre contribution follows, describing the findings in cortical dysplasia, and the way these probably limit the surgical outcome when compared with patients with other structural lesions. There are then three chapters on studies in the mesial temporal region, involving patient selection, prognosis, volumetric MRI, and a combination of acute and chronic electrocorticography techniques. Some of this is then applied to a chapter on hemispherectomy.

    The book finishes with a chapter on the applications of image guided surgery to intraoperative electrophysiology, which is probably one of the most spicy contributions, confirming that a multimodal approach to the application of these investigations will probably be the most fruitful approach in the medium term. Those units contemplating similar work will find this book very useful in terms of selecting some of the techniques that they intend to include or exclude, with natural effects on their resources and clientele. Specialised units which already perform similar work will also find this a useful review. Inevitably this book will be of interest to a relatively selective readership, to whom it is thoroughly recommended.

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