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Stereotactic lesioning in focal epilepsy or less is more—but why has it not worked in the past?
  1. Peter Warnke
  1. Correspondence to Professor Peter Warnke, Department of Neurosurgery, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA; pwarnke{at}

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Cossu and colleagues present their outcome of stereotactic radiofrequency lesioning in nodular heterotopia and show a remarkable rate of Engel class I outcome.1 This adds to the growing volume of publications using stereotactic invasive lesioning combined with high-resolution MRI and invasive stereotactic EEG (SEEG) recordings allowing for a three-dimensional physiological characterisation of the epileptogenic focus techniques used. These are radiofrequency thermoablation,2 laser–guided thermoablation3and interstitial radiosurgery,4 and entities-treated range from hippocampal sclerosis to nodular heterotopias to hypothalamic hamartomas.

Stereotactic radiofrequency lesioning in focal epilepsy has been tried in the past relying on anatomy, brain atlases and …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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