The intraoperative SEEG and <sup>18</sup>FDG-PET tailored temporal lobe resection (iSP-TR) for the tissue-spearing surgical treatment of drug-resistant mesial temporal lobe epilepsy: how we do it.

Battista, Francesca; Carrai, Riccardo; Grippo, Antonello; Della Puppa, Alessandro · Acta Neurochir (Wien) · 2025

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Abstract

For drug-resistant mesial temporal lobe epilepsy (MTLE), surgery is recommended. There is no evidence of a seizure outcome advantage of temporal lobectomy over other strategies despite the high risks of this surgical procedure. We describe a Temporal Resection guided by intraoperative stereo-electroencephalography (iSEEG) and the <sup>18</sup>FluoroDeoxyGlucose PET (<sup>18</sup>FDG PET) (iSP-TR) to treat lesional MTLE. We avoided functional cortical areas using navigated Transcranial Magnetic Stimulation (nTMS). iSP-TR allows for a spare brain parenchyma compared to temporal lobectomy without compromising seizure outcomes.

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