Epilepsy Surgery

of facial sensation, usually transient, and, very rarely, hemiparesis, possibly more common after previous operation. Bilateral sub-temporal strip electrodes are also used for the investigation of temporal lobe problems and, in the authors' practice, have been preferred in recent years, since they allow a wider coverage and have fewer complications.

Major invasive electrode placement serves a number of purposes and can be divided into two groups. Stereotactically determined placement of multi-contact wire electrodes may be used primarily to explore an area of brain, surface and depth, in order to delineate the epilepto-genic zone, and may include some stimulation protocols for functional localization and to provoke seizures. The placement, either epidu-rally or, more frequently, sub-durally, of arrays of point contacts embedded in silastic strips or grids delineates an epileptogenic zone and allows detailed mapping of the primary motor and sensory cortex and assessment of speech lateralization and memory function. Technical details of these methods will be found in appropriate reviews [11].

The interpretation of data obtained from intracranial recordings needs a sophisticated technological set-up with video-EEG, including an adequate number of recording channels. Experienced neurophysiologists with a wide knowledge of seizure semiology and of the clinical data relating to the particular patient under investigation are essential.

The use of depth electrodes has decreased with the advent of good MRI and varies considerably between centers, dependent upon their case-mix, other facilities and previous experience. Stimulation through depth electrodes gives valuable information about seizure thresholds, as well as functional information about motor function and, in the temporal lobe, cognitive function.

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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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