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28: Technical Aspects of Electrical Stimulation Mapping

DOI:

10.1891/9780826136930.0028

Authors

  • Gavvala, Jay R. | 
  • Schuele, Stephan U.

Abstract

Electrical stimulation mapping is affected by the electrode positioning, stimulation parameters, voltage distribution, and the orientation of the individual neurons being stimulated. Safety considerations include charge density and charge per phase, which are dependent on stimulation current, pulse width, and the electrode surface area. Electrical stimulation mapping (ESM) is an essential component of an intracranial electroencephalography evaluation for epilepsy surgery. The aims of resective epilepsy surgery are to completely remove the epileptogenic zone without causing a permanent neurologic deficit. ESM utilizes electrical stimuli to inhibit or excite neurologic functionality and has been utilized to identify eloquent cortex as well as to provoke habitual electroclinical seizures. Years of institutional experience and literature have demonstrated the role of ESM in these venues. Cortico-cortical–evoked potentials (CCEPs) are a novel application of electrical stimulation mapping of stereoelectroencephalography electrodes that highlight electrical connectivity of the epileptogenic and functional network.