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. 2023 Sep 21;10(11):2114–2126. doi: 10.1002/acn3.51900

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© 2023 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Example of the epileptogenic zone quantification using ictal and interictal epileptogenicity markers. Quantified ictal and interictal stereoelectroencephalography (SEEG) data of a patient suffering from drug‐resistant epilepsy associated with a left temporal lateral ganglioglioma are shown. The epileptogenic zone (EZ) defined by visual analysis included the left anterior T1 (perilesional cortex sampled by the electrode T′, just posteriorly to the lesion) up to Heschl gyrus, the temporal pole, the amygdala, and the anterior hippocampus. The resection of these structures sparing the hippocampus led to seizure freedom (Engel class I). (A) Ictal markers. The maximal Epileptogenicity Index (EI, ¹⁵ left panel) and Connectivity EI (cEI, ²⁰ middle panel) values quantified from two spontaneous seizures are represented as spheres on the patient's 3D brain mesh with implanted electrodes. Right panel: Graph showing epileptogenicity values quantified for each contact within the gray matter using EI (blue) and cEI (yellow); EI energy ratio is shown in red. The EZ defined by EI (EI ≥0.41) includes the left anterior T1 (T′1‐3) and the left anterior hippocampus (TB′1‐2). The EZ defined by cEI (cEI ≥0.65) includes the left anterior T1 (T′1‐3) and the left posterior T1 with adjacent superior temporal sulcus (H′14‐16). B. Interictal markers. Left and middle panels: the maximal normalized Spike‐ and high‐frequency oscillations HFO (HFO, 80–300 Hz) rates quantified using Delphos detector ³⁸ are shown on the patient's 3D brain mesh. Right panel: Graph showing the spike– (black) and the ripple (orange) rates/min quantified for each contact from a 5‐min period of NREM sleep. The EZ defined by Spikes (Spikes ≥0.48) includes the left anterior T1 (T′1‐4), the left posterior T1 and superior temporal sulcus (H′12‐16), the left anterior hippocampus (TB′1‐3) and the right rhinal cortex (TB1‐2). The EZ defined by HFO (HFO ≥0.38) includes the left anterior hippocampus, the left anterior T2 (TB′10‐11), the left F3 pars opercularis (OF′11‐12) and the right rhinal cortex (TB1‐2).