Table 2.

Indications of SEEG in lesional and non-lesional temporal lobe epilepsy.

Non-lesional Temporal Lobe Epilepsy	Lesional Temporal Lobe Epilepsy	Both Lesional and Non-lesional Epilepsy
Dominant Temporal Lobe Epilepsy and normal pre-surgical memory: • Explore sparing the hippocampus if not involved in seizure generation to reduce the risk of post-surgical verbal memory decline (65)	Multiple lesions Uncertainty of involvement of bilateral temporal, “pseudo-temporal”, or temporal-plus epilepsies (in discordant electro-clinical manifestations). “Dual pathology”: hypothesis suggests one epileptogenic zone and not multifocal epileptogenic zones, (66) Central hypothesis of the EZ does not coincide with lesion identified on MRI (67)	Clinical: • Aura of unusual presentation of mesial temporal semiology, suggesting lateral or extra-temporal onset. Electroencephalogram: • Interictal scalp electroencephalogram with bilateral temporal spikes • Interictal scalp electroencephalogram with posterior temporal spikes or extra-temporal/neocortical spikes. • Ictal scalp electroencephalogram with unclear seizure onset, extra temporal onset, and/or originating in one temporal region and propagating quickly to contralateral temporal region.	Neuropsychological evaluation: • Neuropsychology testing suggestive of functional deficit in bilateral, extra temporal or contralateral temporal regions. Imaging (additional): • Negative/discordant functional imaging (Positron Emission Tomography and/or Single- Photon Emission Computed Tomography).