Electrocorticography

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Electrocorticography (ECoG) is the practice of using electrodes placed directly on the exposed surface of the brain to record electrical activity from the cerebral cortex. ECoG may be performed either in the operating room during surgery (intraoperative ECoG) or outside of surgery (extraoperative ECoG). Because a craniotomy (a surgical incision into the skull) is required to implant the electrode grid, ECoG is an invasive procedure. ECoG is currently considered to be the “gold standard” for defining epileptogenic zones in clinical practice.

Procedure The ECoG recording is performed from electrodes placed on the exposed cortex. In order to access the cortex, a surgeon must first perform a craniotomy, removing a part of the skull to expose the brain surface. This procedure may be performed either under general anesthesia or under local anesthesia if patient interaction is required for functional cortical mapping. Electrodes are then surgically implanted on the surface of the cortex, with placement guided by the results of preoperative EEG and magnetic resonance imaging (MRI). Electrodes may either be placed outside the dura mater (epidural) or under the dura mater (subdural). ECoG electrode arrays typically consist of sixteen sterile, disposable stainless steel, carbon tip, platinum, or gold ball electrodes, each mounted on a ball and socket joint for ease in positioning. These electrodes are attached to an overlying frame in a “crown” or “halo” configuration. [7] Subdural strip and grid electrodes are also widely used in various dimensions, having anywhere from 4 to 64 electrode contacts. The grids are transparent, flexible, and numbered at each electrode contact. Standard spacing between grid electrodes is 1 cm; individual electrodes are typically 5mm in diameter. The electrodes sit lightly on the cortical surface, and are designed with enough flexibility to ensure that normal movements of the brain do not cause injury. A key advantage of strip and grid electrode arrays is that they may be slid underneath the dura mater into cortical regions not exposed by the craniotomy. Strip electrodes and crown arrays may be used in any combination desired. Depth electrodes may also be used to record activity from deeper structures such as the hippocampus.

Relevant Specialties
Paediatric Neurology
Neurology
Medical Conditions
Epilepsy

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