Two new studies highlight the utility of high-frequency oscillations (HFOs) for the precise delineation of the seizure-onset zone (SOZ) in patients with focal epilepsy. Measurement of HFOs could potentially form part of the presurgical evaluation process in such individuals. For the first study, Francois Dubeau and colleagues selected 16 patients with focal epilepsy who had normal MRI scans. Each patient had previously been found to have least one SOZ. Intracranial EEG was used to measure interictal HFOs (>80 Hz) and spikes during slow-wave sleep. Both spike and HFO activity was elevated in brain regions identified as SOZs, although HFOs were more accurate than spikes at pinpointing the SOZ. This study is the first to correlate interictal HFOs with the SOZ in patients with focal epilepsy and normal MRI.
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