ELECTROCORTICOGRAPHY (ECoG), the intra- operative recording of cortical potentials, has played an important role in the surgical management of patients with medically intractable epilepsy. This technique is useful in epilepsy surgery to delineate margins of epileptogenic zones, guide resection, and evaluate completeness of resection.1 About one third of the patients with intractable epilepsy have obvious causes, such as tumor, sclerosis, or vascular malformation. However, the presence of tumor in the eloquent cortex like speech area makes it challenging to completely resect the tumor. ECoG-based surgery in conjunction with direct cortical stimulation in such cases helps surgical resection of tumor with no functional tissue affected, producing good surgical outcome. This report describes a case treated with ECoG-based surgery in combination with direct cortical stimulation.

Key words: electrocorticography, intractable epilepsy, direct cortical stimulation, speech area