Procedures for ictal SPECT were as follows: on the day following the collection of the interictal images, patients were watched in the monitoring room; 99mTc-ECD(0.4�C0.5MBq/Kg) was administered intravenously in 30seconds as soon as seizures started or the typical epileptic discharges started, patients were scanned within 30 minutes of the attack. Image fusion was performed Volasertib structure with CT data.EEG dipoles were reconstructed and analyzed with MRI images using the Brain Electrode Source Analysis software (Version 5.1beta, MEGIS Software GmbH; Germany). The primary epileptic foci were determined on the findings of these preoperative investigations.2.3. Operative ProceduresDense intraoperative electrocorticography (EcoG) was used to further confirm the localization of epileptogenic foci.

Single-lobe resection or lesionectomy was performed when obvious epileptic discharge was found in one lobe or in a limited area, while multilobe resection in the same hemisphere was performed when multiple epileptogenic foci or diffuse discharges were confirmed. Callosotomy was performed in four patients with significant contralateral epileptic discharge or atonic seizure. Multiple subpial transection was undertaken when epileptic foci were found to be located in functional areas or remnant discharge was found after resective procedures. Resection of anterior temporal lobe was limited to within 5.0cm posterior to the temporal pole in the dominant hemisphere and 5.5cm in the nondominant hemisphere. The range for frontal lobe resection was from 3.0 to 6.

0cm posterior to the frontal pole, while that for occipital lobe resection was from 4.0 to 6.0cm anterior to the occipital pole. Anterior callosotomy was performed from the genu to the tip of the hippocampal Carfilzomib commissure, ranging in length from 4.0 to 7.0cm (2/3 to 3/4 of corpus callosum), while the length of posterior callosotomy was 4.0�C6.0cm.2.4. Intelligence EvaluationThe intelligence quotient (IQ) of children was tested using the Wechsler Preschool and Primary Scales of Intelligence (WPPSI) or Wechsler Intelligence Scale for Children-Revised (WISC-R), and adults were tested with a Wechsler Adult Intelligence Scale (WAIS-III). Memory was assessed using the Rey Auditory-Verbal Learning Test and the Rey-Osterrieth Complex Figure Test. Pre- and postoperative neuropsychological tests were performed by the same psychologist. Postoperative tests were repeated every 6 to 12 months during followup and the latest values were used for analysis.2.5. Statistical AnalysisPaired t-tests were used to compare the pre- and postoperative scores of IQ, the Rey Auditory-Verbal Learning Test, and the Rey-Osterrieth Complex Figure Test.