Temporal lobe spikes: EEG-fMRI contributions to the “mesial vs. lateral” debate

There has been a debate whether scalp electroencephalogram (EEG) can record interictal epileptic discharges (IEDs) generated from the mesial temporal lobe because of attenuation of electrical fields with distance from the source. Alarcon et al. (Alarcon et al., 1994) estimated that the ratio of deep to surface activity recorded during IEDs on the scalp is around 1:2000 and they suggested that scalp-recorded temporal IEDs are generated in the neocortex. As shown in stereoelectroencephalography (SEEG) studies (Gloor, 1991; Pacia and Ebersole, 1997; Koessler et al., 2015), the hippocampus usually generates many spikes and most are not detectable on the scalp.

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