Drug-resistant epilepsy is present in nearly 30% of patients. Resection of the epileptogenic zone has been found to be the most effective in achieving seizure freedom. The study of temporal lobe epilepsy for surgical treatment is extensive and complex. It involves a multidisciplinary team in decision-making with initial non-invasive studies (Phase I), providing 70% of the required information to elaborate a hypothesis and treatment plans. Select cases present more complexity involving bilateral clinical or electrographic manifestations, have contradicting information, or may involve deeper structures as a part of the epileptogenic zone. These cases are discussed by a multidisciplinary team of experts with a hypothesis for invasive methods of study. Subdural electrodes were once the mainstay of invasive presurgical evaluation and in later years most Comprehensive Epilepsy Centers have shifted to intracranial recordings. The intracranial recording follows original concepts since its development by Bancaud and Talairach, but great advances have been made in the field. Stereo-electroencephalography is a growing field of study, treatment, and establishment of seizure pattern complexities. In this comprehensive review, we explore the indications, usefulness, discoveries in interictal and ictal findings, pitfalls, and advances in the science of presurgical stereo-encephalography for temporal lobe epilepsy.

The Plasma Cells Granuloma is a relatively rare lesion, that forms a nodule or a mass, it is conformed of polyclonal plasmatic cells in storiform background fibrosis and spread of fusiform cells. We present the case of a 62-year-old woman, with a history of oophorectomy and increased volume in the right frontal area of the head, then presenting neurologic signs of frontal lobe syndrome. Radiologic images showed a wide right frontal lobe neoplasia that spreads diffusely. Histologically the tumor was formed by plasma cells, B lymphocytes infiltrate, and numerous blood vessels. It was positive for CD20, kappa, lambda, CD3, and CD4. Even though it is uncommon, it can develop at any place and must be included in the differential diagnoses list for plasma cells neoplasia. The positivity of light chains kappa and lambda make evident the polyclonality that confirms the diagnosis.