Bipolar electrocoagulation on functional cortex (BCFC) for intractable epilepsy involving eloquent cortex: a review

Abstract

Twenty percent to forty percent of patients with epilepsy are medically refractory. For these patients, epilepsy surgeries such as resecting the epileptogenic focus may provide an alternative option. However, when the epileptogenic focus is located in the eloquent cortex, the resection of epileptogenic focus may lead to unacceptable functional deficits. Bipolar electrocoagulation on functional cortex (BCFC) is a surgical technique that holds the same principles with multiple subpial transections (MST) and aims to benefit patients with epilepsy whose epileptogenic zone is located in the eloquent cortex. It uses thermal injury to interrupt the horizontal fibers in the cortex while mechanical injury is used in MST. Here, we reviewed the rationale, surgical procedure, laboratory research, and clinical application of BCFC. We also discussed the ongoing challenges of BCFC.

Keywords

functional cortex / epilepsy surgery / bipolar electrocoagulation on functional cortex (BCFC)