PET and iEEG lateralization disagreed in four patients; Three had a category III or IV consequence. Therefore, discordant FDG-PET with other noninvasive exams may be related to poor surgical final result in nonlesional epilepsy. Our data help the role of multimodal strategy in presurgical evaluation of nonlesional epilepsy. First, multimodality imaging allowed us to extend the surgical remedy to patients who couldn’t be thought-about good candidates with out the checks. Based on ictal scalp EEG and clinical semiology, we have been capable of localize the attainable epileptogenic zone in only 1 out of 14 patients (7%, 1/14) and to lateralize the epileptogenic hemisphere in an extra eight patients (57%, 8/14). Without multimodality strategy, 36% of patients (5/14) with poor lateralization might have been discouraged from epilepsy surgical procedure. Second, we were capable of refine the hypothesis on the doable epileptogenic zone and due to this fact to reduce the scale of craniotomy and variety of subdural electrodes. In our sequence, 57% of patients with lateralizing however nonlocalizing seizure onset might have required diffuse hemispheric iEEG coverage with out the multimodal tests.
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