High-frequency oscillations as biomarkers for seizure onset zone localization: systematic review

Summary

Systematic review and meta-analysis of 47 studies using high-frequency oscillations (80-500Hz) from intracranial EEG to localize seizure onset zones in epilepsy surgical planning. HFO-guided resection was associated with significantly better surgical outcomes (odds ratio 3.2 for seizure freedom) versus standard EZ localization, with ripples (80-250Hz) outperforming fast ripples (250-500Hz).