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In the April 2000 issue of the ARCHIVES, Cendes et al¹ present a provocative study that suggests that in a certain highly selected subgroup of patients undergoing evaluation for temporal lobe epilepsy (TLE) surgery, one could dispense with ictal recordings before proceeding to resection. Because surgical outcome data are not provided, their claim is difficult to evaluate. Most epileptologists believe that the ictal electroencephalograph (EEG) is necessary for definitive lateralization because bilateral interictal epileptiform discharges are commonly observed in patients with strictly unilateral seizures.² However, this study is the latest in a series of reports that indicate that it is possible to define a group of patients in which the interictal information is at least as informative as the ictal recordings in terms of lateralization and, furthermore, that discordance is extremely unlikely when the information is backed up by reliable quantitative structural magnetic resonance imaging (MRI) data.^{1, 3, 4} The benefits of . . . [Full Text of this Article]