Direct cortical stimulation–evoked symptoms in the human temporal pole: a cohort study

Objective: The temporal pole is a part of temporolimbic networks and may contribute to seizure generation in temporal lobe epilepsy. Direct cortical stimulation (DCS) during invasive presurgical evaluation in epilepsy patients provides information about its functional organization. Methods: We retrospectively analyzed DCS data from epilepsy patients at a tertiary center between 2012 and 2025. Patients with at least one temporopolar DCS session were included. Stimulation-induced symptoms were categorized by modality and frequency. Results: = 0.003). Thirteen patients reported ipsilateral painful facial sensations, likely reflecting activation of trigeminal sensory pathways due to current spread near the skull base. Conclusions: Temporopolar DCS elicits heterogeneous symptoms, supporting its role as an integrative network node rather than a region with distinct stimulation-induced semiology. Significance: The findings limit the localizing value of temporopolar DCS responses in presurgical evaluation.