Intracranial recordings for non-lesional mesiotemporal epilepsy? Almost always, but not quite always.

•The majority of patients with non-lesional mesial TLE needs intracranial recordings.•This rule should not be rigid and there are some exceptions. Decisions should be individualized.•For bilateral mesial temporal lobe epilepsy, chronic ECoG with RNS may be preferable over "traditional" short-term intracranial recording.