Maeike Zijlmans, PhD, UMC Utrecht, Utrecht, Netherlands, discusses the design and findings from the high frequency oscillation (HFO) study (NCT02207673). Retrospective research has shown that the local presence of HFOs in the electrocorticogram (EcoG) strongly relates to seizure onset, and removal of tissue with HFOs could predict a better surgical outcome. In the HFO study, patients with epilepsy were randomized either into a group in which resection was guided by HFOs in the ECoG or a group in which the resection was guided by epileptiform spikes in the ECoG (the current standard). The outcome of the intra-operative use of HFOs to delineate the epileptogenic cortex in seizure freedom compared to the current method based on spikes, and the future implications of these findings, is discussed. This interview took place at the 14th European Epilepsy Congress (EEC) 2022 in Geneva, Switzerland.