Insular epilepsy surgery. (April 2017)

• Record Type: Journal Article
• Authors: Laoprasert, Pramote; Ojemann, Jeffrey G.; Handler, Michael H.
• Other Names: Cukiert Arthur guestEditor.; Rydenhag Bertil guestEditor.
• Is Part Of: Epilepsia. Volume 58(2017)Supplement 1
• Page Start: 35
• Page End: 45
• Publication Date: 2017-04
• Subjects: Insular epilepsy -- Temporal lobe plus epilepsy -- Insular epilepsy surgery; Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.13682
• Languages: English
• ISSNs: 0013-9580

Abstract

Summary: Since it was originally described nearly 70 years ago, insular epilepsy has been increasingly recognized and may explain failures after apparently well‐planned operations. We review the history of awareness of the phenomenon, techniques for its assessment, and its surgical management. Insular epilepsy can mimic features of frontal, parietal, or temporal seizures. It should be considered when a combination of somatosensory, visceral, and motor symptoms is observed early in a seizure. Extraoperative intracranial recordings are required to accurately diagnose insular seizures. Stereo–electroencephalography (EEG) or craniotomy with implantation of surface and depth electrodes have been used successfully to identify insular onset of seizures. Surgical resection of an insular focus may be performed with good success and acceptable risk.