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Insular epilepsy surgery
Author(s) -
Laoprasert Pramote,
Ojemann Jeffrey G.,
Handler Michael H.
Publication year - 2017
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13682
Subject(s) - insular cortex , epilepsy , electroencephalography , somatosensory system , epilepsy surgery , medicine , psychology , craniotomy , surgery , anesthesia , neuroscience
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.