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Auditory aura in frontal opercular epilepsy: sounds from afar
Author(s) -
Thompson Stephen A,
Alexopoulos Andreas,
Bingaman William,
GonzalezMartinez Jorge,
Bulacio Juan,
Nair Dileep,
So Norman K
Publication year - 2015
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2015.0742
Subject(s) - operculum (bryozoa) , ictal , aura , magnetoencephalography , neuroscience , psychology , epilepsy , stereoelectroencephalography , insula , neocortex , audiology , electroencephalography , medicine , biology , botany , psychiatry , migraine , genus
Auditory auras are typically considered to localize to the temporal neocortex. Herein, we present two cases of frontal operculum/perisylvian epilepsy with auditory auras. Following a non‐invasive evaluation, including ictal SPECT and magnetoencephalography, implicating the frontal operculum, these cases were evaluated with invasive monitoring, using stereoelectroencephalography and subdural (plus depth) electrodes, respectively. Spontaneous and electrically‐induced seizures showed an ictal onset involving the frontal operculum in both cases. A typical auditory aura was triggered by stimulation of the frontal operculum in one. Resection of the frontal operculum and subjacent insula rendered one case seizure‐ (and aura‐) free. From a hodological (network) perspective, we discuss these findings with consideration of the perisylvian and insular network(s) interconnecting the frontal and temporal lobes, and revisit the non‐invasive data, specifically that of ictal SPECT.