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Review ArticleReview
Open Access

Insular epilepsy, an under-recognized seizure semiology

A review for general neurologist

Bandar N. Aljafen
Neurosciences Journal August 2020, 25 (4) 262-268; DOI: https://doi.org/10.17712/nsj.2020.4.20200063
Bandar N. Aljafen
From the College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
MD
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References

  1. ↵
    1. Isnard J,
    2. Guénot M,
    3. Ostrowsky K,
    4. Sindou M,
    5. Mauguière F
    (2000) The role of the insular cortex in temporal lobe epilepsy. Ann Neurol 48, 614–623.
  2. ↵
    1. Ryvlin P,
    2. Minotti L,
    3. Demarquay G,
    4. Hirsch E,
    5. Arzimanoglou A,
    6. Hoffman D,
    7. et al.
    (2006) Nocturnal hypermotor seizures, suggesting frontal lobe epilepsy, can originate in the insula. Epilepsia 47, 755–765.
  3. ↵
    1. Proserpio P,
    2. Cossu M,
    3. Francione S,
    4. Tassi L,
    5. Mai R,
    6. Didato G,
    7. et al.
    (2011) Insular-opercular seizures manifesting with sleep-related paroxysmal motor behaviors: a stereo-EEG study. Epilepsia 52, 1781–1791.
  4. ↵
    1. Penfield W,
    2. Jasper H
    Epilepsy and the functional anatomy of the human brain (Little Brown & Co. Boston (MA)) 1954.
  5. ↵
    1. Penfield W,
    2. Faulk M
    (1955) The insula. Brain 78, 445–470.
  6. ↵
    1. Isnard J,
    2. Guénot M,
    3. Sindou M,
    4. Mauguière F
    (2004) Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia 45, 1079–1090.
  7. ↵
    1. Binder DK,
    2. Schaller K,
    3. Clusmann H
    (2007) The seminal contributions of Johann-Christian Reil to anatomy, physiology, and psychiatry. Neurosurgery 61, 1091–1096.
  8. ↵
    1. Clark TE
    (1896) The comparative anatomy of the insula. J Comp Neurol 6, 59–100.
  9. ↵
    1. Waxman SG.
    Clinical neuroanatomy (McGraw Hill Professional, New York (NY)), 26th edition, 2010.
  10. ↵
    1. Türe U,
    2. Ya?argil DC,
    3. Al-Mefty O,
    4. Ya?argil MG
    (1999) Topographic anatomy of the insular region. J Neurosurg 90, 720–733.
  11. ↵
    1. Morel A,
    2. Gallay MN,
    3. Baechler A,
    4. Wyss M,
    5. Gallay DS
    (2013) The human insula: Architectonic organization and postmortem MRI registration. Neuroscience 23, 117–135.
  12. ↵
    1. Kalani MY,
    2. Kalani MA,
    3. Gwinn R,
    4. Keogh B,
    5. Tse VC
    (2009) Embryological development of the human insula and its implications for the spread and resection of insular gliomas. Neurosurg Focus 27, E2.
  13. ↵
    1. Afif A,
    2. Bouvier R,
    3. Buenerd A,
    4. Trouillas J,
    5. Mertens P
    (2007) Development of the human fetal insular cortex: Study of the gyration from 13 to 28 gestational weeks. Brain Struct Funct 212, 335.
  14. ↵
    1. Türe U,
    2. Ya?argil MG,
    3. Al-Mefty O,
    4. Ya?argil DC
    (2000) Arteries of the insula. J Neurosurg 92, 676–687.
  15. ↵
    1. Tanriover N,
    2. Rhoton AL Jr.,
    3. Kawashima M,
    4. Ulm AJ,
    5. Yasuda A
    (2004) Microsurgical anatomy of the insula and the sylvian fissure. J Neurosurg 100, 891–922.
  16. ↵
    1. Augustine JR
    (1996) Circuitry and functional aspects of the insular lobe in primates including humans. Brain Res Rev 22, 229–244.
  17. ↵
    1. Laoprasert P,
    2. Ojemann JG,
    3. Handler MH
    (2017) Insular epilepsy surgery. Epilepsia 58, 35–45.
  18. ↵
    1. Meyer S,
    2. Strittmatter M,
    3. Fischer C,
    4. Georg T,
    5. Schmitz B
    (2004) Lateralization in autonomic dysfunction in ischemic stroke involving the insular cortex. Neuroreport 15, 357–361.
    1. Liu Z,
    2. Xu C,
    3. Xu Y,
    4. Wang Y,
    5. Zhao B,
    6. Lv Y,
    7. et al.
    (2010) Decreased regional homogeneity in insula and cerebellum: A resting-state fMRI study in patients with major depression and subjects at high risk for major depression. Psychiat Res 182, 211–215.
  19. ↵
    1. Chang LJ,
    2. Yarkoni T,
    3. Khaw MW,
    4. Sanfey AG
    (2013) Decoding the Role of the Insula in Human Cognition: Functional Parcellation and Large-Scale Reverse Inference. Cereb Cortex 23, 739–749.
  20. ↵
    1. Damasio AR,
    2. Grabowski TJ,
    3. Bechara A,
    4. Damasio H,
    5. Ponto LL,
    6. Parvizi J,
    7. et al.
    (2000) Subcortical and cortical brain activity during the feeling of self-generated emotions. Nat Neurosci 3, 1049–1056.
  21. ↵
    1. Gasquoine PG
    (2014) Contributions of the insula to cognition and emotion. Neuropsychol Rev 24, 77–87.
  22. ↵
    1. Wynford-Thomas R,
    2. Powell R
    (2017) Navigating the Island of Reil: how to understand the insular cortex. Pract Neurol 17, 122–126.
  23. ↵
    1. Goodkind M,
    2. Eickhoff SB,
    3. Oathes DJ,
    4. Jiang Y,
    5. Chang A,
    6. Jones-Hagata LB,
    7. et al.
    (2015) Identification of a common neurobiological substrate for mental illness. JAMA Psychiatry 72, 305–315.
    1. Stratmann M,
    2. Konrad C,
    3. Kugel H,
    4. Krug A,
    5. Schöning S,
    6. Ohrmann P,
    7. et al.
    (2014) Insular and hippocampal gray matter volume reductions in patients with major depressive disorder. PLoS One 9, e102692.
  24. ↵
    1. Wylie KP,
    2. Tregellas JR
    (2010) The role of the insula in schizophrenia. Schizophr Res 123, 93–104.
  25. ↵
    1. Afif A,
    2. Minotti L,
    3. Kahane P,
    4. Hoffmann D
    (2010) Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy. Epilepsia 51, 206–213.
  26. ↵
    1. Chevrier MC,
    2. Bard C,
    3. Guilbert F,
    4. Nguyen DK
    (2013) Structural abnormalities in patients with insular/peri-insular epilepsy: spectrum, frequency, and pharmacoresistance. Am J Neuroradiol 34, 2152–2156.
  27. ↵
    1. Roper SN,
    2. Lévesque MF,
    3. Sutherling WW,
    4. Engel J Jr.
    (1993) Surgical treatment of partial epilepsy arising from the insular cortex: report of two cases. J Neurosurg 79, 266–269.
  28. ↵
    1. Duffau H,
    2. Capelle L,
    3. Lopes M,
    4. Bitar A,
    5. Sichez JP,
    6. van Effenterre R
    (2002) Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochir 144, 563–573.
  29. ↵
    1. Mazzola L,
    2. Mauguiere F,
    3. Isnard J
    (2017) Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. J Clin Neurophysiol 34, 307–314.
  30. ↵
    1. Pugnaghi M,
    2. Meletti S,
    3. Castana L,
    4. Francione S,
    5. Nobili L,
    6. Mai R,
    7. et al.
    (2011) Features of somatosensory manifestations induced by intracranial electrical stimulations of the human insula. Clin Neurophysiol 122, 2049–2058.
  31. ↵
    1. Jobst BC,
    2. Gonzalez-Martinez J,
    3. Isnard J,
    4. Kahane P,
    5. Lacuey N,
    6. Lahtoo SD,
    7. et al.
    (2019) The Insula and Its Epilepsies. Epilepsy Currents 19, 11–21.
  32. ↵
    1. Ostrowsky K,
    2. Magnin M,
    3. Ryvlin P,
    4. Isnard J,
    5. Guenot M,
    6. Mauguiere F
    (2002) Representation of pain and somatic sensation in the human insula: a study of responses to direct electrical cortical stimulation. Cereb Cortex 12, 376–385.
  33. ↵
    1. Namkung H,
    2. Kim SH,
    3. Sawa A
    (2017) The insula: an underestimated brain area in clinical neuroscience, psychiatry, and neurology. Trends Neurosci 40, 200–207.
  34. ↵
    1. Blauwblomme T,
    2. Kahane P,
    3. Minotti L,
    4. Grouiller F,
    5. Krainik A,
    6. Vercueil L,
    7. et al.
    (2011) Multimodal imaging reveals the role of gamma activity in eating-reflex seizures. J Neurol Neurosurg Psychiatry 82, 1171–1173.
  35. ↵
    1. Kriegel MF,
    2. Roberts DW,
    3. Jobst BC
    (2012) Orbitofrontal and insular epilepsy. J Clin Neurophysiol 29, 385–391.
  36. ↵
    1. Fei P,
    2. Soucy JP,
    3. Obaid S,
    4. Boucher O,
    5. Bouthillier A,
    6. Nguyen DK
    (2018) The value of regional cerebral blood flow SPECT and FDG PET in operculoinsular epilepsy. Clin Nucl Med 43, e67–e73.
  37. ↵
    1. Dylgjeri S,
    2. Taussig D,
    3. Chipaux M,
    4. Lebas A,
    5. Fohlen M,
    6. Bulteau C,
    7. et al.
    (2014) Insular and insuloopercular epilepsy in childhood: an SEEG study. Seizure 23, 300–308.
  38. ↵
    1. Freri E,
    2. Matricardi S,
    3. Gozzo F,
    4. Cossu M,
    5. Granata T,
    6. Tassi L
    (2017) Perisylvian, including insular, childhood epilepsy: presurgical workup and surgical outcome. Epilepsia 58, 1360–1369.
  39. ↵
    1. Sundaram M,
    2. Hogan T,
    3. Hiscock M,
    4. Pillay N
    (1990) Factors a?ecting interictal spike discharges in adults with epilepsy. Electroencephalogr Clin Neurophysiol 75, 358–360.
  40. ↵
    1. Levy A,
    2. Yen Tran TP,
    3. Boucher O,
    4. Bouthillier A,
    5. Nguyen DK
    (2017) Operculo-insular epilepsy: scalp and intracranial electroencephalographic findings. J Clin Neurophysiol 34, 438–447.
  41. ↵
    1. Afif A,
    2. Chabardes S,
    3. Minotti L,
    4. Kahane P,
    5. Hoffmann D
    (2008) Safety and usefulness of insular depth electrodes implanted via an oblique approach in patients with epilepsy. Neurosurgery 62, ONS471–ONS480.
  42. ↵
    1. Surbeck W,
    2. Bouthillier A,
    3. Weil AG,
    4. Crevier L,
    5. Carmant L,
    6. Lortie A,
    7. et al.
    (2011) The combination of subdural and depth electrodes for intracranial EEG investigation of suspected insular (perisylvian) epilepsy. Epilepsia 52, 458–466.
    1. Nguyen DK,
    2. Nguyen DB,
    3. Malak R,
    4. Leroux JM,
    5. Carmant L,
    6. Saint-Hilaire JM,
    7. et al.
    (2009) Revisiting the role of the insula in refractory partial epilepsy. Epilepsia 50, 510–520.
  43. ↵
    1. Alomar S,
    2. Mullin JP,
    3. Smithason S,
    4. Gonzalez-Martinez J
    (2018) Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy. J Neurosurg 128, 1147–1157.
  44. ↵
    1. Guillaume J,
    2. Mazars G
    (1949) Technique de resection de l’insula dans les epilepsies insulaires. Rev Neurol (Paris) 81, 900–903.
  45. ↵
    1. Silfvenius H,
    2. Gloor P,
    3. Rasmussen T
    (1964) Evaluation of insular ablation in surgical treatment of temporal lobe epilepsy. Epilepsia 5, 307–320.
  46. ↵
    1. Ya?argil MG,
    2. von Ammon K,
    3. Cavazos E,
    4. Doczi T,
    5. Reeves JD,
    6. Roth P
    (1992) Tumours of the limbic and paralimbic systems. Acta Neurochir 118, 40–52.
  47. ↵
    1. Yasargil MG,
    2. Krisht AF,
    3. Türe U,
    4. Al-Mefty O,
    5. Yasargil DCH
    (2002) Microsurgery of insular gliomas: part II: opening of the sylvian fissure. Contemp Neurosurg 24, 1–5.
  48. ↵
    1. von Lehe M,
    2. Wellmer J,
    3. Urbach H,
    4. Schramm J,
    5. Elger CE,
    6. Clusmann H
    (2009) Insular lesionectomy for refractory epilepsy: management and outcome. Brain 132, 1048–1056.
  49. ↵
    1. Malak R,
    2. Bouthillier A,
    3. Carmant L,
    4. Cossette P,
    5. Giard N,
    6. Saint-Hilaire JM,
    7. et al.
    (2009) Microsurgery of epileptic foci in the insular region: clinical article. J Neurosurg 110, 1153–1163.
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Insular epilepsy, an under-recognized seizure semiology
Bandar N. Aljafen
Neurosciences Journal Aug 2020, 25 (4) 262-268; DOI: 10.17712/nsj.2020.4.20200063

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Insular epilepsy, an under-recognized seizure semiology
Bandar N. Aljafen
Neurosciences Journal Aug 2020, 25 (4) 262-268; DOI: 10.17712/nsj.2020.4.20200063
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