Insular epilepsy: similarities to temporal lobe epilepsy case report

Arquivos de Neuro-Psiquiatria

Arthur Cukiert¹  Cassio Forster¹  Mario S.d. Andrioli¹  Leila Frayman¹ 

[1] ,Hospital Brigadeiro Serviço de Cirurgia de Epilepsia Clínica de Diagnóstico e Terapêutica das EpilepsiasSão Paulo SP

关键词: epilepsy;    insula;    electrocorticography;    cavernous angioma;    epilepsia;    insula;    eletrocorticografia;    angioma cavernoso;   

DOI  :  10.1590/S0004-282X1998000100022

来源: SciELO

【 摘 要 】

Insular epilepsy has been rarely reported and its clinical and electrographic features are poorly understood. The electrographic study of the insula is difficult since it is hidden from the brain surface by the frontal and temporal lobe. A 48 years-old woman started having simple partial autonomic and complex partial seizures with automatisms and ictal left arm paresis 8 years prior to admission. Seizure's frequency was 1 per week. Pre-operative EEG showed a right temporal lobe focus. Neuropsychological testing disclosed right fronto-temporal dysfunction. MRI showed a right anterior insular cavernous angioma. Intraoperative ECoG obtained after spliting of the sylvian fissure showed independent spiking from the insula and temporal lobe and insular spikes that spread to the temporal lobe. The cavernous angioma and the surrounding gliotic tissue were removed and the temporal lobe was left in place. Post-resection ECoG still disclosed independent temporal and insular spiking with a lower frequency. The patient has been seizure-free since surgery. Insular epilepsy may share many clinical and electroencephalographic features with temporal lobe epilepsy.

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