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Chapter 19 - Qualitative Interpretation of Intracranial EEG in Insular Epilepsy

from Section 4 - Invasive Investigation of Insular Epilepsy

Published online by Cambridge University Press:  09 June 2022

By
Lorella Minotti ,
Rinki Singh ,
Guillaume Martin ,
Dominique Hoffmann ,
Laurence Martineau  and
Philippe Kahane
Edited by
Dang Nguyen ,
Jean Isnard  and
Philippe Kahane
Dang Nguyen
Affiliation:
Université de Montréal
Jean Isnard
Affiliation:
Claude Bernard University Lyon
Philippe Kahane
Affiliation:
Grenoble-Alpes University Hospital
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Summary

Insular epilepsy has caught increasing attention in the presurgical evaluation of drug-resistant focal epilepsies, and it is evident that intracranial EEG recordings can be considered the best method to investigate such a deep-seated area of the brain, especially in non-lesional patients. Intracranial EEG recordings allow us to better understand the organization of epileptic EEG discharges involving the insular cortex and the complexity of the relationships between the insula and the different connected regions of the brain, particularly the opercular region. This peculiarity thus explains the heterogeneous clinical presentation of seizures arising from insular or insulo-opercular structures. While most patients have an epileptogenic zone extending beyond the insula, some have very focal ictal insular discharges, allowing the possibility of a restricted surgical resection. Consequently, only an appropriate sampling of the insula and of extra-insular connected structures can permit a precise identification of the epileptogenic zone and planning for a tailored resection.

Keywords

insulo-opercular epilepsyanatomo-electro-clinical correlationsintracranial EEGSEEG
Type
Chapter
Information
Insular Epilepsies , pp. 227 - 237
Publisher: Cambridge University Press
Print publication year: 2022

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