Book contents
- Insular Epilepsies
- Insular Epilepsies
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 A Brief History of Insular Cortex Epilepsy
- Section 1 The Human Insula from an Epileptological Standpoint
- Section 2 The Spectrum of Epilepsies Involving the Insula
- Chapter 7 Clinical Presentation of Insulo-Opercular Epilepsy in Adults
- Chapter 8 Clinical Presentation of Insulo-Opercular Epilepsy in Children
- Chapter 9 Are Painful Seizures Specific to Insular Epilepsy?
- Chapter 10 The Role of the Insula in Temporal Lobe Epilepsy and Temporal Lobe “Plus” Epilepsies
- Chapter 11 Insular-Origin Seizures with a Hypermotor Presentation
- Chapter 12 The Role of the Insula in Sudden Unexpected Death in Epilepsy (SUDEP)
- Section 3 Noninvasive Investigation of Insular Epilepsy
- Section 4 Invasive Investigation of Insular Epilepsy
- Section 5 Surgical Management of Insular Epilepsy
- Index
- References
Chapter 12 - The Role of the Insula in Sudden Unexpected Death in Epilepsy (SUDEP)
from Section 2 - The Spectrum of Epilepsies Involving the Insula
Published online by Cambridge University Press: 09 June 2022
Book contents
- Insular Epilepsies
- Insular Epilepsies
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 A Brief History of Insular Cortex Epilepsy
- Section 1 The Human Insula from an Epileptological Standpoint
- Section 2 The Spectrum of Epilepsies Involving the Insula
- Chapter 7 Clinical Presentation of Insulo-Opercular Epilepsy in Adults
- Chapter 8 Clinical Presentation of Insulo-Opercular Epilepsy in Children
- Chapter 9 Are Painful Seizures Specific to Insular Epilepsy?
- Chapter 10 The Role of the Insula in Temporal Lobe Epilepsy and Temporal Lobe “Plus” Epilepsies
- Chapter 11 Insular-Origin Seizures with a Hypermotor Presentation
- Chapter 12 The Role of the Insula in Sudden Unexpected Death in Epilepsy (SUDEP)
- Section 3 Noninvasive Investigation of Insular Epilepsy
- Section 4 Invasive Investigation of Insular Epilepsy
- Section 5 Surgical Management of Insular Epilepsy
- Index
- References
Summary
The insula is known to play a central role in the regulation of autonomic function, although the precise nature and localization of such functions have not been conclusively identified. Autonomic and particularly cardiac disturbances are strongly implicated in sudden unexpected death in epilepsy (SUDEP). Herein, we discuss the contribution of the insula to seizure-related cardiac dysfunction and SUDEP. We also present two illustrative cases of intractable epilepsy patients with structural damage to the insula who succumbed to SUDEP. Both had progressive changes in heart rate variability (HRV), a standard measure of cardiac autonomic function, which noninvasively reflects sympathetic and parasympathetic balance using EKG recordings. In addition, further evidence of insular resection leading to autonomic changes is suggested in patients with intractable epilepsy and radiological evidence of insular damage after epilepsy surgery. The presence of intrinsic insular lesions or acquired insular damage in patients with refractory epilepsy may predispose to cardiac dysfunction and contribute to SUDEP pathomechanisms; however, a definitive association to SUDEP is still undetermined.
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- Information
- Insular Epilepsies , pp. 134 - 140Publisher: Cambridge University PressPrint publication year: 2022
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