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Chapter 10 - The Role of the Insula in Temporal Lobe Epilepsy and Temporal Lobe “Plus” Epilepsies
from Section 2 - The Spectrum of Epilepsies Involving the Insula
- By Carmen Barba, Philippe Kahane
Edited by Dang Nguyen, Université de Montréal, Jean Isnard, Philippe Kahane
Book:

Insular Epilepsies

Published online:

09 June 2022

Print publication:

24 March 2022, pp 110-117
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Summary

The role of the insula in temporal and temporal plus epilepsies has been poorly investigated. The insula is buried deep within the lateral sulcus and has dense connections with neighbored regions, thus limiting the usefulness of available non-invasive diagnostic tools, such as scalp EEG, SPECT, and 18FDG-PET. Also, clinical features related to the involvement of the insula might be misleading, thus making it mandatory to use invasive EEG recordings in most cases. In fact, only a primary involvement of the insula in the epileptogenic network may require to include this area in the resection to achieve seizure freedom. Using modern neurosurgical techniques, insular epilepsy surgery has proved to be safe and beneficial in carefully investigated cases; however, its efficacy remains to be fully elucidated.