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Chapter 8 - Clinical Presentation of Insulo-Opercular Epilepsy in Children

from Section 2 - The Spectrum of Epilepsies Involving the Insula

Published online by Cambridge University Press:  09 June 2022

By
Michael S. Duchowny ,
Delphine Taussig  and
Petia S. Dimova
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

Surgery for medically intractable childhood seizures originating in the opercular-insular cortex has only been undertaken in the last decade. While the need for SEEG interrogation and rates of post-operative seizure-freedom in children are comparable to adults, several important differences distinguish the pediatric experience. Most pediatric surgical candidates are pre-verbal or non-verbal and cannot describe subjective sensory or affective seizure manifestations. There is a higher representation of frontal lobe seizure semiology compared to adults, whereas ictal and inter-ictal electrographic discharges are typically more widespread throughout the cerebral hemisphere. Cortical malformations constitute the primary underlying pathological finding in the majority of pediatric cases. The recent surgical success in medically refractory children provides a compelling rationale to pursue further clinical studies and offer surgical candidacy in selected patients.

Keywords

insulo-opercular seizureschildrenclinical featuresEEGintracranial EEGsurgery
Type
Chapter
Information
Insular Epilepsies , pp. 82 - 97
Publisher: Cambridge University Press
Print publication year: 2022

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References

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