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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

Published online by Cambridge University Press:  09 June 2022

By
Carmen Barba  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

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.

Keywords

insular epilepsyepilepsy surgerystereo-EEGtemporal plus epilepsy
Type
Chapter
Information
Insular Epilepsies , pp. 110 - 117
Publisher: Cambridge University Press
Print publication year: 2022

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References

Penfield, W. Some observations on the cerebral cortex of man. Proc R Soc London Ser B, Biol Sci. 1947;134:329–347.Google Scholar
Guillaume, MG. Technique de resection de resection de l’insul dans les epilepsies insulaires. Rev Neurol (Paris). 1949;81:900–903.Google Scholar
Penfield, Wilder JW. Epilepsy and the functional anatomy of the human brain.1st ed. Boston: Little Brown; 1954.CrossRefGoogle Scholar
Penfield, W, Faulk, ME. The insula; further observations on its function. Brain. 1955;78:445–470.Google Scholar
Silfvenius, H, Gloor, P, Rasmussen, T. Evaluation of insular ablation in surgical treatment of temporal lobe epilepsy. Epilepsia. 1964;5:307–320.CrossRefGoogle ScholarPubMed
Harroud, A, Bouthillier, A, Weil, AG, Nguyen, DK. Temporal lobe epilepsy surgery failures: A review. Epilepsy Res Treat. 2012;2012:1–10.CrossRefGoogle ScholarPubMed
Isnard, J, Guénot, M, Ostrowsky, K, Sindou, M, Mauguière, F, Isnard, J, Guénot, M, Ostrowsky, K, Sindou, M MF. The role of the insular cortex in temporal lobe epilepsy. Ann Neurol. 2000;48:614–623.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Blauwblomme, T, David, O, Minotti, L, Job, A-S, Chassagnon, S, Hoffman, D, et al. Prognostic value of insular lobe involvement in temporal lobe epilepsy: A stereoelectroencephalographic study. Epilepsia. 2013;54:1658–1667.Google Scholar
Aupy, J, Noviawaty, I, Krishnan, B, Suwankpakdee, P, Bulacio, J, Gonzalez-Martinez, J, et al. Insulo-opercular cortex generates oroalimentary automatisms in temporal seizures. Epilepsia. 2018;59:583–594.Google Scholar
Barba, C, Barbati, G, Minotti, L, Hoffmann, D, Kahane, P. Ictal clinical and scalp-EEG findings differentiating temporal lobe epilepsies from temporal “plus” epilepsies. Brain. 2007;130.Google Scholar
Barba, C, Rheims, S, Minotti, L, Guénot, M, Hoffmann, D, Chabardès, S, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain. 2016;139:444–451.Google Scholar
Kahane, P, Barba, C, Rheims, S, Job-Chapron, AS, Minotti, L, Ryvlin, P. The concept of temporal plus epilepsy. Rev Neurol (Paris). 2015;171.CrossRefGoogle ScholarPubMed
Bartolomei, F, Wendling, F, Vignal, JP, Kochen, S, Bellanger, JJ, Badier, JM, et al. Seizures of temporal lobe epilepsy: Identification of subtypes by coherence analysis using stereo-electro-encephalography. Clin Neurophysiol. 1999;110:1741–1754.Google Scholar
Hur, JA, Kang, JW, Kang, H-C, Kim, HD, Kim, JT, Lee, JS. The significance of insular hypometabolism in temporal lobe epilepsy in children. J Epilepsy Res. 2013;3:54–62.Google Scholar
Bouilleret, V, Dupont, S, Spelle, L, Baulac, M, Samson, Y SF. Insular cortex involvement in mesiotemporal lobe epilepsy: a positron emission tomography study. Ann Neurol. 2002;51:202–208.Google Scholar
Won, HJ, Chang, KH, Cheon, JE et al. Comparison of MR imaging with PET and ictal SPECT in 118 patients with intractable epilepsy. AJNR Am J Neuroradiol. 1999;20:534–535.Google Scholar
Nguyen, DK, Nguyen, DB, Malak, R, Leroux, J-M, Carmant, L, J-M, Saint-Hilaire, et al. Revisiting the role of the insula in refractory partial epilepsy. Epilepsia. 2009;50:510–520.CrossRefGoogle ScholarPubMed
Afif, A, Chabardes, S, Minotti, L, Kahane, P, Hoffmann, D. Safety and usefulness of insular depth electrodes implanted via an oblique approach in patients with epilepsy. Oper Neurosurg. 2008;62:ONS471–ONS480.CrossRefGoogle ScholarPubMed
Bouthillier, A, Surbeck, W, Weil, AG, Tayah, T, Nguyen, DK. The hybrid operculo-insular electrode. Neurosurgery. 2012;70:1574–1580.CrossRefGoogle ScholarPubMed
Bouthillier, A, Surbeck, W, Weil, AG, Tayah, T, Nguyen, DK. The hybrid operculo-insular electrode: A new electrode for intracranial investigation of peri-Sylvian/insular refractory epilepsy. Neurosurgery. 2012;70:1574–1580; discussion 1580.CrossRefGoogle Scholar
Ryvlin, P, Cross, JH, Rheims, S. Epilepsy surgery in children and adults. Lancet Neurol. 2014;13:1114–1126.CrossRefGoogle ScholarPubMed
Téllez-Zenteno, JF, Dhar, R, Wiebe, S. Long-term seizure outcomes following epilepsy surgery: A systematic review and meta-analysis. Brain. 2005;128:1188–1198.Google Scholar
West, S, SJ, Nevitt, Cotton, J, Gandhi, S, Weston, J, Sudan, A, et al. Surgery for epilepsy. Cochrane Database Syst Rev. 2019;6:CD010541.CrossRefGoogle Scholar
Téllez-Zenteno, JF, Dhar, R, Hernandez-Ronquillo, L, Wiebe, S. Long-term outcomes in epilepsy surgery: Antiepileptic drugs, mortality, cognitive and psychosocial aspects. Brain. 2007;130:334–345.Google Scholar
Wiebe, S, Blume, WT, Girvin, JP, Eliasziw, M. Randomized, A, Controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001;345:311–318.CrossRefGoogle ScholarPubMed
Najm, I, Jehi, L, Palmini, A, Gonzalez-Martinez, J, Paglioli, E, Bingaman, W. Temporal patterns and mechanisms of epilepsy surgery failure. Epilepsia. 2013;54:772–782.Google Scholar
Jeha, LE, Najm, IM, Bingaman, WE, Khandwala, F, Widdess-Walsh, P, Morris, HH, et al. Predictors of outcome after temporal lobectomy for the treatment of intractable epilepsy. Neurology. 2006;66:1938–1940.Google Scholar
Wyler, AR, Hermann, BP, Richey, ET. Results of reoperation for failed epilepsy surgery. J Neurosurg. 1989;71:815–819.CrossRefGoogle ScholarPubMed
Awad, IA, Nayel, MH, Lüders, H. Second operation after the failure of previous resection for epilepsy. Neurosurgery. 1991;28:510–518.CrossRefGoogle ScholarPubMed
Salanova, V, Markand, O, Worth, R. Temporal lobe epilepsy: Analysis of failures and the role of reoperation. Acta Neurol Scand. 2005;111:126–133.CrossRefGoogle ScholarPubMed
Andermann, F. Pseudotemporal vs neocortical temporal epilepsy: Things aren’t always where they seem to be. Neurology. 2003;61:732–733.Google Scholar
Elwan, SA, So, NK, Enatsu, R, Bingaman, WE. Pseudotemporal ictal patterns compared with mesial and neocortical temporal ictal patterns. J Clin Neurophysiol. 2013;30:238–246.Google Scholar
Blümcke, I, Thom, M, Aronica, E, Armstrong, DD, H V, Vinters, Palmini, A, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 2011;52:158–174.Google Scholar
Lopez-Gonzalez, MA, Gonzalez-Martinez, JA, Jehi, L, Kotagal, P, Warbel, A, Bingaman, W. Epilepsy surgery of the temporal lobe in the pediatric population: A retrospective analysis. Neurosurgery. 2012;70:684–692.CrossRefGoogle ScholarPubMed
Ryvlin, P, Kahane, P. The hidden causes of surgery-resistant temporal lobe epilepsy: Extratemporal or temporal plus? Curr Opin Neurol. 2005;18:125–127.CrossRefGoogle ScholarPubMed
Munari, C, Talairach, J, Bonis, A, Szikla, G, Bancaud, J. Differential diagnosis between temporal and “peri-Sylvian” epilepsy in a surgical perspective. Vienna: Springer; 1980, pp. 97–101.Google Scholar
Kahane, P, Huot, J, Hoffmann, D, Lo Russo, G, Benabid, AL, Munari, C. Peri-Sylvian cortex involvement in seizures affecting the temporal lobe. In Avanzini G, Beaumanoir A, Mira L, Mariani FP, editors. Limbic Seizures in Children. John Libbey; 2001. pp. 115–127.Google Scholar
Nguyen, D, Nguyen, D, Malak, R, Bouthillier, A. Insular cortex epilepsy: An overview. Can J Neurol Sci. 2009;36 suppl 2:S58–S62.Google ScholarPubMed
Surbeck, W, Bouthillier, A, Weil, AG, Crevier, L, Carmant, L, Lortie, A, et al. The combination of subdural and depth electrodes for intracranial EEG investigation of suspected insular (peri-Sylvian) epilepsy. Epilepsia. 2011;52:458–466.CrossRefGoogle Scholar
Ryvlin, P. Avoid falling into the depths of the insular trap. Epileptic Disord. 2006;8 Suppl 2:S37–S56.Google ScholarPubMed
Surbeck, W, Bouthillier, A, Nguyen, DK. Refractory insular cortex epilepsy: Clinical features, investigation and treatment. Future Neurol. 2010;5:491–499.CrossRefGoogle Scholar
Sequeira, KM, Tabesh, A, Sainju, RK, DeSantis, SM, Naselaris, T, Joseph, JE, et al. Perfusion network shift during seizures in medial temporal lobe epilepsy. PLoS One. 2013;8:e53204.Google Scholar
Chassoux, F, Semah, F, Bouilleret, V, Landre, E, Devaux, B, Turak, B, et al. Metabolic changes and electro-clinical patterns in mesio-temporal lobe epilepsy: A correlative study. Brain. 2004;127:164–174.Google Scholar
McDonald, CR, Jr, DJH, Ahmadi, ME, Tecoma, E, Iragui, V, Gharapetian, L, et al. Regional neocortical thinning in mesial temporal lobe epilepsy. Epilepsia. 2008;49:794–803.Google Scholar
Cauda, F, D’Agata, F, Sacco, K, Duca, S, Geminiani, G VA. Functional connectivity of the insula in the resting brain. Neuroimage. 2011;55:8–23.Google Scholar
Almashaikhi, T, Rheims, S, Ostrowsky-Coste, K, Montavont, A, Jung, J, De Bellescize, J, et al. Intrainsular functional connectivity in human. Hum Brain Mapp. 2014;35:2779–2788.CrossRefGoogle ScholarPubMed
Unnwongse, K, Jehi, L, Bulacio, J, Gonzalez-Martinez, J, Najm, I. Contralateral insular involvement producing false lateralizing signs in bitemporal epilepsy: A stereo-encephalography case report. Seizure. 2012;21:816–819.CrossRefGoogle ScholarPubMed
Robles, SG, Gelisse, P, El Fertit, H, Tancu, C, Duffau, H, Crespel, A et al. Parasagittal transinsular electrodes for stereo-EEG in temporal and insular lobe epilepsies. Seizure. 2012;21:816–819.Google Scholar
Ostrowsky, K, Isnard, J, Ryvlin, P, Guénot, M, Fischer, C, Mauguière, F. Functional mapping of the insular cortex: Clinical implication in temporal lobe epilepsy. Epilepsia. 2000;41:681–686.Google Scholar
Isnard, J, Guénot, M, Sindou, M, Mauguière, F. Clinical manifestations of insular lobe seizures: A stereo-electroencephalographic study. Epilepsia. 2004;45:1079–1090.Google Scholar
Ryvlin, P, Minotti, L, Demarquay, G, Hirsch, E, Arzimanoglou, A, Hoffman, D, et al. Nocturnal hypermotor seizures, suggesting frontal lobe epilepsy, can originate in the insula. Epilepsia. 2006;47:755–765.Google Scholar
Small, DM, Zald, DH, Jones-Gotman, M, Zatorre, RJ, Pardo, J V, Frey, S, et al. Human cortical gustatory areas: A review of functional neuroimaging data. Neuroreport. 1999;10:7–14.Google Scholar
Krolak-Salmon, P, M-A, Hénaff, Vighetto, A, Bertrand, O, Mauguière, F. Early amygdala reaction to fear spreading in occipital, temporal, and frontal cortex: a depth electrode ERP study in human. Neuron. 2004;42:665–676.CrossRefGoogle ScholarPubMed
Wright, P, He, G, Shapira, NA, Goodman, WK, Liu, Y. Disgust and the insula: fMRI responses to pictures of mutilation and contamination. Neuroreport. 2004;15:2347–2351.CrossRefGoogle ScholarPubMed
Freeman, R, Schachter, S. Autonomic epilepsy. Semin Neurol. 1995;15:158–166.Google Scholar
Seo, DW, Lee, HS, Hong, SB, Hong, S-C, Lee, E-K. Pilomotor seizures in frontal lobe epilepsy: Case report. Seizure. 2003;12:241–244.CrossRefGoogle ScholarPubMed
Loddenkemper, T, Kellinghaus, C, Gandjour, J, Nair, DR, Najm, IM, Bingaman, W, et al. Localising and lateralising value of ictal piloerection. J Neurol Neurosurg Psychiatry. 2004;75:879–883.Google Scholar
Usui, N, Kajita, Y, Maesawa, S, Endo, O, Takebayashi, S, Yoshida, J. Pilomotor seizures in mesial temporal lobe epilepsy: A case confirmed by intracranial EEG. Seizure. 2005;14:288–291.CrossRefGoogle ScholarPubMed
Benarroch, EE. The central autonomic network: Functional organization, dysfunction, and perspective. Mayo Clin Proc. 1993;68:988–1001.CrossRefGoogle ScholarPubMed
Warren, J. Goosebumps and the insula. Lancet. 2002;360:1978.CrossRefGoogle ScholarPubMed
Bartolomei, F, Cosandier-Rimele, D, McGonigal, A, Aubert, S, Régis, J, Gavaret, M, et al. From mesial temporal lobe to temporoperisylvian seizures: A quantified study of temporal lobe seizure networks. Epilepsia. 2010;51:2147–2158.CrossRefGoogle ScholarPubMed
Freri, E, Matricardi, S, Gozzo, F, Cossu, M, Granata, T, Tassi, L. Peri-Sylvian, including insular, childhood epilepsy: Presurgical workup and surgical outcome. Epilepsia. 2017;58:1360–1369.Google Scholar
Engel, J. Update on surgical treatment of the epilepsies. Summary of the Second International Palm Desert Conference on the Surgical Treatment of the Epilepsies (1992). Neurology. 1993;43:1612–1617.Google Scholar
Barba, C, Minotti, L, Job A-S, Kahane P. The Insula in temporal plus epilepsy. J Clin Neurophysiol. 2017;34.Google Scholar

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