Ictal semiology of epileptic seizures with insulo-opercular genesis. 2022

Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
Epilepsy Center, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany. eva.martinez@uniklinik-freiburg.de.

OBJECTIVE Epileptic seizures with insular genesis are often difficult to distinguish from those originating in the temporal lobe due to their complex and variable semiology. Here, we analyzed differentiating characteristics in the clinical spectrum of insulo-opercular seizures. METHODS Ictal semiology in patients with a diagnosis of insulo-opercular epilepsy (IOE) based on imaging of epileptogenic lesions or electrophysiological evidence of an insulo-opercular seizure origin was retrospectively analyzed and compared to age-matched controls with mesial temporal lobe epilepsy (MTE). RESULTS Forty-six IOE and 46 matched MTE patients were included. The most prominent ictal features in IOE were focal motor phenomena in 80.4% of these patients. Somatosensory sensations, version, tonic and clonic features, when present, were more frequent contralateral to the SOZ in MTE patients, while they occurred about equally often ipsilateral and contralateral to the SOZ in IOE patients. Ipsilateral manual automatisms were significantly more frequent in MTE patients than in IOE (p = 0.010). Multivariate analysis correctly identified IOE in 78.3% and MTE in 84.8% using five semiologic features (Chi-square = 53.79 with 5 degrees of freedom, p < 0.0001). A subanalysis comparing patients with purely insular lesions with MTE patients using only the earliest ictal signs showed that somatosensory sensations are significantly more frequent in insular epilepsy (p = 0.010), while automatisms were significantly more frequent in MTE patients (p = 0.06). CONCLUSIONS Our study represents the first in-depth analysis of ictal semiology in IOE compared to MTE. Use of these differentiating characteristics can serve for a correct syndrome classification and to steer appropriate diagnostic and local therapeutic procedures.

UI MeSH Term Description Entries
D002540 Cerebral Cortex The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions. Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004833 Epilepsy, Temporal Lobe A localization-related (focal) form of epilepsy characterized by recurrent seizures that arise from foci within the TEMPORAL LOBE, most commonly from its mesial aspect. A wide variety of psychic phenomena may be associated, including illusions, hallucinations, dyscognitive states, and affective experiences. The majority of complex partial seizures (see EPILEPSY, COMPLEX PARTIAL) originate from the temporal lobes. Temporal lobe seizures may be classified by etiology as cryptogenic, familial, or symptomatic. (From Adams et al., Principles of Neurology, 6th ed, p321). Epilepsy, Benign Psychomotor, Childhood,Benign Psychomotor Epilepsy, Childhood,Childhood Benign Psychomotor Epilepsy,Epilepsy, Lateral Temporal,Epilepsy, Uncinate,Epilepsies, Lateral Temporal,Epilepsies, Temporal Lobe,Epilepsies, Uncinate,Lateral Temporal Epilepsies,Lateral Temporal Epilepsy,Temporal Lobe Epilepsies,Temporal Lobe Epilepsy,Uncinate Epilepsies,Uncinate Epilepsy
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012640 Seizures Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as EPILEPSY or "seizure disorder." Absence Seizure,Absence Seizures,Atonic Absence Seizure,Atonic Seizure,Clonic Seizure,Complex Partial Seizure,Convulsion,Convulsions,Convulsive Seizure,Convulsive Seizures,Epileptic Seizure,Epileptic Seizures,Generalized Absence Seizure,Generalized Tonic-Clonic Seizures,Jacksonian Seizure,Myoclonic Seizure,Non-Epileptic Seizure,Nonepileptic Seizure,Partial Seizure,Seizure,Seizures, Convulsive,Seizures, Focal,Seizures, Generalized,Seizures, Motor,Seizures, Sensory,Tonic Clonic Seizure,Tonic Seizure,Tonic-Clonic Seizure,Atonic Absence Seizures,Atonic Seizures,Clonic Seizures,Complex Partial Seizures,Convulsion, Non-Epileptic,Generalized Absence Seizures,Myoclonic Seizures,Non-Epileptic Seizures,Nonepileptic Seizures,Partial Seizures,Petit Mal Convulsion,Seizures, Auditory,Seizures, Clonic,Seizures, Epileptic,Seizures, Gustatory,Seizures, Olfactory,Seizures, Somatosensory,Seizures, Tonic,Seizures, Tonic-Clonic,Seizures, Vertiginous,Seizures, Vestibular,Seizures, Visual,Single Seizure,Tonic Seizures,Tonic-Clonic Seizures,Absence Seizure, Atonic,Absence Seizure, Generalized,Absence Seizures, Atonic,Absence Seizures, Generalized,Auditory Seizure,Auditory Seizures,Clonic Seizure, Tonic,Clonic Seizures, Tonic,Convulsion, Non Epileptic,Convulsion, Petit Mal,Convulsions, Non-Epileptic,Focal Seizure,Focal Seizures,Generalized Seizure,Generalized Seizures,Generalized Tonic Clonic Seizures,Generalized Tonic-Clonic Seizure,Gustatory Seizure,Gustatory Seizures,Motor Seizure,Motor Seizures,Non Epileptic Seizure,Non Epileptic Seizures,Non-Epileptic Convulsion,Non-Epileptic Convulsions,Olfactory Seizure,Olfactory Seizures,Partial Seizure, Complex,Partial Seizures, Complex,Seizure, Absence,Seizure, Atonic,Seizure, Atonic Absence,Seizure, Auditory,Seizure, Clonic,Seizure, Complex Partial,Seizure, Convulsive,Seizure, Epileptic,Seizure, Focal,Seizure, Generalized,Seizure, Generalized Absence,Seizure, Generalized Tonic-Clonic,Seizure, Gustatory,Seizure, Jacksonian,Seizure, Motor,Seizure, Myoclonic,Seizure, Non-Epileptic,Seizure, Nonepileptic,Seizure, Olfactory,Seizure, Partial,Seizure, Sensory,Seizure, Single,Seizure, Somatosensory,Seizure, Tonic,Seizure, Tonic Clonic,Seizure, Tonic-Clonic,Seizure, Vertiginous,Seizure, Vestibular,Seizure, Visual,Seizures, Generalized Tonic-Clonic,Seizures, Nonepileptic,Sensory Seizure,Sensory Seizures,Single Seizures,Somatosensory Seizure,Somatosensory Seizures,Tonic Clonic Seizures,Tonic-Clonic Seizure, Generalized,Tonic-Clonic Seizures, Generalized,Vertiginous Seizure,Vertiginous Seizures,Vestibular Seizure,Vestibular Seizures,Visual Seizure,Visual Seizures
D017034 Epilepsy, Frontal Lobe A localization-related (focal) form of epilepsy characterized by seizures which arise in the FRONTAL LOBE. Frontal Epilepsy, Benign, Childhood,Frontal Lobe Epilepsy,Benign Frontal Childhood Epilepsy,Childhood Benign Frontal Epilepsy,Epilepsy, Anterior Fronto-Polar,Epilepsy, Benign Frontal, Childhood,Epilepsy, Cingulate,Epilepsy, Opercular,Epilepsy, Orbito-Frontal,Epilepsy, Supplementary Motor,Anterior Fronto-Polar Epilepsies,Anterior Fronto-Polar Epilepsy,Cingulate Epilepsies,Cingulate Epilepsy,Epilepsies, Anterior Fronto-Polar,Epilepsies, Cingulate,Epilepsies, Orbito-Frontal,Epilepsies, Supplementary Motor,Epilepsy, Anterior Fronto Polar,Epilepsy, Orbito Frontal,Frontal Lobe Epilepsies,Opercular Epilepsies,Opercular Epilepsy,Orbito-Frontal Epilepsies,Orbito-Frontal Epilepsy,Supplementary Motor Epilepsies,Supplementary Motor Epilepsy

Related Publications

Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
September 2022, Journal of neurology,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
March 2023, Epilepsy & behavior : E&B,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
March 2018, Epilepsia,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
December 2023, Pediatric investigation,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
December 1980, Srpski arhiv za celokupno lekarstvo,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
May 2020, Epilepsia,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
January 2011, Epilepsia,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
June 2013, Der Nervenarzt,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
September 2014, Epilepsy & behavior : E&B,
Eva Martinez-Lizana, and Armin Brandt, and Niels A Foit, and Horst Urbach, and Andreas Schulze-Bonhage
January 2019, Epilepsy & behavior : E&B,
Copied contents to your clipboard!