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An embarrassing aura.

Laura Lacazette¹, Olivier Boucher², Ismail Mohamed³

¹Division of Neurology, CHUM, Université de Montréal, Montreal, Canada, Faculty of Medicine, Université de Bordeaux II, Bordeaux, France.

Epileptic Disorders : International Epilepsy Journal with Videotape

|June 22, 2019

Summary

This case study details epilepsy surgery, linking frontal lobe and insula resections to seizure control but also to emotional and motivational deficits. It highlights the complex relationship between brain networks and emotional experiences.

Keywords:

aura embarrassment epilepsy frontal lobe epilepsy insula magnetoencephalography negative moral emotions shame

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Area of Science:

Neuroscience
Epileptology
Psychiatry

Background:

Epilepsy surgery aims to achieve seizure freedom by resecting epileptogenic zones.
Presurgical evaluation is crucial for identifying optimal resection targets.
Understanding the emotional correlates of seizures is important for comprehensive patient care.

Observation:

A patient with epilepsy reported experiencing shame and embarrassment preceding seizures.
Initial resection of the right frontal lobe's polar and ventromedial portions resulted in persistent, albeit nocturnal, seizures without clear aura.
Further resection involving the right anterior insula and posterior orbitofrontal cortex achieved seizure freedom.

Findings:

Surgical intervention for epilepsy can involve complex brain regions associated with emotional processing.
Resection of specific frontal lobe and insular areas can lead to seizure cessation.
Post-surgical outcomes may include significant changes in motivation and emotional regulation.

Implications:

This case underscores the intricate neural networks underlying both seizure generation and emotional experiences.
Targeting specific brain regions for epilepsy surgery requires careful consideration of potential cognitive and emotional side effects.
Further research is needed to elucidate the role of the frontal lobe and insula in negative moral emotions and their modulation by surgical interventions.