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Ictus emeticus and the insular cortex.

M E Fiol1, I E Leppik, R Mireles

  • 1Comprehensive Epilepsy Program, University of Minnesota, Minneapolis 55414.

Epilepsy Research
|March 1, 1988
PubMed
Summary
This summary is machine-generated.

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This study suggests the insula may trigger vomiting during seizures, but needs temporal cortex involvement for full episodes. Surgical removal improved symptoms, indicating the insula's role in focal epilepsy.

Area of Science:

  • Neuroscience
  • Epileptology
  • Clinical Neurology

Background:

  • Focal epilepsy can present with complex sensory and autonomic symptoms.
  • The insula's role in seizure generation, particularly those involving autonomic disturbances like vomiting, is not fully elucidated.

Observation:

  • A 30-year-old male presented with seizures characterized by throat tightness, fear, projectile vomiting, and leftward head/eye deviation.
  • Video electroencephalography (EEG) confirmed the seizure semiology.
  • Corticography revealed residual epileptiform activity in the insula post-temporal lobectomy.

Findings:

  • The insula was implicated as a potential trigger area for emesis during seizures.
  • Complete seizure cessation, particularly vomiting, was not achieved solely by temporal lobectomy.

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  • Residual seizure activity in the insula persisted despite surgical resection.

    • Implications:

    • The insula's role in generating emesis requires further investigation in epilepsy.
    • Combined insular and temporal lobe involvement may be necessary for certain seizure types.
    • This finding could refine surgical strategies for drug-resistant epilepsy involving vomiting.