Insular Epilepsy: Functions, Diagnostic Approaches, and Surgical Interventions
Felix R Ekman1, Jorge A González-Martínez2
1Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, 41390 Gothenburg, Sweden.
Journal of Integrative Neuroscience
|November 29, 2024
Summary
Drug-resistant epilepsy (DRE) is challenging to treat. Insular epilepsy diagnosis and treatment are complex, but advanced imaging, SEEG, surgery, and minimally invasive techniques like LITT offer new hope.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Epilepsy affects many globally, with drug-resistant epilepsy (DRE) posing significant therapeutic challenges.
- Insular epilepsy, originating in a complex brain region, presents diverse symptoms complicating diagnosis.
Purpose of the Study:
- To review diagnostic and therapeutic strategies for insular epilepsy, particularly DRE.
- To highlight advancements in neuroimaging and surgical interventions.
Main Methods:
- Review of advanced imaging modalities for epileptogenic zone localization.
- Discussion of stereoelectroencephalography (SEEG) for precise localization.
- Analysis of surgical resection and minimally invasive techniques.
Main Results:
- Accurate localization of the epileptogenic zone is critical for effective treatment.
- Surgical resection, enhanced by microsurgical techniques and neuroimaging, improves outcomes for DRE.
- Minimally invasive options like laser interstitial thermal therapy (LITT) and radiofrequency thermocoagulation (RFTC) show promise.
Conclusions:
- Insular epilepsy management requires a multidisciplinary approach.
- Advancements in localization and treatment offer improved prognoses for patients with DRE.
- Minimally invasive therapies represent valuable alternatives for select DRE cases.
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