POE03 EEG and imaging correlates of insular seizures

O Jumma
November 2010
Journal of Neurology, Neurosurgery & Psychiatry;Nov2010, Vol. 81 Issue 11, pe46
Academic Journal
BACKGROUND: Insular epilepsy is an uncommon and frequently overlooked condition, causing a rare type of seizures which is still not included by The International League Against epilepsy (ILAE) in its current classification for epileptic seizures, epilepsy or epileptic syndromes. CASE PRESENTATION: A 25-year-old woman presented with new onset secondary generalised seizures. Her seizures began with speech arrest, hypersalivation followed by painful sensation in the throat and automatic chewing movements. Despite the generalised seizures being controlled with antiepileptic treatment, she continued to have 10–30 complex partial seizures a day. She eventually developed auditory hallucinations and retrograde amnesia. She had normal blood tests and CSF examination. However, her EEG revealed slow wave activity over the left mid temporal region (Abstract POE03 Figure 1) and her MRI brain revealed abnormal high signal changes in the left insular region (Abstract POE03 Figure 2) followed by similar changes in the right side (Abstract POE03 Figure 3). These changes resolved subsequently (Abstract POE03 Figure 4). Currently she experiences one minor seizure every 1–2 months. Her auditory hallucination resolved but she continues to suffer from retrograde amnesia for one year of her life prior to her illness. CONCLUSION: The initial MRI brain changes and the EEG finding in our case correlate with insular seizures. The MRI changes in the right lobe suggest functional kindling as a result of repeated seizures in the left lobe.


Related Articles

  • Older epilepsy drugs 'best'. Polak, Monika // GP: General Practitioner;11/17/2003, p19 

    Older antiepileptic drugs should remain the first-line choice of therapy, according to draft guidance from NICE. It has recommended that the newer antiepileptic drugs should only be prescribed on the NHS, within their licensed indications, if the older therapies have not worked or are unsuitable...

  • BEMEGRIDE (MEGIMIDE). TATUM IV, WILLIAM O.; KAPLAN, PETER W.; JALLON, PIERRE // Epilepsy A to Z: A Concise Encyclopedia;2009, p50 

    An encyclopedia entry for the proconvulsant drug "bemegride" is presented. This drug was previously used to activate clinical and electrographic seizures to aid in the classification and characterization of patients with recurrent seizures. Procunvulsant drugs, however, have fallen into disuse...

  • MIGRAINE. TATUM IV, WILLIAM O.; KAPLAN, PETER W.; JALLON, PIERRE // Epilepsy A to Z: A Concise Encyclopedia;2009, p219 

    An encyclopedia entry for "migraine" is presented. Both epilepsy and migraine are common disorders and comorbidities. Studies reveal that there is a genetic link between migraine and epilepsy with up to 50% of people with epilepsy (PWE) have various forms of headache related or unrelated to...

  • MORTALITY. TATUM IV, WILLIAM O.; KAPLAN, PETER W.; JALLON, PIERRE // Epilepsy A to Z: A Concise Encyclopedia;2009, p221 

    An encyclopedia entry for "Mortality" is presented. The association of death among epileptics with seizures is noted. This association has been heterogeneous and the higher risk of dying with epilepsy is uniform. It cites several risk factors that may affect mortality involving epileptics,...

  • postepileptic.  // Taber's Cyclopedic Medical Dictionary;2005, p1739 

    The article presents a definition for the term "postepileptic," which relates to a situation occurring after an epileptic seizure.

  • Optimizing Treatment of Adolescents With Partial-Onset Seizures.  // Neurology Reviews;Feb2013 Supplement, p1 

    The article offers information on the diagnosis and management of partial onset seizures in adolescents. It mentions that partial onset seizure patients comprise patients with childhood-onset epilepsy syndrome that persists into adulthood, and patients with epilepsy syndrome that began in...

  • Klassifikation epileptischer Anf�lle und Syndrome. Noachtar, S.; R�mi, J. // Nervenarzt;Feb2012, Vol. 83 Issue 2, p156 

    Advances in diagnostic and therapeutic options require a revision of the current classification of seizures and epilepsies. Recently, a classification proposal was introduced which reflects the ambivalence of the Internationalen Liga gegen Epilepsie (ILAE). We suggest that epileptology should...

  • Bedeutung des EEG in der Epilepsiediagnostik. R�mi, J.; Noachtar, S. // Nervenarzt;Feb2012, Vol. 83 Issue 2, p172 

    The electroencephalogram (EEG) is a specific diagnostic method for the evaluation of patients with epilepsies. Interictal epileptiform discharges (IED) recorded in the seizure interval have a high association with the clinical diagnosis of epilepsy. IEDs have to be differentiated from normal...

  • Epilepsiechirurgie. Noachtar, S.; R�mi, J. // Nervenarzt;Feb2012, Vol. 83 Issue 2, p209 

    Epilepsy surgery is an important therapeutic option for patients with epilepsy since one third of all epilepsy patients will still not be become seizure free despite newly developed antiepileptic drugs. Anterior temporal lobe resection is the most common procedure. Extratemporal resections...


Read the Article


Sign out of this library

Other Topics