Insular epilepsy surgery
Insular epilepsy surgery
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DOI：
10.1111/epi.13682
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发表时间：
2017-04-01
期刊：
影响因子：
5.6
通讯作者：
Handler, Michael H.
中科院分区：
文献类型：
--
作者：
Laoprasert, Pramote;Ojemann, Jeffrey G.;Handler, Michael H.
岛状癫痫最初是在近70年前被描述的，现在越来越多的人认识到这一点，并可能解释在明显计划良好的手术后出现的失败。我们回顾了对这种现象的认识，评估技术和手术治疗的历史。岛状癫痫可以模仿额叶、顶叶或颞叶癫痫的特征。当在癫痫发作早期观察到躯体感觉、内脏和运动症状的结合时，应予以考虑。为了准确诊断岛状癫痫发作，需要术外颅内记录。立体脑电图（EEG）或开颅植入表面和深度电极已成功地用于识别岛状癫痫发作。手术切除岛状病灶可获得良好的成功和可接受的风险。
Since it was originally described nearly 70years ago, insular epilepsy has been increasingly recognized and may explain failures after apparently well-planned operations. We review the history of awareness of the phenomenon, techniques for its assessment, and its surgical management. Insular epilepsy can mimic features of frontal, parietal, or temporal seizures. It should be considered when a combination of somatosensory, visceral, and motor symptoms is observed early in a seizure. Extraoperative intracranial recordings are required to accurately diagnose insular seizures. Stereo-electroencephalography (EEG) or craniotomy with implantation of surface and depth electrodes have been used successfully to identify insular onset of seizures. Surgical resection of an insular focus may be performed with good success and acceptable risk.