岛叶癫痫的研究进展_Journal of Epilepsy

Authors：

张洪伟 , 张童 , 金瑞峰 , 高在芬 ,  刘勇

山东大学附属儿童医院（济南市儿童医院）　癫痫中心（济南 250022）;

Corresponding author：

刘勇, Email: etyyliuyong@163.com

Keywords：

岛叶癫痫; 立体定向脑电图; 症状学; 治疗

DOI：

10.7507/2096-0247.202210002

Video：

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随着立体定向脑电图（Stereoelectroencephalography，SEEG）技术的广泛使用，岛叶癫痫逐渐被认识，其症状学也逐渐被描述清楚。在岛叶癫痫的研究中，主观症状（如上腹部感觉、听觉和躯体感觉等）对于识别岛叶癫痫至关重要，客观的运动成分也比较突出。岛叶癫痫症状学的多样性与其特殊的皮层构筑特点、广泛的功能连接和致痫网络有关。由于岛叶特殊的位置关系，切除手术有一定的风险，SEEG引导下立体定向脑电图引导下射频热凝毁（Radio frequency thermocoagulation，RF-TC）、激光间质热疗法（MRI-guided laser interstitial thermal therapy，LITT）具有接近于切除性手术的有效性，同时具有更高的安全性。这种精准、微创的治疗方法有可能会部分取代传统的切除性外科手术，使更多的癫痫患者获益，但目前来说该技术仍然只是一种尝试。

Citation： 张洪伟, 张童, 金瑞峰, 高在芬, 刘勇. 岛叶癫痫的研究进展. Journal of Epilepsy, 2023, 9(1): 43-47. doi: 10.7507/2096-0247.202210002 Copy

1.	Isnard J, Guénot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(9): 1079-1090.
2.	Varnavas GG, Grand W. The insular cortex: morphological and vascular anatomic characteristics. Neurosurgery, 1999, 44(1): 127-138.
3.	Mesulam MM, Mufson EJ. Insula of the old world monkey. I. Architectonics in the insulo-orbito-temporal component of the paralimbic brain. J Comp Neurol, 1982, 212(1): 1-22.
4.	Benarroch EE. Insular cortex: Functional complexity and clinical correlations. Neurology, 2019, 93(21): 932-938.
5.	Gogolla N. The insular cortex. Curr Biol, 2017, 27(12): R580-R586.
6.	Morel A, Gallay MN, Baechler A, et al. The human insula: architectonic organization and postmortem MRI registration. Neuroscience, 2013, 236: 117-135.
7.	Fan L, Li H, Zhuo J, et al. The human brainnetome atlas: a new brain atlas based on connectional architecture. Cereb Cortex, 2016, 26(8): 3508-3526.
8.	Ghaziri J, Tucholka A, Girard G, et al. The Corticocortical structural connectivity of the human insula. Cereb Cortex, 2017, 27(2): 1216-1228.
9.	Ghaziri J, Tucholka A, Girard G, et al. Subcortical structural connectivity of insular subregions. Sci Rep, 2018, 8(1): 8596.
10.	Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Curr, 2019, 19(1): 11-21.
11.	Uddin LQ, Nomi JS, Hébert-Seropian B, et al. Structure and function of the human insula. J Clin Neurophysiol, 2017, 34(4): 300-306.
12.	Shelley BP, Trimble MR. The insular lobe of Reil——its anatamico-functional, behavioural and neuropsychiatric attributes in humans——a review. World J Biol Psychiatry, 2004, 5(4): 176-200.
13.	Nieuwenhuys R. The insular cortex: a review. Prog Brain Res, 2012, 195: 123-163.
14.	Kurth F, Zilles K, Fox PT, et al. A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Funct, 2010, 214(5-6): 519-534.
15.	Isnard J, Guénot M, Ostrowsky K, et al. The role of the insular cortex in temporal lobe epilepsy. Ann Neurol, 2000, 48(4): 614-623.
16.	Wang X, Hu W, McGonigal A, et al. Electroclinical features of insulo-opercular epilepsy: an SEEG and PET study. Ann Clin Transl Neurol, 2019, 6(7): 1165-1177.
17.	Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy Behav, 2020, 105: 106964.
18.	Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo-electroencephalography: the emergence of semiology in insula lobe seizures. Ann Neurol, 2020, 88(3): 477-488.
19.	Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(5): 984-994.
20.	Ryvlin P, Nguyen DK. Insular seizures and epilepsies: ictal semiology and minimal invasive surgery. Curr Opin Neurol, 2021, 34(2): 153-165.
21.	Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23(4): 300-308.
22.	Proserpio P, Cossu M, Francione S, et al. Insular-opercular seizures manifesting with sleep-related paroxysmal motor behaviors: a stereo-EEG study. Epilepsia, 2011, 52(10): 1781-1791.
23.	Levy A, Yen Tran TP, Boucher O, et al. Operculo-insular epilepsy: scalp and intracranial electroencephalographic findings. J Clin Neurophysiol, 2017, 34(5): 438-447.
24.	Hagiwara K, Jung J, Bouet R, et al. How can we explain the frontal presentation of insular lobe epilepsy? The impact of non-linear analysis of insular seizures. Clin Neurophysiol, 2017, 128(5): 780-791.
25.	Wang H, David O, Zhou W, et al. Distinctive epileptogenic networks for parietal operculum seizures. Epilepsy Behav, 2019, 91: 59-67.
26.	[Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: is it effective? . J Neurosurg , 2019, Sep 20: 1-10.
27.	Ikegaya N, Iwasaki M, Kaneko Y, et al. Cognitive and developmental outcomes after pediatric insular epilepsy surgery for focal cortical dysplasia. J Neurosurg Pediatr, 2020, 26(5): 543-551.
28.	Kerezoudis P, Singh R, Goyal A, et al. Insular epilepsy surgery: lessons learned from institutional review and patient-level meta-analysis. J Neurosurg, 2021: 1-13.
29.	中国医师协会神经外科分会功能神经外科学组, 中国抗癫痫协会, 国家神经外科手术机器人应用示范项目专家指导委员会. 立体定向脑电图引导射频热凝毁损治疗药物难治性癫痫的中国专家共识. 中华医学杂志, 2021, 101(29): 2276-2282.
30.	邓劼, 方铁, 解自行, 等. 立体脑电图引导的射频热凝术治疗儿童药物难治性癫痫的疗效(附71例报告). 中华神经外科杂志, 2020, 36(4): 342-347.
31.	Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
32.	戴阳, 王逸鹤, 安阳, 等. 立体定向脑电图引导下立体交叉射频热凝毁损治疗药物难治性岛叶癫痫的安全性及有效性观察. 中华医学杂志, 2021, 101(41): 3386-3392.
33.	胡文瀚, 莫嘉杰, 刘畅, 等. 磁共振引导激光间质热疗治疗药物难治性癫痫的手术策略及疗效. 中华神经外科杂志, 2021, 37(8): 764-770.
34.	Hawasli AH, Bandt SK, Hogan RE, et al. Laser ablation as treatment strategy for medically refractory dominant insular epilepsy: therapeutic and functional considerations. Stereotact Funct Neurosurg, 2014, 92(6): 397-404.
35.	Perry MS, Donahue DJ, Malik SI, et al. Magnetic resonance imaging-guided laser interstitial thermal therapy as treatment for intractable insular epilepsy in children. J Neurosurg Pediatr, 2017, 20(6): 575-582.

1. Isnard J, Guénot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(9): 1079-1090.
2. Varnavas GG, Grand W. The insular cortex: morphological and vascular anatomic characteristics. Neurosurgery, 1999, 44(1): 127-138.
3. Mesulam MM, Mufson EJ. Insula of the old world monkey. I. Architectonics in the insulo-orbito-temporal component of the paralimbic brain. J Comp Neurol, 1982, 212(1): 1-22.
4. Benarroch EE. Insular cortex: Functional complexity and clinical correlations. Neurology, 2019, 93(21): 932-938.
5. Gogolla N. The insular cortex. Curr Biol, 2017, 27(12): R580-R586.
6. Morel A, Gallay MN, Baechler A, et al. The human insula: architectonic organization and postmortem MRI registration. Neuroscience, 2013, 236: 117-135.
7. Fan L, Li H, Zhuo J, et al. The human brainnetome atlas: a new brain atlas based on connectional architecture. Cereb Cortex, 2016, 26(8): 3508-3526.
8. Ghaziri J, Tucholka A, Girard G, et al. The Corticocortical structural connectivity of the human insula. Cereb Cortex, 2017, 27(2): 1216-1228.
9. Ghaziri J, Tucholka A, Girard G, et al. Subcortical structural connectivity of insular subregions. Sci Rep, 2018, 8(1): 8596.
10. Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Curr, 2019, 19(1): 11-21.
11. Uddin LQ, Nomi JS, Hébert-Seropian B, et al. Structure and function of the human insula. J Clin Neurophysiol, 2017, 34(4): 300-306.
12. Shelley BP, Trimble MR. The insular lobe of Reil——its anatamico-functional, behavioural and neuropsychiatric attributes in humans——a review. World J Biol Psychiatry, 2004, 5(4): 176-200.
13. Nieuwenhuys R. The insular cortex: a review. Prog Brain Res, 2012, 195: 123-163.
14. Kurth F, Zilles K, Fox PT, et al. A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Funct, 2010, 214(5-6): 519-534.
15. Isnard J, Guénot M, Ostrowsky K, et al. The role of the insular cortex in temporal lobe epilepsy. Ann Neurol, 2000, 48(4): 614-623.
16. Wang X, Hu W, McGonigal A, et al. Electroclinical features of insulo-opercular epilepsy: an SEEG and PET study. Ann Clin Transl Neurol, 2019, 6(7): 1165-1177.
17. Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy Behav, 2020, 105: 106964.
18. Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo-electroencephalography: the emergence of semiology in insula lobe seizures. Ann Neurol, 2020, 88(3): 477-488.
19. Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(5): 984-994.
20. Ryvlin P, Nguyen DK. Insular seizures and epilepsies: ictal semiology and minimal invasive surgery. Curr Opin Neurol, 2021, 34(2): 153-165.
21. Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23(4): 300-308.
22. Proserpio P, Cossu M, Francione S, et al. Insular-opercular seizures manifesting with sleep-related paroxysmal motor behaviors: a stereo-EEG study. Epilepsia, 2011, 52(10): 1781-1791.
23. Levy A, Yen Tran TP, Boucher O, et al. Operculo-insular epilepsy: scalp and intracranial electroencephalographic findings. J Clin Neurophysiol, 2017, 34(5): 438-447.
24. Hagiwara K, Jung J, Bouet R, et al. How can we explain the frontal presentation of insular lobe epilepsy? The impact of non-linear analysis of insular seizures. Clin Neurophysiol, 2017, 128(5): 780-791.
25. Wang H, David O, Zhou W, et al. Distinctive epileptogenic networks for parietal operculum seizures. Epilepsy Behav, 2019, 91: 59-67.
26. [Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: is it effective? . J Neurosurg , 2019, Sep 20: 1-10.
27. Ikegaya N, Iwasaki M, Kaneko Y, et al. Cognitive and developmental outcomes after pediatric insular epilepsy surgery for focal cortical dysplasia. J Neurosurg Pediatr, 2020, 26(5): 543-551.
28. Kerezoudis P, Singh R, Goyal A, et al. Insular epilepsy surgery: lessons learned from institutional review and patient-level meta-analysis. J Neurosurg, 2021: 1-13.
29. 中国医师协会神经外科分会功能神经外科学组, 中国抗癫痫协会, 国家神经外科手术机器人应用示范项目专家指导委员会. 立体定向脑电图引导射频热凝毁损治疗药物难治性癫痫的中国专家共识. 中华医学杂志, 2021, 101(29): 2276-2282.
30. 邓劼, 方铁, 解自行, 等. 立体脑电图引导的射频热凝术治疗儿童药物难治性癫痫的疗效(附71例报告). 中华神经外科杂志, 2020, 36(4): 342-347.
31. Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
32. 戴阳, 王逸鹤, 安阳, 等. 立体定向脑电图引导下立体交叉射频热凝毁损治疗药物难治性岛叶癫痫的安全性及有效性观察. 中华医学杂志, 2021, 101(41): 3386-3392.
33. 胡文瀚, 莫嘉杰, 刘畅, 等. 磁共振引导激光间质热疗治疗药物难治性癫痫的手术策略及疗效. 中华神经外科杂志, 2021, 37(8): 764-770.
34. Hawasli AH, Bandt SK, Hogan RE, et al. Laser ablation as treatment strategy for medically refractory dominant insular epilepsy: therapeutic and functional considerations. Stereotact Funct Neurosurg, 2014, 92(6): 397-404.
35. Perry MS, Donahue DJ, Malik SI, et al. Magnetic resonance imaging-guided laser interstitial thermal therapy as treatment for intractable insular epilepsy in children. J Neurosurg Pediatr, 2017, 20(6): 575-582.

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