癫痫外科手术技术专家共识——第五篇：岛叶癫痫外科手术技术专家共识_Journal of Epilepsy

Authors：

中国抗癫痫协会青年委员会 , 谭启富癫痫外科发展专项基金管理委员会 , 北京神经科学学会脑功能性疾病与认知发育专业委员会 , 国家儿科及小儿外科专业医疗质量控制中心 , 《癫痫杂志》编辑部

执笔郭强（广东三九脑科医院），陈子怡（中山大学附属第一医院），彭镜（中南大学湘雅医院），乔梁（首都医科大学宣武医院），张弨（首都医科大学附属北京天坛医院），隋立森（广东省中医院），刘强强（上海交通大学医学院附属瑞金医院），李少春（广东三九脑科医院），刘畅（首都医科大学附属北京儿童医院）;

Corresponding author：

Keywords：

DOI：

10.7507/2096-0247.202409002

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Citation： 中国抗癫痫协会青年委员会, 谭启富癫痫外科发展专项基金管理委员会, 北京神经科学学会脑功能性疾病与认知发育专业委员会, 国家儿科及小儿外科专业医疗质量控制中心, 《癫痫杂志》编辑部. 癫痫外科手术技术专家共识——第五篇：岛叶癫痫外科手术技术专家共识. Journal of Epilepsy, 2024, 10(6): 478-486. doi: 10.7507/2096-0247.202409002 Copy

1.	中国抗癫痫协会. 临床诊疗指南•癫痫病分册. 北京: 人民卫生出版社, 2023 .
2.	张建国, 栾国明. 癫痫外科学(第3版). 北京: 人民卫生出版社, 2023.
3.	Bourdillon P, Ryvlin P, Isnard J, et al. Stereotactic electroencephalography is a safe procedure, including for insular implantations. World Neurosurgery, 2017, 99: 353-361.
4.	Alomar S, Mullin JP, Smithason S, et al. Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy. Journal of Neurosurgery, 2018, 128(4): 1147-1157.
5.	Ryvlin P, Picard F. Invasive investigation of insular cortex epilepsy. Journal of Clinical Neurophysiology, 2017, 34(4): 328-332.
6.	Stephani C, Fernandez-Baca Vaca G, Maciunas R, et al. Functional neuroanatomy of the insular lobe. Brain Structure & Function, 2011, 216(2): 137-149.
7.	Gasquoine PG. Contributions of the insula to cognition and emotion. Neuropsychology Review, 2014, 24(2): 77-87.
8.	Afif A, Minotti L, Kahane P, et al. Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy. Epilepsia, 2010, 51(1): 206-213.
9.	Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(3): 984-994.
10.	Meyer S, Strittmatter M, Fischer C, et al. Lateralization in autononic dysfunction in ischemic stroke involving the insular cortex. Neuroreport, 2004, 15: 357-361.
11.	Oppenheimer SM, Gelb A, Girvin JP, et al. Cardiovascular effects of human insular cortex stimulation. Neurology, 1992, 42: 1727-1732.
12.	Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo- electroencephalography: the emergence of semiology in insula lobe seizures. Annals of Neurology, 2020, 88: 477-488.
13.	Obaid S, Chen JS, Ibrahim GM, et al. Predictors of outcomes after surgery for medically intractable insular epilepsy: a systematic review and individual participant data meta-analysis. Epilepsia Open, 2023, 8(1): 12-31.
14.	Isnard J, Guenot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(4): 1079-1090.
15.	Barba C, Rheims S, Minotti L, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain, 2016, 139(Pt 2): 444-451.
16.	BarbaC, BarbatiG, MinotiL, et al. Ictal clinical and scalp EEG findings diferentiating temporal lobe epilepsies from temporal 'plus' epilepsies. Brain, 207, 130(Pt7): 1957- 1967.
17.	Ryvlin P, Kahane P. The hidden causes of surgery-resistant temporal lobe epilepsy: extratemporal or temporal plus? Current Opinion in Neurology, 205, 18(2): 125-127.
18.	KahaneP, BarbaC, RheimsS, et al. The concept of temporal' plus' epilepsy. RevNeurol(Paris), 2015, 171(3): 267.
19.	Lüders HO. Textbook of epilepsy surgery. United Kingdom: Informa Healthcare, 2008.
20.	Ryvlin P, Nguyen DK. Insular seizures and epilepsies: Ictal semiology and minimal invasive surgery. Current Opinion in Neurology, 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: 300-308.
22.	Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. Journal of Clinical Neurophysiology, 2017, 34(4): 307-314.
23.	Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy & Behavior, 2020, 105: 106964.
24.	Aljafen BN. Insular epilepsy, an under-recognized seizure semiology. A review for general neurologist. Neurosciences (Riyadh), 2020, 25(4): 262-268.
25.	孙涛. 岛叶癫痫. 2013: 人民卫生出版社.
26.	Türe U, Yaşargil MG, Al-Mefty O, et al. Arteries of the insula. Journal of Neurosurgery, 2000, 92(4): 676-687.
27.	Tanriover N, Rhoton AL Jr, Kawashima M, et al. Microsurgical anatomy of the insula and the sylvian fissure. Journal of Neurosurgery, 2004, 100(5): 891-922.
28.	Talairach J, Bancaud J. Stereotaxic approach to epilepsy. Progr Neurol Surg, 1973, 5: 297-354.
29.	Isnard J, Taussig D, Bartolomei F, et al. French guidelines on stereoelectroencephalography (SEEG). Neurophysiologie Clinique, 2018, 48(1): 5-13.
30.	Surbeck W, Bouthillier A, Weil AG, et al. The combination of subdural and depth electrodes for intracranial EEG investigation of suspected insular (perisylvian) epilepsy. Epilepsia, 2011, 52(3): 458-466.
31.	Cardinale F, Miserocchi A, Moscato A, et al. Talairach methodology in the multimodal imaging and robotics era //In: Scarabin J-M (ed). Stereotaxy and epilepsy surgery. John Libbey Eurotext, London, 2012: 245–272.
32.	Chilukuri AS, Awkwayena E, Abel TJ. Insulo-opercular stereoelectroencephalography exploration in children and young adults: Indications, techniques, and safety. Epilepsia Open, 2022, 7(4): 729-736.
33.	Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
34.	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. 中华神经外科杂志, 2021, 37(29): 2276-2282.
35.	Takayama Y, Kimura Y, Iijima K, et al. Volume-based radiofrequency thermocoagulation for pediatric insulo-opercular epilepsy: a feasibility study. Operative Neurosurgery, 2022, 23(3): 241-249.
36.	Rey-Dios R, Cohen-Gadol AA. Technical nuances for surgery of insular gliomas: lessons learned. Neurosurgical Focus, 2013, 34(2): E6.
37.	Yarsargil M, Von Ammon K, Cavazos E, et al. Tumours of the limbic and paralimbic systems. Acta Neurochirurgica, 1992, 118(1): 40-52.
38.	Duffau H, Capelle L, Lopes M, et al. Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochirurgica, 2002, 144(2): 563-573.
39.	Chevrier M-C, Bard C, Guilbert F, et al. Structural abnormalities in patients with insular/peri-insular epilepsy: spectrum, frequency, and pharmacoresistance. American Journal of Neuroradiology, 2013, 34(10): 2152-2156.
40.	von Lehe M, Wellmer J, Urbach H, et al. Insular lesionectomy for refractory epilepsy: management and outcome. Brain, 2009, 132(4): 1048-1056.
41.	Yasargil MG, Krisht AF, Ture U, et al. Microsurgery of insular gliomas, part II: opening of the sylvian fissure. Contemporary Neurosurgery, 2002, 24(8): 1-6.
42.	Laoprasert P, Ojemann JG, Handler MH. Insular epilepsy surgery. Epilepsia, 2017, 58(Suppl 1): 35-45.
43.	Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: Is it effective? Journal of Neurosurgery, 2019, 20(1): 1-10.
44.	Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 2: Is it safe? Journal of Neurosurgery, 2019, 20(1): 1-11.
45.	Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Currents, 2019, 19(1): 11-21.
46.	Wu C, Sharan AD. Neurostimulation for the treatment of epilepsy: a review of current surgical interventions. Neuromodulation, 2013, 16(1): 10-24.
47.	Jobst BC, Kapur R, Barkley GL, et al. Brain-responsive neuro- stimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia, 2017, 58(6): 1005-1014.
48.	孙涛. 岛叶癫痫. 中华神经外科杂志, 2014, 30(10): 976-978.
49.	Scarabin JM, Seigneuret E, Pasqualini E, et al. The tailored cortectomies//Scarabin JM, Mercier P, Guénot M, et al. Stereotaxy and Epilepsy Surgery. United Kingdom: John Libbey Eurotext Limited, 2012: 307-311.
50.	Malak R, Bouthillier A, Carmant L, et al. Microsurgery of epileptic foci in the insular region. Journal of Neurosurgery, 2009, 110(6): 1153-1163.
51.	郭强, 王艮波, 张伟, 等. 立体脑电图引导外科治疗颞岛型颞叶癫痫附加症. 中华神经外科杂志, 2018, 34(12): 1217-1221.
52.	Duffau H, Taillandier L, Gatignol P, et al. The insular lobe and brain plasticity: lessons from tumor surgery. Clinical Neurology and Neurosurgery, 2006, 108(6): 543-548.
53.	Meyer FB, Bates LM, Goerss SJ, et al. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clinic Proceedings, 2001, 76(7): 677-687.
54.	中国脑胶质瘤协作组, 中国医师协会脑胶质瘤专业委员会. 唤醒状态下切除脑功能区胶质瘤手术技术指南(2018版). 中国微侵袭神经外科杂志, 2018, 23(8): 383-388.
55.	Saito R, Kumabe T, Inoue T, et al. Magnetic resonance imaging for preoperative identification of the lenticulostriate arteries in insular glioma surgery. Technical note. Journal of Neurosurgery, 2009, 111(2): 278-281.
56.	Dasenbrock HH, See AP, Smalley RJ, et al. Frameless stereotactic navigation during insular glioma resection using fusion of three-dimensional rotational angiography and magnetic resonance imaging. World Neurosurgery, 2019, 126(2): 322-330.
57.	张戈. 岛叶胶质瘤的显微外科手术治疗, 中华显微外科杂志, 2005, 28(3): 278-279.
58.	韩正中, 谷佳, 韩宇涵, 等. 显微外科治疗岛叶胶质瘤的疗效分析. 局解手术学杂志, 2019, 28(12): 949-953.
59.	Loan JJM, Wiggins AN, Brennan PM. Medically induced hypertension, hypervolaemia and haemodilution for the treatment and prophylaxis of vasospasm following aneurysmal subarachnoid haemorrhage: systematic review. British Journal of Neurosurgery, 2018, 32(2): 157-164.
60.	Duffau H, Bauchet L, Lehéricy S, et al. Functional compensation of the left dominant insula for language. Neuroreport, 2001, 12(10): 2159-2163.

1. 中国抗癫痫协会. 临床诊疗指南•癫痫病分册. 北京: 人民卫生出版社, 2023 .
2. 张建国, 栾国明. 癫痫外科学(第3版). 北京: 人民卫生出版社, 2023.
3. Bourdillon P, Ryvlin P, Isnard J, et al. Stereotactic electroencephalography is a safe procedure, including for insular implantations. World Neurosurgery, 2017, 99: 353-361.
4. Alomar S, Mullin JP, Smithason S, et al. Indications, technique, and safety profile of insular stereoelectroencephalography electrode implantation in medically intractable epilepsy. Journal of Neurosurgery, 2018, 128(4): 1147-1157.
5. Ryvlin P, Picard F. Invasive investigation of insular cortex epilepsy. Journal of Clinical Neurophysiology, 2017, 34(4): 328-332.
6. Stephani C, Fernandez-Baca Vaca G, Maciunas R, et al. Functional neuroanatomy of the insular lobe. Brain Structure & Function, 2011, 216(2): 137-149.
7. Gasquoine PG. Contributions of the insula to cognition and emotion. Neuropsychology Review, 2014, 24(2): 77-87.
8. Afif A, Minotti L, Kahane P, et al. Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy. Epilepsia, 2010, 51(1): 206-213.
9. Wang H, McGonigal A, Zhang K, et al. Semiologic subgroups of insulo-opercular seizures based on connectional architecture atlas. Epilepsia, 2020, 61(3): 984-994.
10. Meyer S, Strittmatter M, Fischer C, et al. Lateralization in autononic dysfunction in ischemic stroke involving the insular cortex. Neuroreport, 2004, 15: 357-361.
11. Oppenheimer SM, Gelb A, Girvin JP, et al. Cardiovascular effects of human insular cortex stimulation. Neurology, 1992, 42: 1727-1732.
12. Singh R, Principe A, Tadel F, et al. Mapping the insula with stereo- electroencephalography: the emergence of semiology in insula lobe seizures. Annals of Neurology, 2020, 88: 477-488.
13. Obaid S, Chen JS, Ibrahim GM, et al. Predictors of outcomes after surgery for medically intractable insular epilepsy: a systematic review and individual participant data meta-analysis. Epilepsia Open, 2023, 8(1): 12-31.
14. Isnard J, Guenot M, Sindou M, et al. Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia, 2004, 45(4): 1079-1090.
15. Barba C, Rheims S, Minotti L, et al. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain, 2016, 139(Pt 2): 444-451.
16. BarbaC, BarbatiG, MinotiL, et al. Ictal clinical and scalp EEG findings diferentiating temporal lobe epilepsies from temporal 'plus' epilepsies. Brain, 207, 130(Pt7): 1957- 1967.
17. Ryvlin P, Kahane P. The hidden causes of surgery-resistant temporal lobe epilepsy: extratemporal or temporal plus? Current Opinion in Neurology, 205, 18(2): 125-127.
18. KahaneP, BarbaC, RheimsS, et al. The concept of temporal' plus' epilepsy. RevNeurol(Paris), 2015, 171(3): 267.
19. Lüders HO. Textbook of epilepsy surgery. United Kingdom: Informa Healthcare, 2008.
20. Ryvlin P, Nguyen DK. Insular seizures and epilepsies: Ictal semiology and minimal invasive surgery. Current Opinion in Neurology, 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: 300-308.
22. Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. Journal of Clinical Neurophysiology, 2017, 34(4): 307-314.
23. Peltola ME, Trébuchon A, Lagarde S, et al. Anatomoelectroclinical features of SEEG-confirmed pure insular-onset epilepsy. Epilepsy & Behavior, 2020, 105: 106964.
24. Aljafen BN. Insular epilepsy, an under-recognized seizure semiology. A review for general neurologist. Neurosciences (Riyadh), 2020, 25(4): 262-268.
25. 孙涛. 岛叶癫痫. 2013: 人民卫生出版社.
26. Türe U, Yaşargil MG, Al-Mefty O, et al. Arteries of the insula. Journal of Neurosurgery, 2000, 92(4): 676-687.
27. Tanriover N, Rhoton AL Jr, Kawashima M, et al. Microsurgical anatomy of the insula and the sylvian fissure. Journal of Neurosurgery, 2004, 100(5): 891-922.
28. Talairach J, Bancaud J. Stereotaxic approach to epilepsy. Progr Neurol Surg, 1973, 5: 297-354.
29. Isnard J, Taussig D, Bartolomei F, et al. French guidelines on stereoelectroencephalography (SEEG). Neurophysiologie Clinique, 2018, 48(1): 5-13.
30. Surbeck W, Bouthillier A, Weil AG, et al. The combination of subdural and depth electrodes for intracranial EEG investigation of suspected insular (perisylvian) epilepsy. Epilepsia, 2011, 52(3): 458-466.
31. Cardinale F, Miserocchi A, Moscato A, et al. Talairach methodology in the multimodal imaging and robotics era //In: Scarabin J-M (ed). Stereotaxy and epilepsy surgery. John Libbey Eurotext, London, 2012: 245–272.
32. Chilukuri AS, Awkwayena E, Abel TJ. Insulo-opercular stereoelectroencephalography exploration in children and young adults: Indications, techniques, and safety. Epilepsia Open, 2022, 7(4): 729-736.
33. Mullatti N, Landre E, Mellerio C, et al. Stereotactic thermocoagulation for insular epilepsy: lessons from successes and failures. Epilepsia, 2019, 60(8): 1565-1579.
34. 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. 中华神经外科杂志, 2021, 37(29): 2276-2282.
35. Takayama Y, Kimura Y, Iijima K, et al. Volume-based radiofrequency thermocoagulation for pediatric insulo-opercular epilepsy: a feasibility study. Operative Neurosurgery, 2022, 23(3): 241-249.
36. Rey-Dios R, Cohen-Gadol AA. Technical nuances for surgery of insular gliomas: lessons learned. Neurosurgical Focus, 2013, 34(2): E6.
37. Yarsargil M, Von Ammon K, Cavazos E, et al. Tumours of the limbic and paralimbic systems. Acta Neurochirurgica, 1992, 118(1): 40-52.
38. Duffau H, Capelle L, Lopes M, et al. Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochirurgica, 2002, 144(2): 563-573.
39. Chevrier M-C, Bard C, Guilbert F, et al. Structural abnormalities in patients with insular/peri-insular epilepsy: spectrum, frequency, and pharmacoresistance. American Journal of Neuroradiology, 2013, 34(10): 2152-2156.
40. von Lehe M, Wellmer J, Urbach H, et al. Insular lesionectomy for refractory epilepsy: management and outcome. Brain, 2009, 132(4): 1048-1056.
41. Yasargil MG, Krisht AF, Ture U, et al. Microsurgery of insular gliomas, part II: opening of the sylvian fissure. Contemporary Neurosurgery, 2002, 24(8): 1-6.
42. Laoprasert P, Ojemann JG, Handler MH. Insular epilepsy surgery. Epilepsia, 2017, 58(Suppl 1): 35-45.
43. Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 1: Is it effective? Journal of Neurosurgery, 2019, 20(1): 1-10.
44. Bouthillier A, Weil AG, Martineau L, et al. Operculoinsular cortectomy for refractory epilepsy. Part 2: Is it safe? Journal of Neurosurgery, 2019, 20(1): 1-11.
45. Jobst BC, Gonzalez-Martinez J, Isnard J, et al. The insula and its epilepsies. Epilepsy Currents, 2019, 19(1): 11-21.
46. Wu C, Sharan AD. Neurostimulation for the treatment of epilepsy: a review of current surgical interventions. Neuromodulation, 2013, 16(1): 10-24.
47. Jobst BC, Kapur R, Barkley GL, et al. Brain-responsive neuro- stimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia, 2017, 58(6): 1005-1014.
48. 孙涛. 岛叶癫痫. 中华神经外科杂志, 2014, 30(10): 976-978.
49. Scarabin JM, Seigneuret E, Pasqualini E, et al. The tailored cortectomies//Scarabin JM, Mercier P, Guénot M, et al. Stereotaxy and Epilepsy Surgery. United Kingdom: John Libbey Eurotext Limited, 2012: 307-311.
50. Malak R, Bouthillier A, Carmant L, et al. Microsurgery of epileptic foci in the insular region. Journal of Neurosurgery, 2009, 110(6): 1153-1163.
51. 郭强, 王艮波, 张伟, 等. 立体脑电图引导外科治疗颞岛型颞叶癫痫附加症. 中华神经外科杂志, 2018, 34(12): 1217-1221.
52. Duffau H, Taillandier L, Gatignol P, et al. The insular lobe and brain plasticity: lessons from tumor surgery. Clinical Neurology and Neurosurgery, 2006, 108(6): 543-548.
53. Meyer FB, Bates LM, Goerss SJ, et al. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clinic Proceedings, 2001, 76(7): 677-687.
54. 中国脑胶质瘤协作组, 中国医师协会脑胶质瘤专业委员会. 唤醒状态下切除脑功能区胶质瘤手术技术指南(2018版). 中国微侵袭神经外科杂志, 2018, 23(8): 383-388.
55. Saito R, Kumabe T, Inoue T, et al. Magnetic resonance imaging for preoperative identification of the lenticulostriate arteries in insular glioma surgery. Technical note. Journal of Neurosurgery, 2009, 111(2): 278-281.
56. Dasenbrock HH, See AP, Smalley RJ, et al. Frameless stereotactic navigation during insular glioma resection using fusion of three-dimensional rotational angiography and magnetic resonance imaging. World Neurosurgery, 2019, 126(2): 322-330.
57. 张戈. 岛叶胶质瘤的显微外科手术治疗, 中华显微外科杂志, 2005, 28(3): 278-279.
58. 韩正中, 谷佳, 韩宇涵, 等. 显微外科治疗岛叶胶质瘤的疗效分析. 局解手术学杂志, 2019, 28(12): 949-953.
59. Loan JJM, Wiggins AN, Brennan PM. Medically induced hypertension, hypervolaemia and haemodilution for the treatment and prophylaxis of vasospasm following aneurysmal subarachnoid haemorrhage: systematic review. British Journal of Neurosurgery, 2018, 32(2): 157-164.
60. Duffau H, Bauchet L, Lehéricy S, et al. Functional compensation of the left dominant insula for language. Neuroreport, 2001, 12(10): 2159-2163.

Journal of Epilepsy

癫痫外科手术技术专家共识——第五篇：岛叶癫痫外科手术技术专家共识

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