Fig. 1

Anatomo-electro-clinical features of Patient 5. a Lateral and medial view of all implanted stereotactic electrodes on a three-dimensional reconstruction of the cortical surface of the brain. b Semiology of this patient was characterized by bilateral asymmetric tonic posture of left upper limb extension and right arm flexion, followed by hyperkinetic behavior (repetitive movement of the right leg) and left eyelid/arm tonic clonic seizure. c SEEG activity at seizure onset exhibited immediate spike and polyspike discharges followed by a low-voltage fast activity in the ALG of insular cortex (electrodes O’1–3, red-color in panel d), which spread to the parietal operculum (electrodes O’4–5, yellow-color in panel d) and posterior long gyrus PLG and inferior circulating sulcus (electrodes Y’4–5, T’2–3, green-color in panel d). Clinical symptoms start when ictal discharges spread to MCC (electrodes F’1–2,L’1, light blue in panel d) and SMA (electrodes S’1–2, light blue in panel d). d Sagittal view of T1 MRI with electrodes in insula and mesial parts of the brain