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Table 2 Evolution of semiology and seizure location based on SEEG data

From: Bilateral asymmetric tonic seizure in insulo-opercular epilepsy: an anatomo-electro-clinical study

Patient No. (n = 8) No. of seizures recorded No. of seizures analyzed (A20,S40) Seizure duration BATS duration Evolution of semiology Seizure onset and propogation Stimulation site Epileptogenic zone
SIA SIS
1 A0,S6 S5 77–100 s 9–22 s Focal tonic (Rt arm occurring in 2 out of 5 seizures [2/5]) → BATS (four limbs 5/5,face 4/5) → EM (cont. Deviation3/5,ips.deviation 1/5, convergence 1/5) → Focal TCS (Rt arm 1/5, face 5/5) → GTCS (5/5) Cop→MCC + sls + Fop Undone Undone Lt-INS + OP
2 A1,S12 A1,S5 5–52 s 5–19 s Aura (Rt arm numb 3/6) → Autonomic (nausea 1/6) → BATS (4limbs 6/6,face 2/6, ips.eyelid 2/6) → Focal TCS (eyelids 4/6) plg + sls → asg Undone Undone Lt-INS
3 A3,S12 A3,S5 27–42 s 20–32 s Autonomic (tachycardia 8/8,hypersalivation 2/8) → Focal dystonia (Rt hand 2/8) → BATS (four limbs 8/8, cont.face+eyelid 5/8) → Hypermotor (shake head 4/8) → Focal TCS (throat 2/8,eyelids 3/8) msg → asg → alg + plg + als Undone Undone Lt-INS
4 A16,S46 A5,S5 13–66 s 7–56 s Aura (indescribable) → BATS (four limbs 10/10,face 3/10) → Focal TCS (Rt arm 8/10) plg → ils → psg plg, ils, Pop Not induced Lt-INS
5 A0,S41 S5 20–23 s 14–20 s BATS (four limbs 5/5) → Hypermotor (pedaling 3/5) → Focal TCS (Lt arm 5/5, eyelid 5/5) alg → Pop→plg Not induced Pop, HG Rt-INS + OP
6 A2,S46 A2,S5 22–69 s 7–29 s BATS (four limbs 7/7) → EM (forced upward stare 3/7, cont.deviation 1/7) → Focal TCS (Lt arm 4/7, eyelid 3/7) plg → sls → apex+psg + Pop +TP Undone Undone Rt-INS + OP
7 A > 50,S > 50 A5,S5 12–35 s 9–20 s BATS (four limbs 10/10) → Focal tonic (Rt face+eyelid 8/10) → EM (ips.deviation 6/10) → Focal TCS (limbs 6/10, eyelids 10/10) psg → Cop→plg + ils + msg + Pop+SMA Undone Undone Lt-INS + OP
8 A10,S7 A5,S5 8–62 s 6–31 s Focal tonic (pouting 2/10) → BATS (four limbs 10/10, face 6/10) → EM (ips.deviation 2/10, cont. deviation 1/10) IFGop Not induced ds Lt-OP
  1. SIA stimulating induced aura, SIS stimulating induced seizure, A awake, S sleep, Lt left, Rt right, Bil bilateral, cont contralateral, ips ipsilateral, BATS bilateral asymmetic tonic seizure, TCS tonic-clonic seizure, GTCS generalized tonic clonic seizure, EM eye movement, SMA supplementary sensorimotor area, asg anterior short gyrus of insula, msg middle short gyrus of insula, psg posterior short gyrus of insula, alg anterior long gyrus of insula, plg posterior long gyrus of insula, als anterior limiting sulcus, sls superior limiting sulcus, ils inferior limiting sulcus, OP operculum, Fop frontal operculum (inferior frontal gyrus trianglar part and opercular part), IFGop inferior frontal gyrus opercular part, ds diagonal sulcus, Cop central operculum, Pop parietal operculum, Top temporal operculum, MCC middle part of cingular cortex, TP temporal pole, HG Heschl’s gyrus